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Frequently asked questions about Nationwide commercial insurance claims
How do I file a claim?
If you have a username and password, you can log in to your online account and file a claim online. No username and password? No problem. You can register at NWsignup.com or call our Claims Center 24/7 at 1-800-421-3535. You can also reach out to your agent to file a claim. Be sure to file your claim immediately following a loss or employee injury.
What do I need to file a claim?
- Contact information for you and others involved
- Your policy information
- The date of the incident
- A description of the injury or damages
- If applicable, claimant or employee name and contact information
If you need additional help, contact your agent, who’s always there to answer any questions.
I just filed my claim – what happens next?
After your claim has been submitted, your claim will be assigned to a claims associate, who will help you manage your claim and handle most of your questions. Claims associates strive for same-day contact after your claim is submitted. Your claims associate will walk you through all aspects of the claims process and may schedule time with you to do an on-site evaluation.
Who do I contact at Nationwide with questions, including questions about my claims settlement?
Please contact your assigned claims associate with any questions. If you cannot remember the name or contact information of your claims associate, please contact our Claims Center: 1-800-421-3535. This line is open 24/7.
How does the claims management process work?
Claims payments are determined by the cause of loss, type and extent of damages and the coverage that was purchased. Following the receipt of a property, auto or general liability claim, a claims associate will review your coverage, investigate the loss and evaluate the damage(s) to determine what the appropriate payment may be under the policy. If a claim involves a covered cause of loss, payment may be issued directly to the policyholder while the claims associate is on-site. If the check is not issued on-site, it is printed and mailed the day after the payment is entered into our claims system.
For a workers’ compensation claim, the claims associate must first determine whether the claim is covered and eligible for compensation, subject to state regulations. Be sure to immediately report your claim in order to set the claims management process in motion.
For third party claims in which a claimant is alleging that you are liable for damage(s), such as a bodily injury or property claim, we will evaluate your coverage, investigate the loss(es), and work toward final determination of the claim outcome, which might be a settlement or denial of the claim.
What happens if property damage affects the operation of my business?
We have an in-house team of accountants to assist in the evaluation of business income claims. If you have business interruption coverage for a covered cause of loss, we will review your financial records and compensate you for any covered lost income and extra expense during the period while your building is being restored.
What is the difference between replacement cost value (RCV) and actual cash value (ACV)?
Replacement cost is the amount it would cost to replace an item with a product of like kind and quality. Actual cash value is equal to the cost to repair or replace your covered property at the time of the loss or damage with material of like kind and quality, subject to a deduction for deterioration, depreciation and obsolescence.
Unless you repair the damages or replace covered property, a replacement cost value policy allows for reimbursement on an actual cash value basis. In that case, depreciation may be applied and will be reflected in your property damage estimate. (Some states require replacement cost value.) You can collect the recoverable depreciation by providing us with documentation, i.e., receipts, photos, invoices, showing that the damages have been repaired or covered property has been replaced.
How is the deductible applied?
Your estimate will show the full cost of repairs or replacement of covered property. The amount of the deductible will be documented as well.
How do you determine the cost to repair or replace my property?
Damages are determined through several means and often are dependent on the type of loss and amount of damage sustained. We will help you determine the amount of damages based upon local repair costs and labor rates using an electronic estimating system. Some claims will require an inspection by one of our field property associates, while other claims may be handled by a desk claims associate through documentation that you submit following a loss.
What if my contractor’s estimate differs from Nationwide’s?
First, show the estimate we provide you to your contractor (this estimate is based on the local market rates for labor and materials). If there are additional damages or differences in pricing, please contact us immediately so that we can reach agreement on the scope and cost of damages before repairs begin.
What is subrogation?
In some situations, a third party may be legally responsible for causing the damage to your property. If this is the case, we may seek reimbursement from the third party for the claim payments we made and for your policy deductible. This is called subrogation. If we pursue subrogation, we may need your assistance in retaining evidence, damaged products or materials.
Why is my mortgage company or other third parties included on my claim check?
Under the terms of your policy, we are required to include listed mortgagees or other payees with an insurable interest in your business on claim payments.
