Questionable Claims

Be Pro-Active

When dealing with a claim that is questionable in motive, occurrence or circumstances, it is important for you to be pro-active and timely in your response. Follow these steps if you are confronted with a questionable claim:

  • Complete and submit the Report of Injury immediately.
  • Have the employee complete and sign an Employee's Statement Form. Attach it to the Report of Injury and forward to ClearPath Mutual. ClearPath Mutual recommends having the employee complete an Employee's Statement Form any time the claim is questionable or there is lost time involved.
  • Include an explanation of any information you think is questionable and any additional facts regarding the occurrence. This will flag the claim for further investigation.

Questionable Claim

Whenever you think a claim is questionable, you should contact ClearPath Mutual as soon as possible and we will assist you in gathering the necessary investigative and medical information to support or contest the allegations made by the injured employee.

Wage Statement

When an employee incurs a lost time injury (loss of at least one whole day of work) the wage statement must be completed. The average weekly wage must be established before the workers’ compensation weekly benefits can be calculated and payment of lost wages made.