GETTING YOUR CLAIMS TO THE
Typically, when you are treated for
illness or injury,
your doctor files a claim
with Educators Mutual.
However, there are
circumstances when claims
should be
filed with another agency first.
Automobile Accidents
If you are injured in an accident
that involves an automobile, those claims should first be filed with your auto
insurance agency.
·
This includes accidents involving parked
vehicles; for example, if you slam your finger in the door.
·
If you are a pedestrian injured by
an automobile, you should file your claims with the driver’s auto
insurance agency.
·
Once you have exhausted your auto
insurance benefits, Educators Mutual will process any remaining
claims in accordance with the terms of your policy. You must
provide Educators Mutual with the name
of your auto insurance agency, the claims adjuster’s name
and phone number, and the claim number
that has been assigned to your accident.
On-the-job Injuries
Any injury that occurs while you
are on the job should be reported to your employer immediately, so that a
workers’ compensation claim can be filed. Workers’ compensation claims are subject
to strict time limitations and guidelines.
·
If your workers’ compensation
claim is denied, and all appeals are exhausted, Educators Mutual will
review the claim to see if it qualifies for coverage under
the terms of your policy.
·
A claim will not qualify for
coverage under your Educators Mutual plan if it was denied by workers’
compensation because you missed the filing deadline, so it
is important that you act promptly.
·
Most Educators Mutual plans
exclude benefits for injuries that would have been covered under
workers’ compensation.
Property Owner’s Liability
An injury that occurs at someone’s
home or business may be covered by that person’s property/homeowner’s policy,
if the property owner was negligent in some way.
·
For example, property owners may
be negligent by failing to clear snow from their walks, failing to
repair cracks in the cement, or having no stair rails.
·
If you provide Educators Mutual
with a good, detailed explanation of how the accident occurred,
Educators
Mutual will determine if the claim should be submitted to the property owner’s
insurance.
If you have any questions about who is responsible for a
particular claim,
please contact Educators Mutual’s subrogation representative.
Educators
Mutual Insurance Association
852 East Arrowhead Lane, Murray, UT 84107
Toll-free (800) 662-5851
www.educatorsmutual.com