Special Resources
» Forms:
» Insurance
Download a large number of workers compensation forms. Sample bid package - forms, checklists, etc. used by a university's risk management department. Series of risk management forms and letters. Forms for life & health, property casualty, WC insurance, etc.
Accident Analysis » Accident Investigation
Accident investigation programs, job safey analyses, etc.
Accident Analysis » Claims Investigations
P-C insurance claims checklists, interview statement guides, etc
The following is a checklist of steps to take in the event of loss
Accident Analysis » Injury Codes
Sample injury code tables and related information
Example of a request for proposal for claims processing software
Emergency Management » Business Continuity
Business continuity planning, business recovery post-disaster
Business continuity concerns that should be addressed in the planning process
Emergency Management » Insurance
Flood National Flood Insurance Program documents - flood zones
Fleet Safety » Driver Age
Driving tips for senior drivers and teenagers
Sample form to assist with planning ahead for a time when a person must stop driving
Fleet Safety » Fleet Policies
Sample fleet-related company policies - vehicle use, drivers, seat belts, etc.
Insurance Loss Control » Business Interruption
Contingency planning and business interruption materials
Insurance Loss Control » Construction Insurance
Risk management and insurance related issues in the construction industry
Checklist to audit your construction risk management/insurance programs
Insurance Loss Control » EPL
Employers Professional Liability (EPL) insurance
Self audit related to hiring practices, terminations, etc.
Insurance Loss Control » Hold Harmless
Hold harmless agreements
Full text of a hold harmless agreement and insurance contract requirements used by a state agency
Insurance Loss Control » OCIP
Owner Controlled Insurance Programs (OCIP), construction wrap up materials
Insurance Loss Control » Product Liability
Insurance articles, legal resources related to product liability
To evaluate elements of a product liability risk control program related to product complaints and insurance claims
To evaluate elements of a product liability risk control program related to the design process
A series of yes/no questions to evaluate elements of a product liability risk control program for manufacturers
To evaluate elements of a product liability risk control program related to the manufacturing and distribution stages
To evaluate elements of a product liability risk control program related to sales and advertising
To evaluate elements of a product liability risk control program related to product recall planning
To evaluate elements of a product liability risk control program related to the product recall process
For those that manufacture, import, distribute, retail or sell consumer products
Insurance Loss Control » Property Insurance
Property insurance and risk management
The following is a checklist that should help determine your loss preparedness
Insurance Loss Control » Reinsurance
Resources related to property casualty reinsurance
Reinsurance specific arbitration and mediation information - such as sample forms
Insurance Loss Control » Risk Control Programs
Full text of risk management policy and procedure manuals
This program helps state agencies develop a Risk Management culture to increase safety awareness and reduce claims
Recommended elements of a safety and loss control program for state agencies - forms, checklists
Insurance Loss Control » Risk Management Dept
Home pages of risk management departments
Serving Insurance and Risk Management Needs of Connecticut State Agencies, Colleges, Universities
Internet » Cyberliability
Insurance coverage issues for internet liability
Covers intellectual property, privacy, and communications liability
Job Analysis » Job Accommodations
Creating job accommodations for the disabled and injured employees
Steps to take for accommodating an injured employee's return to work
Occupational Medicine » Medicare
Center for Medicare & Medicaid Services - directories, fees, contracts
Forms for wheelchairs, hospital beds, infusion pumps, etc
Information for physicians, health care professionals, researchers, etc.
Safety Forms » RFP
How to write and respond to a Request for Proposal (RFP)
Full text of a sample RFP for expert advice regarding risk financing for liability & WC
Full text of a sample RFP for a claims audit and actuarial study
Full text of a sample RFP used by a municipality for TPA services
16 page sample request for proposal for a Third Party Administrator for WC
Safety Forms » Risk Management
Library of forms used by the risk management department, sample RFPs
Summary of the state regulations and sample standard forms
Insurance & liability forms in use by a major university
Checklist provides a snapshot into the many action items that must be faced on a major claim
Checklist for collecting information about the WC claim
What to do in the event of a property loss
Internal audit report form - claims management internal control questionnarre
Application forms from a commercial lines carrier - listed by insurance program
Rating basis by line of coverage - includes instructions and forms
Example of the guidelines/form used by the State of Idaho for state owned buildings
Review procedures for accuracy of claim payments and efficiency of operation
Sample form used by insurance brokers in Idaho to disclose broker service fees to clients
Checklist for auditing a firm's insurance risk management program
Checklist designed to help you evaluate your insurance carrier's safety services
Gather the information claim representatives are most likely to need when a claim is reported
General and motor vehicle claims audit procedures checklist (pdf)
For consumers insurance claims - homeowners, auto, travel, health, life, etc
Checklist of sources for policies or secondary evidence of coverage
Property/casualty insurance risks that arise out of fortuitous events
A sample audit with focus on self-insured medical plan and prescription drug plan
Full text of a sample risk transfer clause for use in a construction contract
Full text of a sample risk transfer clause for use in a construction contract involving hazmat
Model risk transfer agreement for facilities use
For claims related to injury to person or damage to personal property presented to a city
17 page internal controls audit for property and casualty insurance operations (pdf)
Includes risk management forms as well as the full text of the manual
Step by step process of conducting an audit of a risk management department with commercial insurance responsibilities
