Workers Compensation Claims Kit
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1 Argonaut Other States Coverage Welcome to Argonaut Insurance Workers Compensation Claim Services. We appreciate your business. Please refer to this document for reporting claims, contacting our claims offices, and sharing workers compensation information with your injured worker. If you have additional questions regarding Argonaut Claims Services please contact Beth Ratchford, Account Executive at or Method Contact Information Quick Notes Argo Online Click the Tab Labeled: Report a Claim Requires a valid address Users will select and enter a password each time that they report a new claim to Argo Complete a first report of injury for the jurisdiction where the accident occurred. The first report will be ed to the designated claims office for investigation A copy of the first report will be ed to you in a PDF format within minutes of reporting You will be required to enter the password selected in order to open the PDF attachment. Ability to cc two additional recipients to receive a copy of the injury report. Phone Fax Have all details regarding the claim available and be ready to report. Have the report of injury completed with as many details as possible. Attention: Argonaut Insurance Company Mailing Address for Medical Bills and Claims Correspondence: Argonaut Insurance Company PO Box San Antonio, TX or Fax Last Revised Page 1
2 Reporting Claims Online Please review all instructions below including Frequently Asked Questions to assist you with online reporting of claims to Argonaut. To report a claim online please visit our website Select the tab marked Report a claim Exhibit 1: Argo Online Home Last Revised Page 2
3 First Notice of Loss Forms by Jurisdiction Select the Jurisdiction; note there will be instructions for each state form as well as the actual state form listed when you click on the appropriate state. Please select the First Report of Injury, not the instruction form, to report a claim. Exhibit 2: First Notice of Loss Forms by Jurisdiction Last Revised Page 3
4 Injury Forms and Instructions Exhibit 3: Injury Forms and Instructions Last Revised Page 4
5 Information/Password Set Up For security reasons we ask that you provide your address and a password of your choice. Once the entire form is completed and submitted you will receive a PDF copy of the first report ed back to you. In order to open the document you will need the password entered on this screen. Exhibit 4: Information/Password Set Up The free form box allows for additional information to be provided that you would like our adjusters to be aware of regarding the claim. Last Revised Page 5
6 State Form At the next page a PDF of the state form will appear. Complete the first report by filling in as much information as possible. At the bottom of the page select Submit. Exhibit 5: State Form Last Revised Page 6
7 Confirmation of Successful Online Report The next page will be a message notifying you that the claim was successfully reported. Exhibit 6: Confirmation of Successful Online Report Questions or Problems Reporting Online please contact Beth Ratchford at or bratchford@argogroupus.com Last Revised Page 7
8 Frequently asked Questions Regarding Argo Online Reporting 1. Who provides the password to report claims online? The password is a randomly selected password that is entered by the user reporting the claim. Argonaut does not provide passwords. 2. Why do I need a password to report claims online to Argonaut? The password is needed for security of personal information on the ed file. This password will be required to open the submitted PDF Injury report. Note the password is case-sensitive. 3. How can I send a copy of the first report of injury to my safety director or my agent? We provide the option for two additional s to be entered to receive a copy of the first report. Keep in mind that you will need to share the password in order for the recipient to open the document. Please send this password in a separate to the recipient. 4. Are there any requirements for entering the employee s information on the first report of injury? Yes per Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 please enter the employee s legal name as it appears on their Social Security Card as well as their Social Security Number. 5. Is there some way to report additional facts or information about a claim or an employee without having it appear on the first report? Yes if you would like to add additional information regarding the claim enter it in the free form box after entering your address. 6. How can I notify Argonaut of a catastrophic claim or fatality? Check the box next to the free form screen if immediate hospitalization is required. This will send an additional notice to our Catastrophic Claims team. 7. How do I know that I have successfully submitted a claim online? After hitting the Submit button the screen will turn blue to let you know that the claim was successfully reporting online. 8. I have tried to click the Submit button and nothing happens; now what do I do? You may need to adjust the Preferences in Adobe Acrobat. Please follow the steps below and check your settings before reporting online to ensure that you have the correct options selected. Last Revised Page 8
9 Checking Preferences in Adobe Acrobat 1. Open the application for Adobe Acrobat 2. Under the toolbar select Edit from the dropdown and Preferences Last Revised Page 9
10 3. Under Categories select Internet and check the box for Display PDF in browser. Click OK Last Revised Page 10
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