Claims Kit
Alaska
Forms
State Compliance Information
Posting Requirements 23.30.060
The notice must be posted and kept on the premises of the employer (or on the premises where the employer's operations are being carried out) in three conspicuous places: at the office of the employer, at the mess house or boarding house if there is one, and in some conspicuous place on the premises or works. The notice must be substantially in the form described in the statute, and the signature must be witnessed by two witnesses.
An employer is conclusively presumed to have elected to pay compensation directly to employees until notice is posted.
Employer's Notice of Insurance
Physician Selection 23.30.095
The injured employee may designate a licensed physician to provide all medical and related benefits when medical care is required. The employee may not make more than one change in the employee's choice of attending physician without the written consent of the employer. Referral to a specialist by the employee's attending physician is not considered a change in physicians. Upon procuring the services of a physician, the injured employee must give proper notification of the selection to the employer within a reasonable time after first being treated. Notice of a change in the attending physician must be given before the change.
Reporting of Claim by Employer 23.30.070
Within 10 days from the date the employer has knowledge of an injury or death or from the date the employer has knowledge of a disease or infection--alleged by the employee or on behalf of the employee to have arisen out of and in the course of the employment--the employer must file with the division a Report of Occupational Injury or Illness
Insured employers must report all injuries to the insurer’s claims administrator who then files the report of injury with the Alaska Division of Workers’ Compensation. Uninsured employers are personally responsible for filing the required report of injury to the division. Injured employees may also file their own reports of injury when employers fail or refuse to do so.
Report Of Occupational Injury Or Illness.
Penalties for Late Reporting 23.30.070
Failure to file the Report Of Occupational Injury Or Illness within 10 days from the employer's knowledge of an injury or death--or from the date the employer has knowledge of a disease or infection--may subject the employer and/or the insurer to a penalty equal to 20% of the amount of compensation due to the injured worker. The Statute of Limitations does not begin to run until the report is filed.
Posters & Brochures
Brochure
Documents Provided by CopperPoint
Form LS-241 Required for USL&H Policies
Portal User Help
Pharmacy First Fill - ENG/SPA
Change of Address
Witness Statement - ENG/SPA
Accident Report - ENG/SPA
Gramm-Leach-Bliley Act (GLBA) Privacy Notice
Return To Work
Return To Work Transitional Employment Offer Template - ENG/SPA
Return To Work Policy Guide
Injured Workers Guide
The worker's compensation system can be complicated, and each state has its own laws regarding workers' compensation.
The information contained in your state's guide provides a general guide for workers injured or made ill on the job.
This state-issued publication will assist you in navigating the workers' compensation system and serve as a resource for basic legal rights as well as steps to take to initiate workers' compensation benefits, deadlines and who to contact for additional assistance.
If you have questions about the workers' compensation process, this guide will provide the contact information for the regulatory agency for your state. In addition, many states have an ombudsman to oversee and assist all interested parties in the workers' compensation system.
Publications
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Claims Kit Contents
CopperPoint Insurance Company
PO Box 36070
Phoenix, AZ 85067
Phone: 800.231.1363
For Claim Reporting, please complete your First Notice of Loss and email to reportaclaim@copperpoint.com