Talking to your insurer part 1: First Contact

First contact is always important.

The insurer will probably know of you before you know of them. The way the system works is that your employer will generally inform their workers compensation insurer once you have given your employer the certificate of capacity. The insurer then has 72 hours to contact you.

What you should be ready for when this happens is the following:

  • They will tell you they have received your claim.
  • They will give you a claim number (write this down).
  • They will ask you to confirm your personal details (such as Treating doctor, name contact address etc…)
  • They will (probably) ask you some details about the incident and the lead up to it. this may include asking you if you this has happened before.

The important thing is to be prepared before they ring you up.

Have your details with you.

Your bank account details, your contact numbers, your employee number (if you have it) and the contact details of any of the medical services you have needed since the incident are important information for the first phone call.

Write down a time-line of events

This will help you if they do ask. It doesn’t have to be a lengthy exercise but having some idea about when, where and how the incident/s happened will make it easier for you to talk about it with a stranger.

Take notes about the phone call.

When you are on the phone to the insurer remember to write things down so you can remember them afterwards.

While you are on the phone:

  • Be polite, you might not feel like it but it does make a difference in how they treat you into the future.
  • If you can’t talk, let them know and make another time to talk to them. The insurer does need to speak to you as soon as possible about your claim so you cant avoid the conversation. if you need an interpreter let them know, if you need someone else to take the phone call (such as you are in too much pain) let them know who that person is and how they can get in touch with them.
  • If you don’t understand anything, ask them to explain it to you again.
  • If you don’t know the answer to something, tell them you don’t know the answer to that. Most of the time this will have to do with your treatment so you can ask them to talk to your doctor about that.  What ever you do don’t make something up on the spot (you wont remember it)
  • get the case managers details as well. Name and email address are important.

Once you are off the phone:

  • Record the conversation as best you can. At a minimum write down the time, date and the persons name.

A few days after the phone call you will receive a letter from them about the claim with most of the information they gave during the phone call, but don’t just rely on getting this letter- things do get lost in their mailing system.

Throughout your claim your case manager will change (average of 6 months)

Because of this you should always keep track of what is going on. record your conversations, send emails to the case manager after a phone call confirming what you spoke about, make sure someone else knows what is going on as well.