A series of risk management forms in use by a major university in Canada
Checklist for conducting and insurance risk management program audit
A facility inspection guidebook for performing a facility audit for due diligence
View a variety of risk management forms in use by a California university
Full text of risk management forms in use by a major university
Includes typical claims administration questionnaires and WC policy forms
Safety Forms » Safety Audits
Regulatory compliance self-inspections, program audits, self-evaluations
A sample program audit checklist used by a state to evaluate their state agency loss control programs
Safety Forms » Safety Forms
Forms used by safety departments
Safety Forms » WC Forms
Download state workers compensation forms such as first report of injury
Download Alaska workers compensation forms, first report of injury and more
Nearly 20 different workers compensation forms for the state of Arkansas may be downloaded
Workers comp forms, self-insured forms, ADOSH forms and more
Download workers compensation forms for the state of California self-insureds
Download physician and employer first report of injury forms, etc for the state of California
Download a set of WC forms for the state of California
Example of an attachment to First Notice of Loss when employer doubts injury has occurred
Large number of forms from the Connecticut Workers Compensation Commission
Download the commonly used workers compensation forms for Florida
Download a large number of workers compensation forms for the state of Georgia
Also provides statutory filing requirements
Download WC forms for the state of Idaho
Download a large number of WC forms for the state of Kansas
Download Kansas WC self-insurance application forms - spreadsheets
Download forms used for workers compensation in Kentucky
Download WC forms for the state of Louisiana
Download WC forms for the state of Massachusetts
Download WC forms, including the Employers Basic Report of Injury
Download frequently used workers compensation forms
Download legal forms for the Workers Compensation Court of Montana
Download forms required for workers compensation in North Carolina
Download forms related to workers compensation in Nebraska
Download workers compensation forms for the state of New Jersey
Download workers compensation forms for the state of New Mexico
Download commonly used forms required for WC in the state of New York
Download IME forms for the state of New York
Download a very large number of workers compensation forms for Oregon
Download WC forms for the State of Rhode Island
Download a series of workers compensation forms for the state of South Carolina
Download WC forms including First Report of Injury for South Dakota
Download a series of workers compensation forms for the state of Tennessee
OWCP forms for federal workers to apply for workers compensation benefits under Black Lung benefits
Claims forms for benefits under the Energy Employees Occupational Illness Compensation Program Act
OWCP forms for federal workers to apply for workers compensation benefits
OWCP forms for federal workers to apply for workers compensation benefits under Longshore benefits
Download WC forms for the state of Virginia - self-insurance forms, etc
Access a variety of forms (e.g., first report of injury) related to workers compensation
The following forms are approved for use in West Virginia workers compensation claims
Security » Business Security
Crime-free workplace, corporate security, business protection from burglary
Security checklist with a focus on retail jewelry sales crime loss prevention
Specific Industries » Public Sector Safety
Safety materials for local and municipal governments
15 chapter manual for municipalities, county governments, state agencies, etc.
US State Laws » AK-Alaska
Access to state agencies and laws for the state of Alaska
Series of documents, forms, etc. related to self-insurance in the State of Alaska
US State Laws » AZ-Arizona
Access to state agencies and laws for the state of Arizona
Download WC forms for self-insured employers in the State of Arizona
US State Laws » CT-Connecticut
Access to state agencies and laws for the state of Connecticut
Information package for employers wishing to self-insure their WC liabilities - includes forms
US State Laws » IN-Indiana
Access to state agencies and laws for the state of Indiana
US State Laws » LA-Louisiana
Access to state agencies and laws for the state of Louisiana
Download the application to become self-insured for WC in LA
US State Laws » MO-Missouri
Access to state agencies and laws for the state of Missouri
Information and forms for the Missouri self-insurance program for WC
US State Laws » NH-New Hampshire
Access to state agencies and laws for the state of New Hampshire
Provides links to the WC self-insurance laws and can download the self-insurance application
US State Laws » NY-New York
Access to state agencies and laws for the state of New York
Information for self insuring for workers compensation in the State of New York
US State Laws » OH-Ohio
Access to state agencies and laws for the state of Ohio
US State Laws » WI-Wisconsin
Access to state agencies and laws for the state of Wisconsin
A brief summary of legislative changes to the Worker’s Compensation Act
US State Laws » WV-West Virginia
Access to state agencies and laws for the state of West Virginia
Download forms, checklists and general information about self-insurance in West Virginia
Workers Compensation » WC Federal Laws
Federal workers compensation laws
Workers Compensation » WC Programs
Support materials for implementation of workers compensation programs
Forms, program materials, checklists for state agencies in Nevada
Workers Compensation » WC Return to Work
Managing workers compensation costs by returning injured workers to work
Example of a form to be completed when an injured employee has been off the job for 14 days due to the injury
Full text of WC return to work program for state agencies in Texas - plus, checklist & forms
An explanation of the state of Georgia's RTW program for state employees
Steps for creating a list of duties that can be offered to an injured worker who is returning to work
A sample policy statement to be signed by the injured worker
A sample form that is signed by the injured worker to accepts a modified work assignment (pdf)
Text of a policy that outlines the procedures plus a sample letter to be sent to the injured worker
A form for use in outlining the plan specifications for returning an injured employee to work
Provides essential management information concerning the health status of an injured worker after each physician visit
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