WORKERS' COMPENSATION - CLAIM CONTACT

Program Carrier: American Compensation Insurance Company (Parent Company is RTW)

Claim Administration: RTW, Inc.
Address: P.O. Box 390327, Minneapolis, MN 55439
Tel: 866.620.3137
Fax: 866.286.5258
Website: www.RTWI.com

Program Carrier: Delos Insurance Company

Claim Administration: Athens Administrators
Address: P.O. Box 696, Concord, CA 94522
Claim Reporting Tel: 888.534.6375
General Inquiries Tel: 866.482.3535
Fax: 925.671.9183

MPN - Coventry
Website: www.firsthealth.com
Login to Health Plan Members by typing CYB

Program Carrier: Everest National Insurance

Claim Administration: American Claims Management
Address: P.O. Box 85251 San Diego, CA 92186
Claim Reporting and General Inquiries Tel: 866.671.5042
Fax: 619.744.5030
E-mail: WCinfo@ACMclaims.com
Everest MPN for all dates of injury after January 1, 2011
Everest MPN for all dates of injury before December 31, 2010
Sign up for Automatic Loss Runs and Plan of Action reports here >>

Program Carrier: Health Care and Human Services

Claim Administration: American Claims Management
Address: P.O. Box 85251 San Diego, CA 92186
Claim Reporting and General Inquiries Tel: 866.671.5042
Fax: 619.744.5030
E-mail: WCinfo@ACMclaims.com
ACM MPN
Sign up for Automatic Loss Runs and Plan of Action reports here >>

Program Carrier: Lincoln General Insurance Company

Claim Administration: American Claims Management
Address: P.O. Box 85251 San Diego, CA 92186
Claim Reporting and General Inquiries Tel: 866.671.5042
Fax: 619.744.5030
E-mail: WCinfo@ACMclaims.com
ACM MPN
Sign up for Automatic Loss Runs and Plan of Action reports here >>

Program Carrier: Nova Casualty Company

California Only
Claim Administration: Athens Administrators
Address: P.O. Box 696 , Concord, CA 94522
Tel: 888.534.6375
Fax: 925.609.5434

MPN - First Health
Website: www.firsthealth.com
Login using CYB by clicking on channeling tools

Nationwide
Claim Administration: Gallagher Bassett Services
Tel: 877.541.5224
Fax: 800.748.6159

MPN - First Health
Website: www.firsthealth.com
Password: SELECT

Program Carrier: The PMA Insurance Group

Claim Administration: American Claims Management
Address: P.O. Box 85251 San Diego, CA 92186
Claim Reporting and General Inquiries Tel: 866.671.5042
Fax: 619.744.5030
E-mail: WCinfo@ACMclaims.com
ACM MPN
Sign up for Automatic Loss Runs and Plan of Action reports here >>

Program Carrier: Praetorian Insurance Company

Claim Administration: LWP Claims Solutions, Inc.
Address: P.O. Box 57001 San Jose, CA 95157
Tel: 800.565.5694
Fax: 408.725.0395
E-mail: froi@lwpclaims.com
Website:www.lwpclaims.com

MPN - Concentra
Website: www.concentra.com
Client ID: campn

Program Carrier: Redland Insurance

Claim Administration: LWP Claims Solutions, Inc.
Address: P.O. Box 57001 San Jose, CA 95157
Tel: 800.565.5694
Fax: 408.725.0395
E-mail: froi@lwpclaims.com
Website: www.lwpclaims.com

Program Carrier: Redwood Fire & Casualty Insurance Company

Claim Administration: Berkshire Hathaway Homestate Companies
Address: P.O. Box 881716, San Francisco, CA 94188
Tel: 800.661.6029
Fax: 800.661.6984
Email: newclaim@bhhc-wc.com

MPN - Blue Cross / Kaiser On-the-Job
Website: www.bhhc-wc.com
Access: Choose Claims, then click on Medical Provider Network (MPN), then click on Provider Network.

Carrier: SeaBright Insurance Company

Claim Administration: SeaBright Claims
Tel: 866.367.7242
MPN - mpn@sbic.com
Website: www.sbic.com/brightnotice

Carrier: SPARTA Insurance Company

Claim Administration: Gallagher Bassett Services. Inc. (Policies effective 2.28.11 and prior)
Address: P.O. Box 85013, San Diego, CA 92186
Claims Reporting Tel: 877.563.1080
General Inquiries Tel: 619.471.1219
Fax: 800.748.6159

MPN - Coventry
Website: www.geoaccess.com/cvty/Client.asp
Client ID: CAMPN

Claim Administration: American Claims Management (Policies effective 3.1.11 and after)
Address: P.O. Box 85251, San Diego, CA 92186
Tel: 866.671.5042
Fax: 619.744.5030
E-mail: WCInfo@ACMclaims.com

ACM MPN
Sign up for Automatic Loss Runs and Plan of Action reports here >>

Program Carrier: Travelers Insurance Companies

Claim Administration: St. Paul Travelers
Address: P.O. Box 8112, Walnut Creek, CA 94596-8112
Claim Reporting Tel: 800.238.6225
General Inquiries Tel: 800.842.7354
Fax: 877.801.9679

MPN - First Health
MPN Tel: 800.287.9682
Website: www.firsthealth.com

Program Carrier: Member Company(s) of Zurich Insurance Group:

• Zurich American Insurance Company of Illinois
• Zurich American Insurance Company
• American Guarantee & Liability Insurance Co
• American Zurich Insurance Company
• Maryland Casualty Company
• Assurance Company of America
• Northern Insurance Company of New York

Claim Administration: Zurich North America for out of state as well as CA policies effective 11.30.2010 and prior
Address: P.O. Box 92566, Los Angeles, CA 90009-2566
Claim Reporting Tel: 800.987.3373
General Inquiries Tel: 800.338.3160
Fax: 877.962.2567
E-mail: USZ_CareCenter@Zurichna.com
Website: www.zurichna.com

MPN - First Health
Website: www.firsthealth.com

Claims Administration: American Claims Management for CA policies effective 12.1.2010 and greater
Address: P.O. Box 85251, San Diego, CA 92186
Tel: 866.671.5042
Fax: 619.744.5030
E-mail: WCInfo@ACMclaims.com
ACM MPN
Sign up for Automatic Loss Runs and Plan of Action reports here >>