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Claim FAQs

Find answers to your claims questions fast!

We hope you find answers here, but if you still have questions, contact the Customer Care Center: 858.350.2835.

Employee Injury

Claims Processing

Other

 

What if the employee claims to be injured at work, but I don't think it's true?

Handle this as you would a normal claim. However, document your concerns in writing to ICW Group. We will investigate and respond accordingly.

What if I am worried that the employee is not really able to safely handle normal duties after an injury?

If you have this concern, talk to your claims adjuster.

Can I just pay the medical bills myself and not report the injury to ICW Group?

No. You have an obligation to report all work-related injuries or illnesses to ICW Group.

Do I have to keep a job open for someone who's been hurt at work?

The law recognizes that you may have legitimate business reasons for replacing an employee who cannot continue on the job, and does not prohibit you from doing so. However, you should be aware of your responsibilities under state and federal laws that may apply in this situation. Consult ICW Group, an attorney or a state information and assistance officer for more information.

Can I access claim reports online?

Claims Summary Reports are available online if you are in one of the following states: Arizona, California, Colorado, Florida, Georgia, Illinois, Indiana, New Jersey, Nevada, North Carolina, Pennsylvania, South Carolina, Texas, and Wisconsin, Claims Summary Reports can be viewed online through myResource. Please note that only those authorized by your company will be provided access to Claims Summary Reports. Not signed up for myResource? Ask your Risk Management Consultant or request accounts today.

What is your reserving philosophy?

Our examiners set reserves to reflect our best estimate of the most likely cost of the claim based on the information available and our years of experience. New claims are generally reserved within five (5) days from our receipt of the claim.

How do you handle fraudulent claims and do you utilize subrosa?

We have experts in our Special Investigation Unit (SIU) who work closely with our Claims Examiners on investigating possible fraudulent claims. Subrosa is utilized when we have adequate information to secure quality surveillance.

Who does ICW Group use for bill review?

ICW Group utilizes Mitchell International bill review services for medical bill review and PPO access.

Can I access loss reports online?

Yes, the fastest way to view your loss reports is online through myResource. Please note that only those authorized by your company will be provided access to Loss Reports. Not signed up for myResource? Ask your Risk Management Consultant or request accounts today. Your agent or broker can provide you up to 5 years of Loss Reports. You can also make an authorized, mailed request to ICW Group. For more information about myResource, contact your Risk Management Consultant today.

Do you have any bilingual Claims Examiners?

Yes. ICW Group proudly employs bilingual Claims Examiners and Assistants. We also partner with outside translation services as needed.

Who do I contact for more information?

Contact your Agent/Broker directly or an ICW Group Work Comp Claims representative near you.