Access Claims Services
Report a Claim
We are committed to delivering superior claim service to you and your employees. As a policyholder, your role in this process is critical. We encourage you to report employee injuries on the same day the accident occurs. Studies have shown that prompt reporting helps reduce claim costs. We offer several ways to report a claim:
By Phone - Call us toll-free any time day or night at 1-844-722-7827. A trained representative will guide you through the reporting process.
By Email - Complete the required state and/or federal form and email it to [email protected]. This is the fastest, most efficient way of complying with laws requiring workers' compensation policyholders to notify the jurisdiction in which the accident occurred.
First Notice of Loss Forms
Required Federal USL&H Form
To meet federal requirements for claims made under the U.S. Longshore and Harbor Workers’ Act (USL&H), click on the link below, complete the form, and file it with the district director in the appropriate district office of the Office of Workers’ Compensation Programs, U.S. Department of Labor. The form must be filed within 10 days from the date of injury or death, or from the date the employer first knew of the injury or death.
USL & H Employer’s First Report of Injury or Occupational Illness
Required State Forms
We offer 24/7 online access to these forms specific to your policy within our Online Services portal. This provides the ability to complete the form(s) online, save them directly and send them via email at [email protected].
Recommended Claims Processing Forms
The entire StarStone and CCMSI claims staff is dedicated to resolving claims fairly and paying benefits as quickly as possible. To help expedite your claims, we encourage you to have the appropriate people send us the following information as soon as possible after the injury or illness occurs:
- Personnel Statements: Three personnel statement forms contain information that helps expedite claim investigations.
Mileage Reimbursement Voucher: This form reports transportation expenses for an injured worker’s trips to medical facilities and doctors’ appointments related to the claim. We recommend you submit these forms monthly during the life of each claim.
Authorization to Obtain Information – English and Spanish: Prior to paying workers’ compensation benefits, we need to see all past and current medical records relevant to the claim. Once the injured worker completes this form and gives it to his or her medical provider(s), we can request the necessary medical records.
Temporary Prescription Services ID – CCMSI: This form enables an injured worker to fill an initial prescription prior to the claim’s activation without incurring any out-of-pocket expenses. Participating pharmacies are listed at the bottom. (Note: StarStone does not need to receive a copy of this.)
California Medical Provider Network (MPN) - Claims with Dates of Loss 11/1/2020 and after
For policyholders residing in California please click this link to Find a Provider
California MPN Forms
Workplace Initial Employee Written Notification Regarding Your Medical Provider Network – English
Workplace Initial Employee Written Notification Regarding Your Medical Provider Network – Spanish
Notice to Employees — Injuries Caused by Work
Enstar Primary California Medical Provider Network (MPN) - Claims with Dates of Loss Prior to 11/1/2020
For policyholders residing in California that are enrolled in the Enstar Primary MPN: Find a Provider
Provider Network for All Other States - Claims with Dates of Loss 11/1/2020 and after
We offer Talispoint to search providers by name, address, region/provider listings or quick search – click for access instructions. Find a Provider
Pharmacy Benefit Program
To lower prescription costs and avoid out-of-pocket expenses, injured workers can obtain injury-related medications at discounted prices from a nationwide network of over 64,000 pharmacies. Drug cards are mailed to the injured worker after the injury has been reported and prescription needs have been identified. Affiliate pharmacies also review prescriptions prior to their being filled, and cross-check patient information to help identify any potential adverse effects. In addition, health care providers receive StarStone's experience-based formulary of effective drugs for various worker-related injuries, with an emphasis on lower-cost generic equivalents, as appropriate. Beyond this, physicians provide an added level of expertise by reviewing requests for narcotics, guiding treating physicians in weaning recovering workers off chronic narcotics use, and serving as an ongoing resource for our claims examiners.
A form provided below for use before a claim becomes fully active that enables injured workers to fill their initial prescription without having to pay for it out-of-pocket and seek reimbursement later.
Cannon Cochran Management Services, Inc. / CCMSI Temporary Prescription Services ID
Fraud Detection
Our claims examiners are trained to detect indicators of fraud. If they spot a red flag, they refer the suspicious activity to an independent investigator to pursue the case. Please contact us to report fraud.