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Third Party's Insurance Company. Third Party's Attorney (If known). Address, Claim No. and Claims Rep. Name and Address ...
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What is bwc subrogation referral form?
The bwc subrogation referral form is a document used to refer potential subrogation claims to the Bureau of Workers' Compensation.
Who is required to file bwc subrogation referral form?
Employers or their representatives are required to file the bwc subrogation referral form.
How to fill out bwc subrogation referral form?
Fill out the form with details of the incident, parties involved, and any known insurance information.
What is the purpose of bwc subrogation referral form?
The purpose of the form is to initiate the process of recovering workers' compensation benefits paid to an injured employee.
What information must be reported on bwc subrogation referral form?
Information such as the employee's name, date of injury, employer's name, and any insurance information must be reported on the form.
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