WC Claims Submissions - PEO
General Information
| Field | Details |
|---|---|
| Author | Ken Monce |
| Stakeholders | Ken Monce |
| Purpose/Scope | To submit employee's WC Claims to Zurich for processing |
| Systems | Zurich Claims Portal |
| Effective Date | 3/19/2025 |
| Revision Number | 1 |
| Frequency | On demand |
| Revision Date |
Process Overview
Process: WC Claim Submission - PEO
Process Steps
| Step | Task | Owner |
|---|---|---|
| 1.0 | Triggering event: Client or employee submits completed WC Claim Form to Client Rep. | Client or Employee |
| 2.0 | Client Rep: Client Initial Notification Form. Submit. This will trigger a notification to the WC team. | Client Rep |
| 3.0 | Provide client with Aspen's claim packet. Review WC Claims Form for completeness. | Client Rep |
| 4.0 | Claim Submitted. Record Claim Submission Date, Report Number, and Claim Status. | WC Team |
| 5.0 | Once Claims ID is received, provide Claims ID to Client Rep and Client. | WC Team |
| 6.0 | If Return-to-Work (RTW) documents are returned: HR Associate to contact WC team to determine claim status. Email the claims adjuster a copy of the RTW documents. If there are restrictions to returning to work, coordinate with the Client Rep and Jeanine Schottler to reach out to the client contact to discuss (involve the claims adjuster as needed). | HR Associate |
| 7.0 | Coordinate with the Client Rep on any additional questions, information, or form completion requested by the claims adjuster. | HR Associate |
Additional Information
- Escalation Directives: If not completed timely, client and/or AspenHR may face fines; employee will not be able to seek medical services without the claim ID. If not completed timely, contact the Client Services Supervisor.
- Related Links: WC Claim Submission - PEO