Insurance Claims Procedures

Document Type: Procedure
Version: 1.0
Last Updated: February 2026
Distribute To: Safety Director, Project Managers, CFO

---

Purpose

Establish procedures for managing insurance claims to ensure proper coverage, timely resolution, and protection of company interests.

---

Why Proper Claims Handling Matters

Business Impact:

• Protects company from financial loss
• Maintains insurance relationships
• Impacts future premiums (EMR)
• Legal exposure if mishandled
• Reputation with clients and sureties

Types of Claims:

Claim Type	Coverage	Priority
Workers' compensation	WC policy	Immediate
General liability	GL policy	Prompt
Auto	Auto policy	Prompt
Property/equipment	Property policy	Prompt
Professional liability	E&O policy	Immediate

---

Workers' Compensation Claims

Immediate Response (0-24 hours):

================================================================
         WORKERS' COMPENSATION INCIDENT REPORT
================================================================

EMPLOYEE INFORMATION:

Name: _______________________
Position: _______________________
Project/location: _______________________
Supervisor: _______________________

----------------------------------------------------------------

INCIDENT DETAILS:

Date: _______________________  Time: _______________________
Location: _______________________
Witnesses: _______________________

Description of incident:
___________________________________________________________
___________________________________________________________

Description of injury:
___________________________________________________________

----------------------------------------------------------------

IMMEDIATE ACTIONS TAKEN:

☐ First aid administered
☐ Medical attention obtained
  Facility: _______________________
☐ Employee transported by: _______________________
☐ Supervisor notified
☐ Safety manager notified
☐ Site secured (if serious)
☐ Witness statements obtained

----------------------------------------------------------------

MEDICAL TREATMENT:

☐ First aid only (no claim)
☐ Medical treatment required
  Provider: _______________________
  Diagnosis: _______________________
  Work restrictions: _______________________
  Return to work date: _______________________

----------------------------------------------------------------

REPORT COMPLETED BY:

Name: _______________________
Date: _______________________
Time: _______________________

================================================================

Claim Filing (Within 24-48 hours):

================================================================
         WC CLAIM FILING CHECKLIST
================================================================

☐ Complete incident report
☐ Obtain witness statements
☐ Take photos (if applicable)
☐ File First Report of Injury with:
    ☐ State WC board
    ☐ Insurance carrier
    ☐ Third-party administrator
☐ Provide employee with claim information
☐ Establish communication with adjuster
☐ Begin return-to-work planning

Claim number: _______________________
Adjuster: _______________________
Phone: _______________________

================================================================

Return to Work Program:

================================================================
         RETURN TO WORK PLAN
================================================================

Employee: _______________________
Injury date: _______________________
Injury: _______________________

================================================================

MEDICAL STATUS:

☐ Full duty
☐ Modified duty with restrictions:
    _______________________________________________________
☐ Unable to work

Next medical appointment: _______________________

----------------------------------------------------------------

MODIFIED DUTY ASSIGNMENT:

Position: _______________________
Location: _______________________
Hours: _______________________
Restrictions accommodated: _______________________

Supervisor: _______________________

----------------------------------------------------------------

TRACKING:

| Date | Status | Restrictions | Notes |
|------|--------|--------------|-------|
|      |        |              |       |

================================================================

---

General Liability Claims

Incident Response:

================================================================
         GENERAL LIABILITY INCIDENT REPORT
================================================================

Date/time of incident: _______________________
Location: _______________________
Project: _______________________

================================================================

TYPE OF INCIDENT:

☐ Third-party bodily injury
☐ Property damage
☐ Completed operations issue
☐ Other: _______________________

----------------------------------------------------------------

INJURED PARTY/CLAIMANT:

Name: _______________________
Company (if applicable): _______________________
Address: _______________________
Phone: _______________________

----------------------------------------------------------------

DESCRIPTION:

What happened:
___________________________________________________________
___________________________________________________________

Damages/injuries claimed:
___________________________________________________________

----------------------------------------------------------------

WITNESSES:

| Name | Contact | Statement Obtained |
|------|---------|-------------------|
|      |         | ☐ Yes ☐ No        |
|      |         | ☐ Yes ☐ No        |

----------------------------------------------------------------

DOCUMENTATION:

☐ Photos taken
☐ Witness statements
☐ Daily reports preserved
☐ Relevant documents gathered
☐ Equipment secured (if applicable)

----------------------------------------------------------------

IMPORTANT - DO NOT:

☐ Admit liability or fault
☐ Make promises to claimant
☐ Discuss claim details publicly
☐ Destroy any documents
☐ Repair/alter conditions (unless safety)

