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16The Hartford <br />Reporting a Work -Related Injury is Time Sensitive! <br />Call The Hartford's LossConnect immediately to report a claim. <br />1-800-327-3636 <br />Available 24 hours a day, 365 days a year. <br />The Benefits of Timely Loss Reporting: <br />Researc❑ ❑as sown tCot faster loss reporting significantly affects loss costs. Tie sooner we are notified, t❑e sooner we <br />can in[ostigate t❑e accident and coordinate wit❑yoq t❑e in❑red employee, and tie medical team to ensC7e t❑e fastest <br />possi:]e retC7n to ❑ealt❑and wor❑ <br />The Effect of Timely Reporting on Controlling the Cost of Your Loss: <br />Average Loss for Closed Claims <br />(Accident Years 2002-2005) <br />Report Lag in Days <br />Percent Change in Loss Costs <br />Compared to First Week Report <br />Incident Day <br />-6❑ <br />Wee❑1 <br />0❑ <br />Wee❑2 <br />13❑ <br />Wee❑3 or <br />1611 <br />1 Mont❑or Later <br />2411 <br />Statutory requirements also necessitate the prompt initial reporting of the accident causing <br />injury or death. Failure to comply may result in a fineable offense by the State. <br />Information You'll Need <br />Company Information <br />o AccoC7it ❑EMEJer <br />o Location Code Cif applicade❑ <br />o Parent Company -or program name[] <br />o Policy ❑EMEJer <br />Worker Information <br />o :lame, DOB, Address, PCone <br />o Social SecFirity ❑EMEJer <br />o Age, Gender <br />o Marital Stat❑s, ❑En❑er of Dependants <br />o —ire Date, Years in C_rrent Position <br />o Wage Information <br />Incident Information <br />o Type of in❑ry C❑C]m, cCt, etc.C❑ <br />o EL:8ct Cody part in❑red❑ <br />o W1at caC:8ed t❑e accident[] <br />o Any reason to ❑❑estion t❑e in❑ry❑ <br />o Any witnesses[] <br />o Address w—ere in❑ry occC7red❑ <br />o W—ere was t❑e in [Hired employee treated ❑ EProdde <br />name, address, pEone of medical prodder.❑ <br />o W❑en was tie accident reported to yo❑ and CCy <br />w❑bm Cdate, timeCZ <br />Network Providers <br />A listing of more twin 400,000 networ❑prodders ❑Eialified to treat worE4elated in❑iries is aE:8ilade online at <br />www.talispoint.com/ilarteEt or ❑y calling oC7 ❑etwor❑Referral —nit at 1-800-32C-3636 -select 4 at t❑e prompt❑ Since <br />networ❑referrals are often impacted !❑y state specific ryes, please call to learn Cow to madmiCo oCr networ❑capa::jlities <br />on Da❑alf of yo-r employees. <br />Form WC 66 03 84 Printed in ❑.S.A. <br />