Employers Reporting Procedure forWorkers’ Compensation Claims
Dear Insured:If an accident occurs or if an employee thinks that they have suffered from a work-related accident or illness, theprocedure outlined below should be followed.

Medical ControlImmediately send injured worker to industrial clinic or hospital depending upon the critical nature of theinjury.
‒For non-emergency but complex or disputed claims, the employee may be directed to a specialist
instead of a clinic. The employer should discuss these cases with the claims examiner who will find acredible and qualified specialist.

‒Depending upon the state, the employer sometimes has a period of time to direct medical treatment
and should exercise these rights to better manage the claim. (See attached state info.)‒Getting early medical attention may reduce risks of potential injury complications.

‒

Timely and appropriate treatment helps employees return to work quickly.

Communicate frequently with doctors to get updated information and to ensure a timely return to work.

Investigation
When an employee reports a work related injury, the supervisor (or other person told) should immediately report theinjury to the person/department in charge of handling industrial injuries. An investigation report should be completed
to obtain the following information:1



Facts about the circumstances of the injury & sequence of events

WitnessesTimeliness of employee reporting injuryWhy did it happen? Future prevention?

Other medical information - prior injuries, auto accidents

Other employment / outside activities

Employers Reporting Procedure forWorkers’ Compensation Claims
Reporting Claims - Form CompletionComplete Employer’s First Report of Injury via the 1-800 reporting service (1-877-567-7486), Internet(www.tokiomarineclaims.com), or Email Completed Reports to claims@actec.net. (Please see Tokio
Marine Zone Guide.) This should be completed within 1 business day following the injury. The timeliness ofthe employer’s report affects the claims examiners’ investigation periods.

Give employee any state specific claim forms if required and/or any employee rights notifications within 24hours (Note: this is not an admission of liability on the employer’s part. Suspicious claims will be delayed
and investigated by Tokio Marine.)

Wage statement (will be sent separately by Tokio Marine)Description of Job Duties (will be sent separately by Tokio Marine)

Return to Work / Modified Duty

Returns the employee to a work environment as quickly as possible.



Usually encourages employee to return to full duty more quickly.

Cost savings realized in regards to benefit payments.

Litigation AvoidanceRefer injured worker to Tokio Marine examiner for questions regarding the workers’ compensation claims
process.

Be responsive to the injured workers’ needs.

Choose a quality occupational medicine clinic/doctor. (See attached info regarding PPO network.)Refer file timely to Tokio Marine to enable timely contacts by examiner.

Keep the lines of communication open.

We exist to deliver ANSHIN (safety, security and peace of mind) to our customers by providing the highest quality services.

TMA is committed to the highest customer trust. We exist to deliver ANSHIN (safety,security and peace of mind) to our customers by providing the highest quality services.

This information is provided solely as a client service. Tokio Marine Management, Inc. does not represent, warrant, or guarantee the appropriateness, validity or accuracy of this information in every situation.
This information does not necessarily cover every possible condition, protection, hazard, situation or exposure and is not warranted to be in compliance with laws, regulations, codes or standards in every
jurisdiction. This information is representative of reasonable practices in the industry. However, you may wish to investigate whether these recommendations are applicable to your specific operations. Losscontrol is the responsibility of your management. | © 2016 Tokio Marine America, All Rights Reserved.