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Apr 12, 2010

How To Get Help If You Have A Problem With The System?

Further Assistance

There are various places to turn to if you have questions or concerns regarding workers' compensation insurance.

Your Insurance Representative

Your first resource for assistance with workers' compensation issues is your insurance representative (agent or broker). Your insurance representative should be able to answer questions concerning classification, experience rating, and ownership. In addition, your insurance representative should be able to help you with many issues that are not under the jurisdiction of the WCIRB, such as billing problems, claims handling, and employment status i.e., whether a worker is an employee or an independent contractor.
Policyholder Ombudsman

If you are an employer, a workers' compensation Policyholder Ombudsman is available to explain the rules and processes making up the workers' compensation insurance system. The Ombudsman is not part of the formal appeal process, and is not an alternative to the services provided by your insurance representative. The Ombudsman can act as an intermediary between you and your insurance company and/or the WCIRB by clarifying issues and putting you in contact with the appropriate individuals. The Ombudsman is not permitted to be an advocate for any of the parties involved, nor does the Ombudsman have direct authority to implement changes.
California state law defines the Policyholder Ombudsman's position as an employee of the WCIRB who provides information and assistance to policyholders. The position receives guidance from an oversight committee comprised of an insurer, an employer representative, and a representative of the California Department of Insurance, who chairs the committee.