Claims

Should I report an incident that does not require treatment?

Yes, any work-related incident should be reported. This way there is a documented record of the event. If your employee ultimately receives treatment for this incident, Beacon will already have a claim set up in our system, which will allow us to process any related medical bills as they are submitted. Incident claims are reported for record purposes only. No reserves are established unless the employee seeks treatment and Beacon receives a bill.

What should I expect when I report a claim?

Once your claim is reported to Beacon either online or by phone, you will receive a claim number, which will be your reference number for future calls or correspondence. The claim number can be shared with your employee as they may need to provide it to the doctor’s office if they seek treatment for their injury.

What information is needed when I report a claim?

You should have the following information available when you call or report an injury online: employee name, address, date of birth, social security number, date of the incident, where the injury occurred, injury type, location of the injury (body part), a description of injury, witness information, and the place where medical treatment was administered.

How do I report a claim?

Report a claim as soon as you become aware of the injury. The claim can be reported on beaconmutual.com or BEACONNECT. Claims can also be reported by calling 401-825-2667-and then follow the prompts to report the claim. By law, a claim must be reported within 10 days or within 48 hours if the claim is a fatality.

Where should employees go for initial treatment?

By law, an injured employee initially has the freedom of choice to obtain health care from any qualified health care provider. Beacon Mutual does have an approved Preferred Provider Network (PPN) comprised of physicians and other health care providers who are experienced in the care and treatment of work-related injuries. You can refer to the PPN available on beaconmutual.com. View Preferred Provider Network. There are Urgent Care and Occupational Health Centers and the injured worker can choose one that is most convenient.

If I do not believe an injury is work related, do I need to report it?

Beacon encourages you to report ALL alleged work-related injuries. The earlier we are made aware of a potential claim, the sooner we can initiate communication and investigation to preserve facts in the event of future litigation. If you have concerns about a claim that you wish to discuss with a claim representative, please be sure to mention this when you report the claim.

I received a notice of pretrial conference or other correspondence from the injured worker’s attorney, what should I do?

Any legal correspondence that you receive, which references an allegation of a work-related injury, should immediately be sent to your Beacon claim representative for review. Many of these documents are time sensitive and need a response as soon as possible.

Do I have to take an employee back after an injury?

Under the RI Workers’ Compensation Act, there are certain instances in which the injured employee has a right to reinstatement. Please contact your claim representative for more information.

I have questions about the claim, who do I contact?

If you have questions regarding your reported claim, contact your assigned claim representative. If you do not know who your representative is, call (401) 825-2667 and ask for Claims. You will be directed to the proper party. You can also send your question now by filling out a form on the Contact Us page.

I reported the claim – should I expect a phone call from Beacon?

For all lost-time claims, you can expect to receive a call from the assigned claim representative within 24 hours. If the claim is reported as a medical-only claim, you are not usually contacted unless it is requested. If your employee misses more than 3 days of work, you will be contacted by a claim representative. If you do not hear from Beacon, please call to make us aware that your employee is losing time from work.

What should I do when one of my employees is injured on the job?

Make sure the employee gets proper medical attention. Next, gather all of the pertinent information about what happened and document it, and obtain the names of any witnesses. Consider taking photographs of the scene of the incident to preserve the facts. If someone or something else caused the injury, obtain all the information by securing police reports, identification of a property owner or manufacturer of the product or machine that caused the injury. Collect any operator manuals, recent work or service orders or agreements, and obtain any contracts that might exist between you and the responsible party. Then, report the claim to Beacon online at beaconmutual.com or by calling 401-825-2667. Click here to Report an Injury online.

Once the claim is reported, how will I know when my employee is able to return to work?

Keep in touch with your employee when he or she is out of work and throughout the claim. Keep the lines of communication with your employee open and ongoing. Communication is the key. In addition, you will receive ongoing communication from the assigned claim representative with regard to the employee’s ability to work and if they are capable of either modified or full duty.

Policy

How is my premium calculated?

Premium is calculated based upon the rate for the business classification code (or combination of codes) that best describes your operations. The National Council of Compensation Insurance (NCCI) is the national organization that determines the class codes for your operation. Each class code has a rate per $100 of payroll that is multiplied by your total estimated annual payroll for that code. Other rating factors may also affect your premium such as your safety practices and experience modification factor.

What is the experience modification factor?

The National Council of Compensation Insurance (NCCI) develops your experience modification factor. It reflects your claims history for the last three years compared to other businesses in your classification. Premiums are adversely affected if your claims history is worse than average or positively impacted if better than average. The experience period generally consists of the last three completed policy years.

How can I reduce my experience modification?

Reduce losses! Your business can reduce your experience modification by reducing the frequency and severity of your claims. Reduce the number of injuries as much as possible and, when you do have a claim, reduce the costs by getting the employee back to work as soon as medically possible.

What does the premium audit process entail?

The determination of premium is a function of remuneration, predominantly payroll. At the inception of the policy, the premium is based on estimated payroll information. As a result, policyholder financial records are reviewed at expiration to accurately verify the amount of payroll for the policy period. Any changes in payroll might result in an additional premium or a return premium. View the Premium Audit page for more information.

What criteria are used to determine who is an independent contractor?

No one factor is used to determine if a worker is an independent contractor. Issues such as work schedule control, invoicing, uses of tools/equipment, as well as the existence of a separate liability policy, are taken into consideration when determining whether the person is truly an independent contractor versus an employee. Also, an independent contractor must file a DWC-11-IC “Notice of Designation as Independent Contractor” with the Department of Labor and Training.

Can an employee exclude themselves from coverage?

Yes, an employee or executive officer can exclude themselves from coverage by completing Form DWC-11 “Notice of Claim of Common Law Rights” and filing it with the Department of Labor and Training.