Welcome
Welcome to the Athens Administrators and Leavitt workers’ compensation website. This website was developed to assist Leavitt with their workers’ compensation program.
It is our goal to provide you with exceptional service. For your convenience, we have tailored your website to have valuable information needed for claims reporting, obtaining information such as state mandated reporting requirements and necessary forms for your workers’ compensation program.
On behalf of your Athens Claims Team we are committed to work together in providing you with all the tools and information you need to manage your workers’ compensation program. If you need any further assistance or have questions, please feel free to contact us via the Contact tab above.
Regards,
Athens Administrators
Claims Kit
Welcome Letters
Report a Claim
| Internet: | https://www.athensadmin.com/report-a-claim-netclaim/ |
| Telephone: | 866-308-4446 |
| Fax: | 877-263-4389 |
| Email: | reportclaim@athensadmin.com |
| Mail: | P.O. Box 696, Concord, CA 94522 |
| How to Report a Claim Document » | |
California Claims Kit Attachments
Notice to Employees MPN (DWC 7) – MUST BE POSTED »
Workers’ Compensation Claim Form (DWC 1) & Notice of Potential Eligibility »
Employer’s Report of Occupational Injury or Illness (Form 5020) »
Athens MPN Employee Written Notification – MUST BE POSTED »
Athens MPN Implementation Notice »
Athens MPN Acknowledgement Form »
Affidavit Of Distribution »
Predesignation of Personal Physician Form »
Time of Hire Pamphlet »
Time of Hire Pamphlet (Spanish) »
Facts About Workers’ Compensation »
Facts About Workers’ Compensation (Spanish) »
Whistle Blower Notice »
Athens Claim Supply Request »
Athens California MPN – Internet Physician Lookup
| Internet: | www.medexadvantage.com/athens/ |
Marketing Information
CA WC Benefit Summary 2010 »
WC Post Term Flyer »
For all claims related inquiries
Leann Farlander, Director of Cost Containment
949-296-3961
lfarlander@athensadmin.com
CLAIMS TEAM »
Welcome Letter
Non-California Welcome Letter »
Report a Claim
| Internet: | https://insuredportal.gaig.com |
| Telephone: | 877-836-1555 |
| How to Report a Claim Document » | |
| First Notice of Loss – See “Non-California | FNO” tab |
State Insurance Depts. & Claims Kits
For all claims related inquiries
Paul Gladden
925-988-2279
pgladden@gaig.com
Non-California | FNO Information
Great American has launched a new Worker’s Compensation claim reporting tool, the First Notice of Loss Application for non-California claims only, written through PacWest.
Benefits associated with using the application to report claims are:
- Instantly establishes a claim in the Great American claim system
- Claim number provided upon submission
- Instant escalation for catastrophic losses
- Gathers critical claim information
- Removes need for duplicate submission of data
- Allows for incident only reporting
To use the app, you will first need to register on the Great American Insured Portal https://insuredportal.gaig.com/
After clicking on the link:
- Click the Request Access link
- Complete the PolicyholderRegistration form
- Confirmthe Insured Portal system generated “Identity Verification” email
Once registered, you may access the app at: https://reportwcclaim.gaig.com
This reporting method permanently replaces on-line claim reporting through the Network, and is preferred over reporting losses by phone.
Finally, attached please find a helpful FAQ list to guide you through the reporting process and our updated claim filing card for Workers Compensation claims OUTSIDE CALIFORNIA ONLY.