What should I expect if I have a large loss?
Large losses often introduce an increased level of complexity and impact to your business, your family and your employees. To assist you, we have claims associates dedicated to handling large loss claims. They will travel to the loss location and help you through the claims process. For the most complex claims, we have a team of general adjusters who will travel anywhere in the country to inspect and estimate the damages and aid in the management of your claim.
What should I do when an employee is injured?
It is important to educate your employees on workplace injury reporting procedures and train your supervisors on how to report incidents to our claims department. Be sure to report all workplace injuries or illnesses immediately, even if the injury does not require medical treatment. Some state statutes include fines or penalties for employers that fail to report within a prescribed timeframe.
Document any information you receive from the injured employee, such as a written statement, medical treatment provider, contact information and wage information, as well as accident scene information and witness statements. Also, make sure you photograph and/or secure any object that caused the injury (if applicable), and keep in touch with the injured employee to ensure they are being cared for and supported through their return.
If your employee needs emergency medical care, please direct them to the nearest emergency medical facility for treatment. Once the need for emergency care has ended, many states permit employers to direct their injured employees to obtain care with network providers. In some cases, a listing of authorized medical treatment providers must be provided to all employees before an injury occurs. Please refer to our online workers’ compensation toolkit for more information.
What online resources are available to help me manage my workers’ compensation claim?
Our online workers’ compensation toolkit includes state-specific claims department contact information, instructions, and forms for your use. We also provide easy online access to a searchable healthcare provider network.
What should I expect once a workers’ compensation claim has been reported?
Once you submit a claim, and depending on the severity of injury involved, Nationwide may offer medical case management assistance to the injured employee to obtain prompt medical treatment, access to network pharmacy providers, physical therapy and diagnostic vendor partnerships. Our medical provider search tool, your claims associate or the medical case management nurse can assist you with locating network healthcare providers close to an employee’s home or work.
What is temporary total or temporary partial disability?
These are classifications commonly used within state workers’ compensation statutes to define the injured employee’s current work status and the types of benefits that may be due. Work status is determined by a medical treatment provider and indicates whether an injured employee may return to work full- or part-time. It also determines how much physical activity he or she may participate in given his or her injury or medical condition.
What about permanent partial or total disability?
These are classifications commonly used within state workers’ compensation statutes to define the type of benefits due to an injured employee once a medical treatment provider has determined that he or she is medically stable following a work-related injury or medical condition. A medical treatment provider will determine what level of permanent impairment an injured employee may have following the conclusion of medical treatment for a work-related medical condition. Permanent impairment may result in payment to the injured employee. This varies according to state law and the severity of the injury.
What is a return-to-work program?
Return-to-work refers to the return of the injured employee to full- or part-time employment at full duty or less-than-full duty, within medical restrictions, with their current employer. In our return-to-work program, we can partner with you and the treating medical provider to determine what medical restrictions or limitations apply to the injured employee, if any, as well as job availability. When necessary, we also look at alternative job duties or functions that an employee can perform within their physical capabilities following the work injury. We strive to reinstate the worker in their previous role when possible.
What should I do if I am injured at work?
You should immediately report the injury to your supervisor, manager, team leader, health nurse, or human resources department as directed by your employer. Please be prepared to give a detailed report as to how the injury occurred, time of injury, activity being performed, and the severity of the injury. Be sure to indicate whether you believe you may need medical treatment.
What should I expect after my workers’ compensation claim has been submitted?
You will be contacted by one of our claims associates, who will initiate a claim investigation, explain the process of how your claim will be administered, and begin a process of helping to arrange care and treatment for your injuries and assist you in returning to work with your employer. A medical case manager (nurse) may be assigned to your claim in addition to your claims associate. The nurse and claims associate work together to help manage your claim and answer any questions you may have. Feel free to contact either individual if you have questions regarding your claim.
Can I still receive workers’ compensation benefits if the accident was my fault?
It depends upon your state-specific workers’ compensation statutes. Check with your state’s workers’ compensation bureau or insurance commission for more information.
What types of injuries are covered under workers’ compensation?
