All Insurance claims are reported using the Incident Track System at lossfreeRx.com.  If you need assistance entering a claim please call the Insurance Office at 727-374-0222.

Workers’ Compensation

Commercial Risk Management (CRM) is our administrator for our employee accidents/injuries.  All Workers’ Compensation Claims are reported using the Incident Track System at lossfreeRx.com.

The six steps to care for an employee accident/injury.

  1. Give initial first aid treatment on site.  If no additional treatment is needed, report the claim to CRM using the Incident Track System.
  2. If additional treatment is needed, send the employee to one of the listed Emergency Treatment Centers.  Emergency Treatment Centers
  3. Give the employee the following forms:
    1. To authorize treatment and coordinate the billing information.  Initial Treatment Form     Initial Treatment Form – SAMPLE  
    2. To authorize Prescriptions that are ordered during the first initial visit. My Matrixx, WC Prescriptions First fill    My Matrixx, WC Prescriptions First fill – SAMPLE
  4. If the accident/injury has not been reported to CRM do so now by using the Incident Track System at lossfreeRx.com.
  5. Step by Step instructions for reporting an employee accident/injury.  DOSP – WC Claims Reporting Steps_Sept. 2018 
  6. Complete the accident investigation reports and upload them into the claim on the Incident Track System. 

General Liability Claim

General liability claims are accidents that occur to non-employees on our property.  Even though not all accidents may be covered under our liability policy they should be reported to Catholic Mutual Group (CMG) our claims administrator using the Incident Track System at lossfreeRx.com  All claims should be reported within 24-48 hours of the accident.

Property Claims

Property Claims are reported using the Incident Track System at lossfreeRx.com.  Property claims are administered by Catholic Mutual Group (CMG). Claims should be reported within 24-48 hours of the incident.

Auto Claims

Auto accident claims are reported using the Incident Track System at lossfreeRx.com.  Auto Claims are administered by Catholic Mutual Group (CMG).  Claims should be reported within 24-48 hours of the accident.

Volunteer Accidents

Volunteer accidents are reported using the Incident Track System at lossfreeRx.com.  Accidents are administered though the Insurance Office. Accidents should be reported within 24-48 hours of the accident.

Student Accidents

Our Student Accident Insurance Provider is AIG.  This excess policy is designed to  supplement the families own health insurance

AIG _Student Accident Benefit Outline August 2020

To Report a Student Accident: 

Reporting steps to be completed by the school.

  1. The school completes Section A & parent contact information in Section B of the AIG Student Accident Form 
  2. The Principal or Asst. Principal signs as the policy holder.
  3. Prior to submitting the claim form to AIG, please make sure the parents name, address, phone number and email address if available are on the form
  4. Email the form directly to AIG the insurance carrier (ahclaims@aig.com).
  5. Email (vcb@dosp.org) or fax (727-374-0214) a copy of the claim form to the Insurance Office.
  6. The school should keep a copy of the form on file for future reference as needed.
  7. Make a copy of the claim form to give to the parents.
    1.   Student Accident Form__AIG_August 2020
    2.   Student Accident_AIG – Spanish_August 2020
    3.   Sample, AIG Student Accident Form_August 2020

Claim Submission steps to be completed by the parents for reimbursement of out of pocket expenses.

  1. Student Accident Insurance is an Excess Plan – Eligible covered expenses will be determined after benefits have been paid by other valid private insurance.
  2. Parents complete Section B of the claim form. Sign and date twice at the bottom of the form.
  3. Submit the following directly to AIG, the claim form, itemized bills, and the Explanation of Benefits (EOB) from their insurance carrier.