CALL PREPARATION GUIDE - Worldwide Equipment



Call Preparation Guide877.836.1555Strategic Comp & Great American Insurance GroupAccident InformationDate of AccidentTime of AccidentDate injury/occurrence was reported to employerTime the accident was reportedTo whom did employee report the claim?Employee’s supervisorAccident location (street address, city and state)Does employer think the claim is questionable?What was employee doing at time of incident?Any other employees involved?Did the accident result in a fatality?Number of days employee expected to lose because of accidentLast date employee workedFirst full day of work employee missed due to accidentIs employee receiving regular salary while off work due to injuryHas employee returned to work?Date employee returned to workAny witness (es) to the accident?Name, address and phone number of witness (es)FASTER RESPONSEIS A BETTER IDEA!Employee InformationName Social Security numberHome phone numberPhysical home addressCounty in which employee residesDate of BirthGenderMarital StatusRegular OccupationDepartment in which employee regularly worksWas employee injured in the course of their regular job?What language does the employee speak?Employee’s total number of dependents, excluding the injured employeeState in which the employee was hiredName, address and phone number of contact personMedical Provider InformationName of any doctor’s office, clinic or hospital that treated the injured employeeAddress of any doctor’s office, clinic or hospital that treated injured employeeName & address of treating doctorHotline877.836.1555Call Preparation GuideAccident Reporting Center877.836.1555Serviced by Great AmericanInsurance Group24 / 7 ACCIDENT REPORTING HOTLINEThis hotline service is provided exclusively to employers for the reporting of claims 24-hours a day, 7 days a weekA copy of all 1st Report of Injury forms will be emailed to your office within 24 hours after reporting the claimFor claims reported after hours, the 1st Report of Injury will be assigned the next business day to an adjuster for further investigation and claims handlingSpending a few minutes answering the questions on the back of this page before you place the call will help us process your claim quickly and efficiently.If you have any questions regarding our 24 / 7 Accident Reporting Hotline, please contact your Claims Specialist. ................
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