How to File a Claim

The Procedure

If the employee is injured and is in need of immediate medical treatment send him/her to the nearest medical provider for care. The claim can be filed after the employee receives treatment.

Have the following information ready before calling, but do not delay reporting the claim if you are missing any information:

  • Name of employee, employee's social security number,  employee's date of birth, employee's home address, employee's home telephone number
  • Date and time of the injury, nature of the injury, location address where injury occurred
  • Company name and street address of employer  
  • Name, address and  telephone number of treating facility and/or physician
  • Contact name and telephone number at the Agency

The Gallagher Bassett representative should give you a Loss Reference Number and the name, address, and the phone number of the Claim Center where the claim will be handled.  You may pass along this information to the employee and any medical provider.  A Claim Number will be assigned later.

As a general rule, the claim office will not call you regarding medical only claims.  For indemnity claims (loss of time/wage), a claims manager will be assigned and will contact you with an update.

To report a Work Comp claim, please contact the 4A's Benefits team.