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International and Out of State Claims

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Resources

Employee's First Report of Work-Related Injury of Endemic Illness - FVWC

Employer's Supplementary Report of Accident or Occupational Illness

Employer's Statement of Wage Earnings
  
Foreign General Liability Notice

Foreign Automobile Claims

INTERNATIONAL CLAIMS

DEFENSE BASE ACT CLAIMS

OUT OF STATE CLAIMS

 

 

 

 

 


 
International Claims
Claims Reporting

To report international injuries, contact Brent Holman at 512-499-4645 or at bholman@utsystem.edu.

Claim Information

ORM has purchased other insurance products to assist in covering exposures for travelers and Institutions for workers’ compensation and liability claims related to incidents abroad.

ORM placed an International Package Policy which includes foreign workers’ compensation, foreign business auto, foreign general liability, and a local Mexico general liability and tourista policy.

Injured employees should complete the Employee’s First Report form following injury.  https://www.utsystem.edu/documents/docs/general-documents/2020/employees-first-report-of-work-related-injury-of-endemic-illness-fvwc  Claims are to be called into the Institution’s WCI Representative who will work with the UT System Office of Risk Management and insurance carrier.

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Defense Base Act Claims
Claims Reporting

To report international injuries, contact Brent Holman at 512-499-4645 or at bholman@utsystem.edu.

Defense Base Act Claims

OWCP - The Office of Workers’ Compensation Programs is the division of the US Department of Labor, Employment Standards Administration that is responsible for the administration of the US Longshore & Harbor Workers’ Act and the Defense Base Act.

It is similar to the Workers’ Compensation Board or Commission under a state workers’ compensation system. It is divided into various District Offices each of which is headed by a district director and staffed by claims examiners.

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Out of State Claims
Claim Information

The Office of Risk Management has procured three individual workers’ compensation policies to ensure coverage of our out-of-state employees in the event any should be injured in the course and scope of employment. These policies are presently held with and claims will be handled by the individual states of Washington and Ohio as well as a multi-state policy for all other employee locations via Liberty Mutual.  Regardless of the location, each claim should be reported to the UT System WCI Office.

Out-of-State Employee Claims Reporting

To report international injuries, contact Brent Holman at 512-499-4645 or at bholman@utsystem.edu.

Out-of-state claim submissions do not apply to individuals traveling on business domestically.  For all claims of this nature please follow the standard claims submission process as dictated by your institution and via your institution’s WCI Representative.

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