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CLAIMS INFORMATION

Workers’ Compensation Claims

If you need to report a new worker's compensation claim, contact your employer or the Texas Department of Insurance's Division of Workers' Compensation.  The TPCIGA cannot accept a first report of injury.

If you need information concerning an existing worker's compensation claim, please contact us.   

The TPCIGA will pay the full amount of a covered claim for statutory workers' compensation benefits.  The claim filing deadline applicable to other types of claims does not apply to claims for worker's compensation benefits under the Texas Workers' Compensation Act or the U.S. Longshoremen's and Harbor Workers' Compensation Act, provided that the claim arises under Coverage A or Part 1 of the policy, and that proper notice was given in accordance with the respective compensation act.  See TPCIGA's Plan of Operation.

Note:  The TPCIGA does not cover employer liability claims for gross negligence, because claims for punitive or exemplary damages are not "covered claims." Unlike claims for statutory benefits, all claims arising under the employer liability coverage of a workers' compensation policy are subject to TPCIGA's claim filing deadline and its $300,000 statutory claim cap.

Forms from the Texas Department of Insurance

Employee Forms

Medical Provider Forms


Links

Workers’ Comp Medical Providers / eBilling

Texas Department of Insurance

TXCOMP - TDI-DWC’s automated system

MyMatrixx - Pharmacy Benefit Management

IMO - Preauthorization

Review Med -Ethos - Bill Review

Claims

Information on this site is not legal advice and is not intended to be a comprehensive statement of the law or of the TPCIGA's policies and procedures.  References to the laws of any jurisdiction are for informational purposes only and are not a substitute for the official version of a statute. TPCIGA makes no warranty as to the accuracy or reliability of the content of this website or other related websites.  


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