Argonaut Other States Coverage Workers Compensation Claims Kit Welcome to Argonaut Insurance Workers Compensation Claim Services. We appreciate your business. Please refer to this document for reporting claims, contacting our claims offices, and sharing workers compensation information with your injured worker. If you have additional questions regarding Argonaut Claims Services please contact Beth Ratchford, Account Executive at 210-321-6541 or bratchford@argogroupus.com Method Contact Information Quick Notes Argo Online http://online.argonautgroup.com Click the Tab Labeled: Report a Claim Requires a valid email address Users will select and enter a password each time that they report a new claim to Argo Complete a first report of injury for the jurisdiction where the accident occurred. The first report will be emailed to the designated claims office for investigation A copy of the first report will be emailed to you within minutes of reporting in a PDF format You will be required to enter the password selected in order to open the PDF attachment. Ability to cc two additional recipients to receive a copy of the injury report. Phone 1-800-820-3903 Have all details regarding the claim available and be ready to report. Fax 1-888-329-3764 Have the report of injury completed with as many details as possible. Mailing Address for Medical Bills and Claims Correspondence: Argonaut Insurance Company PO Box 469010 San Antonio, TX 78246 Or Fax 303-773-7249 Attention: Argonaut Insurance Company 1
Reporting Claims Online Please review all instructions below including Frequently Asked Questions to assist you with online reporting of claims to Argonaut. To report a claim online please visit our website https://online.argonautgroup.com Select the tab marked Report a claim Exhibit 1: Argo Online Home 2
Exhibit 2: First Notice of Loss Forms by Jurisdiction Select the Jurisdiction; note there will be instructions for each state form as well as the actual state form listed when you click on the appropriate state. Please select the First Report of Injury not the instruction form to report a claim. Exhibit 3: Injury Forms and Instructions 3
Exhibit 4: Email Information/ Password Set Up 4
For security reasons we ask that you provide your email address and a password of your choice. Once the entire form is completed and submitted you will receive a PDF copy of the first report email back to you. In order to open the document you will need the password entered on this screen. The free form box allows for additional information to be provided that you would like our adjusters to be aware of regarding the claim. Exhibit 5: State Form 5
At the next page a PDF of the state form will appear. Complete the first report by filling in as much information as possible. At the bottom of the page select submit. 6
Exhibit 6: Confirmation of successful online report. The next page will be a message notifying you that the claim was successfully reported. Questions or Problems Reporting Online please contact Beth Ratchford at 210-321-6541 or bratchford@argogroupus.com Frequently asked Questions Regarding Argo Online Reporting 7
1. Who provides the password to report claims online? The password is a randomly selected password that is entered by the user reporting the claim. Argonaut does not provide passwords. 2. Why do I need a password to report claims online to Argonaut? The password is needed for security of personal information on the emailed file. This password will be required to open the submitted PDF Injury report. Note the password is case-sensitive. 3. How can I send a copy of the first report of injury to my safety director or my agent? We provide the option for two additional emails to be entered to receive a copy of the first report. Keep in mind that you will need to share the password in order for the recipient to open the document. Please send this in a separate email to the recipient. 4. Are there any requirements for entering the employee s information on the first report of injury? Yes per Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 please enter the employee s legal name as it appears on their Social Security Card as well as their Social Security Number. 5. Is there some way to report additional facts or information about a claim or an employee without having it appear on the first report? Yes if you would like to add additional information regarding the claim enter it in the free form box after entering your email address. 6. How can I notify Argonaut of a catastrophic claim or fatality? Check the box next to the free form screen if immediate hospitalization is required. This will send an additional notice to our Catastrophic Claims team. 7. How do I know that I have successfully submitted a claim online? After hitting the submit button the screen will turn blue change to let you know that the claim was successfully reporting online. 8. I have tried to click the submit button and nothing happens now what do I do? You may need to adjust the Preferences in Adobe Acrobat. Please follow the steps below and check your settings before reporting online to ensure that you have the correct options selected. Checking Preferences in Adobe Acrobat 8
1. Open the application for Adobe Acrobat 2. Under the toolbar select Edit from the dropdown and Preferences 3. Under Categories select Internet and check the box for Display PDF in browser. 9
Click OK 10