Q – When should a Workers' Compensation claim be reported?
A – Members should report the injury as soon as possible, but no later than seven (7) days beyond their knowledge. If an employee alleges that they were hurt at work, the member must report a claim, even if the accident description is not believable. Once a claim is reported, the adjuster will investigate the incident and make a determination of compensability. If the investigation reveals that an injury is not covered, the employee will be sent a notice of denial and the State is made aware of the determination. If you do not report the claim in a timely manner and a denial is not reported to the State, benefits may not be awarded.
Q – How do I report a claim?
A – There are numerous ways as follows:
- Phone- (800) 756-3042 (24 hours a day)
- Online- insurance.flcities.com – Click on "Report a Loss" on the upper right hand side of the page and then login to your Members Dashboard.
- Email – email@example.com
- (855) FMITLOS - (855) 364-8567
Q – To whom do I report suspected fraudulent activity?
A – Suspected fraudulent activity can be reported openly to the handling adjuster or to the League’s Special Investigations Unit (SIU) department at (888) 447-5877. You can also report fraudulent activities directly to the Division of Insurance Fraud by calling (850) 413-3115.
Q – When are benefits paid?
A – Benefits are paid bi-weekly.
Q – How much will be paid?
A – Benefits checks are paid at 66 2/3 of the injured worker’s average weekly wage.
Q – How is the Average Weekly Wage calculated?
A – Use the 13 calendar weeks immediately preceding the week of the accident and start with the most recent full calendar week before the week of the accident. For example, if the accident occurred on a Wednesday, then week No. 1 should begin the preceding Sunday and end the preceding Saturday. DO NOT report any wages earned during the week of the accident. Calendar Week: means a seven-day period of time, which starts on Sunday and continues through Saturday.
Q – What does an injured worker do with unpaid medical bills that should be paid on the WC claim?
A – Provide a copy of the bill or itemized statement to the handling adjuster.
Q – What do I do if I get a subpoena for records?
A – Notify your adjuster immediately. The adjuster will ask for your records and provide them to our defense counsel for response.
Q – Can I talk to my employee about their Workers' Compensation claim if they have an attorney?
A – Yes, but your conversation(s) should be limited to job specifics and/or return to work aspects.