Claims Overview

Over the years, many of our customers have relied on our strength in claims management. We set the standard for excellent service.

Our claims representatives have been trained in various areas of claims handling. We’ll work with you to properly investigate and effectively manage the medical and indemnity costs of your claims.

Providing you with the tools you need

You can best manage claims by being prepared for them. When you receive your Republic Indemnity policy, we’ll give you tools to help you prepare and minimize the impact of worker injury on your business.

You’ll receive a Claims Kit in the mail, which contains:

  • Claim forms to report worker injuries
  • Workers’ compensation materials for employees
  • Required posting notices for your workplace

California policyholders can access the Claims Kit online. It includes claim forms, posting notices, pamphlets, and other California workers’ compensation materials. Forms for other states are available in Claims Forms & Posting Notices.

Report a claim immediately to minimize costs

For an employee, a job-related injury can range from a minor, temporary inconvenience to a major, life-changing event. When an injury occurs, you should:

  • Call 911—in case of a medical emergency.
  • Provide first aid treatment when necessary.
  • Assess whether treatment beyond first aid is needed.
  • Exercise right of medical control when additional treatment is required and where statutes allow.
  • Report all injuries requiring physician assistance to Republic Indemnity so that all claim resources are utilized to help minimize costs. (In some states, including California, state law requires this reporting.)

 What happens when you report an injury?

When you report an injury, a claims representative assigned to your case will guide you through the claims process. For all injuries involving lost time, we’ll initiate our three-point contact. We contact you to verify the information submitted and provide a forum for additional discussion. Then we’ll reach out to the injured employee and treating physician to discuss the course of treatment and the return-to-work process (as necessary). When we issue the first temporary disability payment, we’ll follow up with you to confirm that the employee remains off work and discuss the availability of a modified or alternate work position.

Our in-house teams are staffed with bilingual claims examiners to facilitate communication with your injured employees.

Quality medical treatment

Workers’ compensation provides injured workers with a right to quality medical treatment that needs to be cost effective, providing a cure and/or relief from the injury at a reasonable price.

We work with Kaiser On-the-Job and Networks by Design to provide our California policyholders with access to the Republic Indemnity Company Medical Provider Network (MPN). The network utilizes evidence-based medical treatment guidelines to enhance early return to work and efficient medical care.

You benefit from our Return-To-Work Program

Each day an injured employee is absent adds to the claims cost, with a negative impact on productivity.

Our return-to-work program reduces the time an injured employee is away from the job and mitigates potential increased claims costs that can help improve your bottom line.

You can begin our 10-step program before an injury occurs to help your entire team understand the financial and emotional impact of workplace injuries.

Here’s how injured workers can benefit from the program:

  • It reinforces your commitment to their welfare by providing them with a sense of security and stability, while also promoting a positive self-image.
  • It promotes positive reinforcement for a quick recovery by discouraging the “Disability Syndrome” thought process.
  • It supports the “going to work daily” habit.
  • It allows them to continue to directly contribute to the profitability of your company.


California policyholders

When an employee is injured, the injured worker must be immediately provided with the Employee Information Packet for Injured Worker and the Employee DWC-1 claim form. The pamphlet provided in English and Spanish is included in your Claims Kit. You may also download these forms under Claims Forms & Posting Notices

At the time of a work injury, the injured employee must be referred to a Republic Indemnity Company Medical Provider Network, and the claim must be immediately reported to Republic Indemnity.

Complete the “If A Work Injury Occurs” Posting Notice included in your Claims Kit (or download under Claims Forms & Posting Notices) by filling in the name of the provider selected from the Republic Indemnity Company Medical Provider Network list of contracted providers, which can be obtained by either accessing www.republicmpn.com or by calling 888-545-3795. The Network provides industrial medical clinics that understand Workers’ Compensation regulations, and the importance of early return to work.

You may also contact one of the following Republic Indemnity Claims Representatives for assistance:

Northern California - Fely Ramiro, 415-954-1097
Los Angeles - Mara Broderick, 818-382-1171
San Diego - Delinda Ceccotti, 858-467-7839

Assistance in adhering to the above procedures is appreciated. Failure to do so may jeopardize our rights to effectively utilize the Medical Provider Network.