Scenario 1: Fatality Service Requirements
ABC Tractor Manufacturing has a June 2006/2007 workers compensation policy with A-1 Insurance Company. On Wednesday, August 2, 2006, an explosion and fire occurs, causing a fatality. A-1 Insurance Company was notified of the accident and fatality August 3, 2006. Claims notified the Loss Control Department August 7, 2006
| Scenario 1 Questions |
| 1. When is an LCR required to visit the policyholder? |
| 2. What should the Loss Control Manager or LCR do? |
| 3. What should be done if the policyholder says they cannot meet with you within the three working day requirement? |
| Now assume that A-1 Insurance Company and the Loss Control Department were notified of the fatality August 2, 2006. The LCR calls and leaves a message for ABC's Safety Manager August 3, 2006. The Safety Manager does not return the LCR's call. The LCR calls again Friday, August 4, 2006 and is told the Safety Manager along with the other management employees were attending the funeral. Monday morning, August 7, 2006, a claims adjuster tells the LCR that while they were talking to the policyholder, ABC's management mentioned they would probably close the plant until OSHA finished their investigation. |
| 4. Now when is an LCR required to visit the policyholder? |
| 5. What should the LCR do? |
| 6. What type of documentation should be kept? |
| 7. What do you need to do if the policyholder tells you that they refuse to meet with you? |
| 1. When is an LCR required to visit the policyholder? |
| The visit to the insured is required within three working days of notification and/or knowledge of a fatality. The insurance company was notified on Thursday, August 3. The visit should be made by Tuesday, August 8. |
| 2. What should the Loss Control Manager or LCR do? |
| The Loss Control Manager or LCR should contact the policyholder and schedule to meet with them within three workings days of August 3 (which would be August 8). |
| 3. What should be done if the policyholder says they cannot meet with you within the three working day requirement? |
| Make arrangements to visit with the policyholder as soon as possible on a date that is agreeable with the policyholder and be sure to document the date of contact with the policyholder as well as the agreed upon date of the visit. Don't forget to document the visit as well. |
| 4. Now when is an LCR required to visit the policyholder? |
| When notification is made on August 2, the visit should take place by August 7. |
| 5. What should the LCR do? |
| The LCR should continue to try and reach the Safety Manager or another upper management contact. The LCR does not know for sure that ABC's plant has been closed. Even if they did decide to close the manufacturing process, it does not mean that the total plant and administrative offices would be closed. A visit can still be made. The LCR visit does not have to include a "hands-on" investigation of the accident at this time. |
| 6. What type of documentation should be kept? |
| Documentation should be kept on all of the LCR's attempts to set up a visit with the policyholder. The date, person contacted and brief recap of the conversation or action taken should be documented until the visit is conducted. |
| 7. What do you need to do if the policyholder tells you that they refuse to meet with you? |
| Document the declination of the visit. Get it in writing from the policyholder on their letterhead stationery. If this cannot be done, send them a confirmation letter stating their declination of service. Document in the file the date that service was declined and the person who was contacted. |
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Last updated: 10/15/2012
