AmTrust Claims

Log-in to AmTrust Online or call 888-970-3552

Claims

Our center is staffed by special claims operators who provide assistance for reporting claims.  Once a claim is reported you can also check its status and if necessary locate a doctor via the National Provider Directory.

AmTrust’s professional claims staff has an average of 20+ years of experience, and our claims adjusters maintain low workloads, enabling them to effectively manage claims. We use an automated claims system and operate in a paperless environment.

Three-point contact is immediately initiated with the injured worker, employer and doctor. Our Medical Director assists in determining proper diagnoses, provides access to treating physicians and holds peer-to-peer reviews to discuss claims directly with physicians.

   
24/7 Toll-Free Claim Reporting

Workers’ Compensation for All States

Phone: 888-887-3062
Fax: 775-908-3724 or 877-669-9140
Email: Amtrustclaims@qrm-inc.com
 

Non-Workers’ Compensation

Phone: 888-887-3062
Fax: 877-207-3961
Email: anaclaimsreporting@amtrustgroup.com
   
Provider Instructions for Workers' Compensation eBilling

Payor ID: 12491
Name of Clearing House: Optum Property and Casualty Clearinghouse (OPCC)
Identification number: OPCC's Tax ID: 352170347
To obtain a claim number, please call: 855-399-1185

How the Provider Should Submit the Claim #: If the subscriber is the patient, the claim # should be sent in a 2010BA.REF*Y4 segment in X12 837 transactions;  otherwise, if the patient is different than the subscriber, the claim # should be sent in a 2010CA.REF*Y4 segment. For example, REF*Y4*CLAIMNUMBER~. Our “OPCC Companion Document” and "OPCC Connectivity Guide" both explain how to use our system, and can be found here.

Providers/bill submitters can call our OPCC Customer Support at 866-990-3201, or email OPCChelpdesk@optum.com.

   
Information required for all claims reported
  1. Name of the insured and policy number 
  2. Date, time and place of accident or incident
  3. Description of accident or incident 
  4. Name, phone and/or e-mail of person making the report
   
Additional information required for specific claim types
For Workers’ Compensation 
  1. MUST have the injured employee’s social security number as it is required by law 
  2. Description of injury 
For Property Claims
1. Physical address of the loss
2. If more than one building on property, must have specific building(s) involved
3. Type of loss, i.e., fire, theft, etc.
4. Description of loss or damage 
 
For Motor Vehicle (Auto) Claims 
1. Name, address and contact information of ALL parties involved.
2. Make, model and VIN of the insured vehicle 
3. Make, model of all other vehicles involved 
4. Current location of all vehicles 
5.  Name and contact information for each driver and all passengers 
6. Name and contact information any known witnesses 
 
For General Liability Claims 
1. Physical address of where the loss occurred 
2. Name, address and contact information for all persons claiming injury or damage 
3. Name and contact information any known witnesses  
   
Customer Benefits
  • 24/7 call center, staffed by claims operators, allowing claimants, policyholders and producers to speak with a live person
  • Injured employees, medical providers and others are paid without delay
  • Return-to-work options are initiated through a joint effort among the employer, physician and injured employee
  • Each business segment is supported by a senior position with a high level of experience
  • Preferred One Source Repair Program streamlines claims handling for automobile repairs through quality, authorized collision repair facilities across the country
   
Disability Claims
New York DBL Claims 
The forms required when an employee becomes disabled in NY and may be entitled to disability benefits are:
  • DB-271S—Statement of Rights: The NY DBL law requires an employer to send a “Statement of Rights” – entitlement of benefits under the Disability Benefits Law to an employee, within 5 days after the employee has been absent from work for more than 7 consecutive days. This statement is in standardized format approved by the Workers' Compensation Board.
  • DB-450—Notice and Proof of Claim: After the disability begins, Part A – Claimant and Part B – Health Care Provider statements should be completed, signed and the form returned to the employer for completion of Part C – Employer Statement. The form should then be submitted to Wesco Insurance Company. Claims should be filed within 30 days after the employee last worked and the physician has certified the employee is totally disabled. Failure to submit the claim within 30 days may result in a partial or total rejection of the claim.
New Jersey TDB Claims
The forms required when an employee in NJ becomes disabled and may be entitled to disability benefits is:
  • DS-I – Division of Temporary Disability Insurance Claim for Disability Benefits: Claim form is used to file a New Jersey TDB claim when an employee becomes totally disabled while employed. Claim must be filed within 30 days of disability. The employer must send the employee a Disability Form (Form DS-1), containing the worker’s name, address, Social Security number and wage information needed to determine the worker’s eligibility for temporary disability benefits.

Send a completed claim form for NY and NJ to:
Wesco Insurance Company
PO Box 980, Bowling Green Station
New York, NY 10274
OR
via fax at 800-584-9303
OR
via email at DBClaims@amtrustgroup.com

   
Surety Bond Claims

Contact Information
To make a claim or to contact our claims department:
Attn: Claims Department
17771 Cowan, Suite 100
Irvine, CA 92614
949-553-8143 fax
claimsbox@inscodico.com

Still have questions, or need help with a claim? Simply call 888-970-3552.

 

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