[IGPP Everyone] [EPSS Everyone] FW: Winter Break Claims Reporting

[Brown, Carlene]

For anyone who will be working during the campus closure, please review the information below concerning reporting of workers' comp and other insurance claims. Hopefully you will not need to use it!

Carlene Brown
CAO, Earth, Planetary, and Space Sciences
Phone: 310-825-9784
Fax: 310-825-2779

From: Director Dean Malilay, Insurance & Risk Management [mailto:bruinpost at mdds.ucla.edu]
Sent: Wednesday, December 13, 2017 1:02 PM
To: Brown, Carlene <cbrown at epss.ucla.edu>
Subject: Winter Break Claims Reporting

[UCLA]Insurance & Risk Management

December 13, 2017
To:

Deans, Directors, Department Chairs, and Administrative Officers

Re:

Winter Break Claims Reporting: Workers' Compensation and Auto, Property, & General Liability

The Office of Insurance & Risk Management (IRM) will be closed from December 25, 2017 to January 1, 2018.
During the closure, please use our third party claims administrator's convenient telephonic claims center. Customer Service representatives are available to take your calls 24 hours a day, 365 days a year. Our office will continue to receive electronic notification of all claims within 24 hours or less, and where appropriate, contact the department representatives.
For Workers' Compensation injuries, prompt reporting will ensure timely information and benefits for injured workers.
MEDICAL TREATMENT DURING WINTER BREAK
OHF will be closed from December 25, 2017 to January 1, 2018. Injured Employees should be referred or taken to the Emergency Medicine Center (EMC) at Ronald Reagan/UCLA Medical Center. Make sure the injured employee identifies themselves as a UCLA employee who is covered by UCLA's Workers' Compensation program. Follow-up medical treatment should be scheduled with OHF when they re-open on January 2, 2018.
REPORTING Workers' Compensation incidents (employee injuries):
877-6UC-RPRT (877-682-7778) 24/hr Sedgwick, CMS report line
Please be prepared to supply the employee's full name, social security number or Bruin ID number, date of injury, brief description of how the injury happened, what parts of the body were injured, name of the department, supervisor and contact telephone number.
The Claim Form (DWC 1) and Incident Report Form must be completed and scanned to wcreports at irm.ucla.edu<mailto:wcreports at irm.ucla.edu> or faxed to (310) 794-6957.
EFR (Electronic First Report) website should not to be utilized to report Workers' Compensation Claims during the Winter Break.
REMEMBER:
Serious injuries must be reported to Cal-OSHA within 8 hours of occurrence.
To report, call EH&S HOT LINE (310) 825-9797.
OSHA SERIOUS INJURY:

  *   Death
  *   Amputation
  *   Concussion
  *   Serious fracture
  *   Serious burn
  *   Laceration that requires stitching
  *   Laceration with significant bleeding
  *   Hospitalization
REPORTING Auto, Property, & General Liability (injuries or property damage to 3rd parties) claims:
To report an incident the caller will dial 800-416-4029.
Also, complete and email a general liability incident report<https://irm.ucla.edu/general-liability> to Cynthia Roberts at glreports at irm.ucla.edu<mailto:glreports at irm.ucla.edu>.
Contacts:
Workers' Compensation
Dianna Cumpian, WC Manager
dcumpian at irm.ucla.edu<mailto:dcumpian at irm.ucla.edu>
(310) 794-6954

Auto, Property, & General Liability
Dean Malilay, Director
dmalilay at irm.ucla.edu<mailto:dmalilay at irm.ucla.edu>
(310) 794-8013

Thank you in advance for assisting in this important process.
Sincerely,
Dean Malilay
Director
Insurance & Risk Management
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