Claims Process

A recent study proved that the average cost of a claim is significantly affected by how quickly a claim is reported. Specifically, a claim reported 4-21 days after an injury occurs are on average 15% more costly than those reported 1-3 days after an injury occurs. The average claims cost increases 47% if a claim is reported more than 22 days after an injury occurs. When an injury is reported late, attorney involvement increases by an average of 50%, medical costs increase an average of 16%, and the injured worker often becomes bitter and uncooperative due to the feeling of abandonment – becoming an obstacle in handling the claim effectively.

After reporting a claim, it is important for both the supervisor and injured employee to complete an accident investigation form to determine how and why the workplace accident occurred. By using the information gained through an investigation, a similar or perhaps more disastrous accident may be prevented.

The accident investigation forms can be found below – one for the employer to complete and another for the employee to complete. Please remember to include the claimant’s completed Post Offer Medical Questionnaire document (if applicable) when submitting these forms to Synergy Coverage Solutions.

Click the below Claims Process steps to expand information.

Employer directs non-life threatening injured employee to receive medical care (if necessary) and sends employee to an in-network PPO facility with completed WC Medical Provider Instructions and Pharmacy Network First Prescription Form to hand to the treating physician (click here to find an in-network facility near you). Employer then submits claim via Synergy's online claim reporting form or by calling 1-877-327-5444. The injured employee's Post Offer Medical Questionnaire (if available) should also be submitted when reporting a claim.

Alternatively, Synergy Coverage Solutions offers a telemedicine option in which injured workers can speak with a physician over the phone for injuries involving soft tissue, sprains and strains, and skin irritations. Click here to request a telemedicine phone call with a physician.

Within 24 hours contact is made with the employer, injured worker and medical provider.

After the claim has been thoroughly investigated, a decision about compensability is made and communicated to the Employer and Employee.

Reporting A Claim

Synergy Coverage Solutions has made claim reporting a simple, streamlined process. 

Option 1.

Report a claim by completing our First Report of Injury web form.

Option 2.
Telephonic Claims

Report a claim by phone using our 24/7 claims hotline.

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