Most workers’ compensation statutes provide benefits for injuries or illnesses suffered as a result of a specific accident or disease caused by a condition of your employment. Each claim must be investigated for a decision to be made that would entitle you to workers’ compensation benefits for your injury or illness.
What should I do if I am unable to work?
Contact your claims associate for a complete explanation of wage loss benefits that may be available under the state statute that has jurisdiction over your claim.
Can I see my own doctor?
Your claims associate will work with you to select a doctor or healthcare provider in accordance with the applicable state workers’ compensation statutes. You can also search for medical providers within our network through our medical provider search tool.
What information should I bring to my doctor’s appointment?
You should bring the following to your appointment:
- A list of your current medications
- Medical records related to your current injury, if available
- Work status report, if available
Be sure to give your claim number and the mailing address for your medical bills to the provider. If you have questions about these, contact your claims associate for help.
Should I call my claims associate when I visit the doctor?
Yes. It’s important to keep in regular contact with your claims associate and provide a status update after each medical provider visit. Your claims associate can help you through the process, answer your questions, and work with you, your provider and your employer to assist you in your recovery.
If the doctor prescribes medication for my work-related injury, how can I get that medication?
You will receive a prescription card that will allow you to obtain your prescriptions through any participating pharmacy at no cost to you.
What should I do if the doctor prescribes medical equipment, like crutches or a brace, or other medical services like home health care?
You should contact your claims associate to request assistance in coordinating equipment and/or medical services. In most cases, these are provided through one of our vendors, who will contact you to deliver any equipment or schedule home health care visits.
How do my medical bills get paid?
You should provide your claim number and the mailing address for your medical bills to all of the providers providing you with treatment for the work-related injury. If you have questions about these, contact your claims associate for help. All medical bills will be sent to the claims office handling your claim for review and payment when applicable. State requirements for medical payments may vary.
I have a medical case manager (nurse). What is the role of my nurse?
Your nurse will work with you and your claims associate to assist with the coordination, authorization or facilitation of treatment or medical concerns. He or she will advocate on behalf of you and assist in locating a medical provider, changing a medical provider, coordinating care between multiple providers, scheduling treatment, obtaining medical records and otherwise communicating with providers. Your nurse may also assist in the coordination of your return to work.
Will I get paid for the time I miss from work?
If you miss work because of your work-related injury, you will be eligible for wage benefits in accordance with the applicable state workers’ compensation statutes. This will be subject to any waiting period that may apply.
What benefits can I receive from workers’ compensation?
Most state workers’ compensation statutes provide for wage loss benefits and permanent impairment and medical benefits for work-related injuries depending on the severity of your injury.
Do I need to hire an attorney to file a claim?
You are not required to hire an attorney to file a workers’ compensation claim. You should report your injury to your employer immediately to begin the workers’ compensation claims handling process.
What should I do if I am in an accident?
Move your vehicle to a safe location if it is safe to drive and call 911 and/or the police or fire department if needed. Remain calm and be sure to exchange contact and insurance information as well as drivers’ licenses with the other drivers. If one of your employees is involved, be sure to gather their information as well. Avoid discussing fault. If it is safe to do so, take photos of the damage to all vehicles and the location of the accident. If your vehicle is hauling product, you should also file a property claim by logging in and filing the claim on your online account, calling our Claims Center at 1-800-421-3535 or reaching out to your agent.
Should I report the claim if I’m not hurt?
Yes. Because your insurance policy also provides liability protection in the event of a claim against you, the submission of a claim will allow us to begin immediate investigation. Filing the claim regardless of injury also allows Nationwide to both investigate and protect your interests.
What if my vehicle was carrying materials or substances that spilled?
If you or your employee was operating a vehicle that was carrying materials or substances that spilled during the accident, please let us know immediately. In most cases, a local first response team will arrive for cleanup.
How do you determine who is at fault for the accident?
Your claims associate will conduct a thorough investigation to determine which party is at fault for the accident.
What are my options for getting a written appraisal for the damage to my vehicle?
We offer several options:
- We can recommend a repair facility through our On Your Side Auto Repair Network® program if your vehicle qualifies for service at one of our locations; the repair facility can provide you with an appraisal.
