Alliance of Schools for Cooperative Insurance Programs

ascip

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  • COVID-19
    • Reopening Schools Planner
  • About
    • Calendar
    • Financial Strength
    • Governance
    • Members
    • News & Updates
    • FAQ’s
  • Insurance for Schools
    • Coverages
    • Property & Liability
    • Workers’ Compensation
    • Health Benefits
    • OCIP – Construction Insurance for Schools
    • Request A Quote
  • Risk Services
    • Member Shared Resources
    • Risk Management Prevention Services
    • Guidelines & Best Practices
    • Sample Agreements & Forms
    • Abuse Prevention Resources
    • Special Education Resources
    • Risk Alerts & Bulletins
    • Lessons Learned – Sharing Experiences
    • Safety Spotlight Resources
    • Additional Resources and Forms
    • FAQs
  • Training
    • 2022 Virtual Annual Membership Meeting
    • Online Training
    • Seminars & Webinars
    • Resources
  • Forms & Tools
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Workers' Compensation

Home > Insurance for Schools > Workers’ Compensation > Viewing and Reporting Claims
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Viewing and Reporting Claims

How to Report a Claim

If an employee reports an injury or illness, the employer must:
  1. Instruct the employee to immediately contact Company Nurse by calling (888) 770-0929
  2. Within 24 hours of knowledge of injury, provide the injured or ill employee with:
    • DWC-1 Claim Form
    • MPN Informational Pamphlet
    • Pharmacy First Fill Flyer
    • Receipt of Workers’ Compensation Information Form. Once the employee returns the DWC-1 Claim Form, the employer must complete the employer section at the bottom of the form and return a copy to the claims administrator.
  3. Complete the Employer’s Report of Occupational Injury or Illness (Form 5020) and return a copy to your designated claims administrator.
  4. Serious injuries/illnesses must be reported to Cal/OSHA within 8 hours of knowledge.  Learn more…
Viewing Claims

ASCIP members have access to view their claims on-line. In order to view claims, you must have a login and password. To request a login, please contact a member of our workers’ compensation team at wc_info@ascip.org.

  • Athens Administrators
  • York Risk Services Group

Contact Info

Main Office/Southern California Claims Handling:
16550 Bloomfield Avenue
Cerritos, CA 90703

Northern California Claims Handling:
1531 "I" Street, Suite 100
Sacramento, CA 95814

Email: ascip_info@ascip.org
Phone: (562) 404-8029
Fax: (562) 404-8038
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