================================================================

Claim Filing:

================================================================
         GL CLAIM NOTIFICATION
================================================================

To: _______________________  (Insurance carrier)
From: _______________________
Date: _______________________

RE: Notice of Potential Claim

Insured: _______________________
Policy number: _______________________
Date of occurrence: _______________________
Location: _______________________

Description of occurrence:
___________________________________________________________

Potential claimant(s):
___________________________________________________________

Estimated damages (if known):
___________________________________________________________

Contact for this claim:
Name: _______________________
Phone: _______________________
Email: _______________________

================================================================

---

Property/Equipment Claims

Property Damage Report:

================================================================
         PROPERTY/EQUIPMENT LOSS REPORT
================================================================

Date of loss: _______________________
Location: _______________________
Reported by: _______________________

================================================================

TYPE OF LOSS:

☐ Theft
☐ Vandalism
☐ Fire
☐ Weather/natural disaster
☐ Vehicle accident
☐ Equipment breakdown
☐ Other: _______________________

----------------------------------------------------------------

PROPERTY AFFECTED:

| Item | Description | Serial/ID | Est. Value |
|------|-------------|-----------|------------|
|      |             |           | $          |
|      |             |           | $          |

Total estimated loss: $_________________

----------------------------------------------------------------

CIRCUMSTANCES:

Description of loss:
___________________________________________________________

☐ Police report filed: Report #_______________________
☐ Photos taken
☐ Documentation of ownership gathered

----------------------------------------------------------------

CLAIM FILING:

☐ Carrier notified: _______________________
☐ Claim form submitted
☐ Adjuster assigned: _______________________
☐ Inspection scheduled: _______________________

================================================================

---

Claims Management Process

Claims Tracking:

================================================================
         CLAIMS LOG
================================================================

Year: _______

| Claim # | Date | Type | Description | Status | Reserve | Paid |
|---------|------|------|-------------|--------|---------|------|
|         |      |      |             |        | $       | $    |
|         |      |      |             |        | $       | $    |

----------------------------------------------------------------

SUMMARY BY TYPE:

| Type | Count | Total Reserve | Total Paid |
|------|-------|---------------|------------|
| WC   |       | $             | $          |
| GL   |       | $             | $          |
| Auto |       | $             | $          |
| Property |   | $             | $          |

================================================================

Claim Status Review:

================================================================
         CLAIM STATUS REVIEW
================================================================

Claim #: _______________________
Date of loss: _______________________
Type: _______________________

================================================================

CURRENT STATUS:

☐ Open - Under investigation
☐ Open - In litigation
☐ Reserved
☐ Settled
☐ Closed

Reserve: $_________________
Paid to date: $_________________

----------------------------------------------------------------

ADJUSTER CONTACT:

Name: _______________________
Phone: _______________________
Last contact: _______________________

----------------------------------------------------------------

OUTSTANDING ITEMS:

☐ _______________________________________________________
☐ _______________________________________________________

Next steps:
___________________________________________________________

----------------------------------------------------------------

LITIGATION STATUS (if applicable):

Attorney: _______________________
Stage: _______________________
Next hearing: _______________________
Settlement authority: $_________________

================================================================

---

Claims Impact Management

EMR Impact (Workers' Comp):

================================================================
         EMR PROJECTION
================================================================

Current EMR: _____
Effective date: _______________________

Open claims affecting EMR:

| Claim | Loss Date | Reserve | Paid | EMR Impact |
|-------|-----------|---------|------|------------|
|       |           | $       | $    | Est.       |

Projected EMR (next period): _____

----------------------------------------------------------------

EMR IMPROVEMENT ACTIONS:

☐ Return injured workers to modified duty
☐ Manage medical treatment appropriately
☐ Close claims promptly
☐ Challenge inappropriate reserves
☐ Focus on injury prevention

================================================================

---

Working with Adjusters

Best Practices:

Do	Don't
Report promptly	Delay notification
Cooperate fully	Obstruct investigation
Document thoroughly	Destroy documents
Be honest	Exaggerate or minimize
Ask questions	Assume understanding
Follow up regularly	Let claims languish
Provide requested info	Withhold information

When to Involve Attorney:

• Serious injury or fatality
• Significant property damage
• Disputed liability
• Bad faith concerns
• Third-party litigation

---

Related Documents

• Safety Program
• Insurance Requirements
• Workers' Compensation Procedures
• Risk Management

---

Template provided by support.construction. Handle claims right—your premiums depend on it.