Provider:
The Hartford
The Diocese of Raleigh provides a comprehensive workers’ compensation insurance program at no cost to employees. This program covers disability incurred through accident or occupational disease—arising out of, and in the course of, employment—that requires medical, surgical, or hospital treatment. In order to be eligible for workers’ compensation benefits, the injured person must be a paid employee of the Diocese.
Coverage for the Diocese of Raleigh workers’ compensation insurance is being administered by The Hartford. Eligibility for workers’ compensation benefits is determined solely by their representatives.
To report a work related injury or illness, please follow the procedure below:
- All work-related injuries or illnesses should be reported immediately to the employee’s supervisor and a Workers’ Compensation First Notice of Loss Form (Word) must be completed upon report of the injury or illness. The form can be filled out using Microsoft Word. Please note: The NC Form 19 is not required to file a workers’ compensation claim with The Hartford.
- Fax the completed Workers’ Compensation First Notice of Loss Form to Lindsey Chehreh, Human Resources HRIS/Compliance, at 1-866-955-8172 within three days after knowledge of the injury or accident.
- Please keep the original copy of the First Notice of Loss Form on file at your location. The original should be kept in a separate folder with other Workers’ Compensation claims and not in the employee’s file.
- All subsequent bills relating to the claim must be sent to Human Resources HRIS/Compliance following the same procedure as above.
Contact Lindsey Chehreh at 919-821-9727 for questions regarding Workers’ Compensation benefits.