- You can obtain a written appraisal at one of our drive-ins if your vehicle qualifies.
- One of our claims associates can provide you with an appraisal.
Where can I get my vehicle repaired?
The choice of repair shops is up to you. You can choose to use your own repair shop or one of our On Your Side repair shops, if your vehicle qualifies. Typically, your vehicle would qualify for On Your Side repair shop service if it is a private passenger vehicle, which would include passenger cars, pickup trucks, vans and SUVs. However, you should reach out to your claims associate to discuss your eligibility for an On Your Side repair shop and your repair shop options.
What is the benefit of using an On Your Side repair shop?
If you choose one of our On Your Side repair shops, the workmanship on appraised and completed repairs is guaranteed for as long as you own or lease your vehicle.
What if I want to use a different repair shop?
You can use a repair shop of your own. Be sure to give the name of your repair shop to your claims associate; your repair shop may be able to send us an electronic copy of the estimate it prepares. If not, your claims associate will ask you to send us a copy of the estimate, which we will need to process your claim. Some claims may require an inspection by an appraiser. We cannot provide the same guarantee of repairs for shops outside of our On Your Side repair shop network.
What is a “non-OEM” part? Do you guarantee the non-OEM parts specified on my repair appraisal?
A “non-OEM” part is a part not manufactured by or for the original equipment manufacturer (OEM) of the vehicle. Yes, we will repair or replace any defective non-OEM part specified on your repair appraisal for as long as you own or lease your vehicle. The use of a non-OEM part will not void the warranty on your vehicle.
Do I have a choice in the selection of parts to be used in the repair of my vehicle?
Yes. You always have a choice as to which parts will be used in the repair of your vehicle. Even if there is a non-OEM part available, you can choose to use an OEM part. You simply pay the difference in cost between the OEM part and the non-OEM part.
Can I get a rental vehicle?
Nationwide may provide rental car coverage for a business auto loss. Please contact your claims associate to discuss whether rental car coverage applies and if so, what your options are for obtaining a rental vehicle.
How will my deductible work?
Your appraisal will show the total cost of repairs related to the accident. Included in the appraisal will be the amount of your deductible, which will be your responsibility to pay to the repair facility. You will pay your deductible to the repair shop when your repairs are complete.
What if my vehicle is a total loss?
If your vehicle is determined to be a total loss, a Nationwide claims associate will review your damage estimate and your vehicle’s condition and discuss options and valuation with you.
What if I am injured and need medical treatment?
If injuries are covered within your policy, we will work directly with your healthcare provider to ensure that your medical bills are paid on time.
Why is my lien-holder’s name on my claims/settlement check?
If you have a loan on your vehicle, your lien-holder has an interest in seeing your vehicle repaired, and we may be required to include them on the payment.
When do I pay the shop for my repairs?
We recommend that you do not pay the shop until the repairs are completed to your satisfaction.
What types of claims are covered under my general liability policy?
General liability insurance policies are designed for the following, although coverage depends upon your individual elections at the time of purchase (check your policy or talk to your agent for more details):
- Liability for bodily injury to customers or other third parties on your premises
- Medical payments for those injured on your premises
- Third-party property damage claims brought against you for claims arising out of your business operations
- Advertising or personal injury
What should I do when I learn of a customer or other third-party accident or injury?
Be sure to immediately report a claim as soon as you become aware of a customer or other third-party accident or injury on your premises.
If someone files a claim or a lawsuit against me or my business, where should I send that information?
If you are served with a lawsuit or claim from a third party, please notify your claims associate immediately. He or she will let you know where to send the information about the claim or lawsuit.
What happens if someone files a claim or a lawsuit against me or my business?
If a third party files a claim or lawsuit against you or your business, we will evaluate your coverage, investigate and review the facts of the claim, and hire counsel to represent your interests if coverage applies. We work with highly skilled and experienced attorneys who are specialists in their field, and we will defend your interests in the event of a third-party claim or lawsuit. Remember that it is important to immediately report a claim to allow us time to hire appropriate counsel if necessary.