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Questions?
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800-334-2370
Boise
208-332-2100
Claims
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If you have a dispute
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Dispute resolution
Most claims are processed without incident. At times, disputes may arise between you and the State Insurance Fund. If you
disagree with a decision that has been made regarding your claim, you should contact your claims examiner to see if the issue can be
resolved. The examiner will listen to your complaint and review the claim file. The examiner then will notify you if the issue can be
resolved or will tell you your options. Several options for resolving disputes are:
- Lump sum settlement: If there is a dispute between you and the State Insurance Fund regarding your entitlement to benefits, both
parties may agree to a cash settlement. In exchange for a cash settlement, your claim is closed and cannot be reopened. All lump sum
settlements must be approved by the Industrial Commission. This process generally takes one to two months.
- Mediation: Mediation enables the parties to negotiate their disputes in an informal, non-binding atmosphere. An Industrial
Commission mediator facilitates a discussion between you and the State Insurance Fund to work toward an acceptable resolution of the disputed
matters. This process generally takes one to two months.
- Hearing: If the dispute cannot be resolved , you can elect to go through the formal hearing process. This proceeding brings the
dispute before the three Industrial Commissioners or one of the Industrial Commission referees. A hearing date is set for the evidence
and legal arguments to be heard. The Commission will then consider the facts and issue a binding decision. This process generally takes six
months to one year.
Legal representation
The State Insurance Fund will make every effort to resolve any disputes in a fair and equitable manner. If you feel it is necessary,
you have the right to hire an attorney to assist you. Generally, you will be responsible for the cost of your attorney based on state law
and the rules adopted by the Industrial Commission. Once you retain an attorney, legal protocol will require that all communications must be
through your attorney and the Fund can not ethically discuss your claim directly with you.
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