How to Report a Claim
Incident Report Form - All injuries, illnesses, incidents, accidents, sprains, or strains (no matter how slight) shall be reported in a prompt manner. If immediate treatment is needed:
Select a clinic that accepts Workers' Compensation.
If medical personnel is seeking authorization prior to providing treatment, call the Insurance Program Manager 254-710-4586.
Workers' Compensation Claims
Workers Compensation is a form of insurance that is provided and designed to protect employees who, experience a work-related injury or illness. If your incident occurred while you were at work, complete the Incident Report Form.
View Baylor's Preferred List of Healthcare Providers. You may choose any facility that accepts Workers' Compensation.
- Baylor's Insurance Program Manager will file your claim with The Hartford, our insurance carrier.
- All future communication will be with the Insurance Program Manager, your adjuster, and yourself.
- If you need emergency medical attention or treatment after office hours from an injury on the job, please inform the Emergency Room that this is a Workers Compensation claim. If the incident is a Workers Compensation claim, please don't provide your personal health insurance and contact your Insurance Program Manager.
**Note to Employees and Supervisors: Absences due to work-related injuries may also fall under the provisions of The Family and Medical Leave Act (FMLA). Proper FMLA procedures must be followed.
Automobile Accident Reporting Guide - Information on what to do if you are involved in an automobile accident in a rental vehicle, dealer loaner vehicle or Baylor owned vehicle.
Incident Report Form - Complete the incident form for all automobile accidents.
Lost, Stolen, and Damaged Property Report - Use this fillable form to report any lost, stolen, damaged or recovered property. Email completed forms to firstname.lastname@example.org
Lost, Stolen, and Damaged Property Inventory Sheet - Use this fillable form as an addendum to the Lost, Stolen, Damaged or Recovered Property Report to list multiple lost, stolen or damaged items. Email completed forms to email@example.com