Lines of Business

Workers’ Compensation

Expert and efficient handling has helped us resolve claims with 61 percent less ultimate loss on closed indemnity claims*

Our Workers’ Compensation claims handling supports a partnership approach so employers play a critical role throughout the life of the claim. Success is based upon immediate intervention and proactive guidance to facilitate expeditious return to work. We are able to monitor an effective course of treatment, mitigate the extent of disability through effective return to work practices and reduce the instances of attorney involvement.

  • Immediate involvement in medical recovery and return to work
  • Proactive medical and disability claim management

*As compared to average ultimate projected by WCIRB

CONTACT

P.O. Box 85251
San Diego, CA 92186

TOL 866.671.5042
FAX 619.744.5030
E-MAIL WCInfo@ACMclaims.com

REPORT A CLAIM
ReportAclaim@ACMclaims.com

Hours of Operation
Mon.-Fri. 8:00 AM – 5:00 PM PST

Resources

Medical Provider Networks

Our medical provider network (MPN) provides a group of health care providers to treat workers injured on the job.

  California Contractors Network, Inc.

 *Kaiser On-the-Job Model of Care

  CRMBC

 *Kaiser On-the-Job Model of Care

  DS Services
  El Camino Hospital
  Everest National Insurance Company
  Glatfelter Public Practice

 *Kaiser On-the-Job Model of Care

  • MunichRe – Glatfelter (GPP) American Alternative Ins. Corp. (AAIC)
  • MunichRe – Glatfelter (GPP) American Family Home Ins. Corp. (AFHIC)
  • MunichRe – Glatfelter (GPP) American Modern Home Ins. Corp. (AMHIC)
  JT Wimsatt
  Munich Re Companies

 *Kaiser On-the-Job Model of Care

  • American Alternative Insurance Company
  • American Family Home Insurance Company
  • American Modern Home Insurance Company
  Pennsylvania Manufacturers' Association (PMA)

 *Kaiser On-the-Job Model of Care

  • Manufacturers Alliance Insurance Company
  • Pennsylvania Manufacturers Assoc. Insurance Co.
  • Pennsylvania Manufacturers Indemnity Company
  Sparta

 *Kaiser On-the-Job Model of Care

  Tower - Preserver Insurance Company
  United Wisconsin Insurance Company - Accident Fund

 *Kaiser On-the-Job Model of Care

  Work First
  Zurich - American Guarantee & Liability Company

 *Kaiser On-the-Job Model of Care

Medical Provider Network Forms

Forms by state
California MPN forms by company

MunichRe - American Alternative Insurance Company

Covered Employee Notification of Rights – English / Spanish
MPN Implementation Notice to Employees – English / Spanish
Employee Notification Affidavit – English / Spanish
Instructions for Implementing the MPN – English / Spanish
Pre-designation of Personal Physician –  English / Spanish
Pre-designation of Personal Chiropractor or Personal Acupuncturist – English / Spanish

MunichRe - American Family Home Ins. Company

Covered Employee Notification of Rights – English / Spanish
MPN Implementation Notice to Employees – English / Spanish
Employee Notification Affidavit – English / Spanish
Instructions for Implementing the MPN – English / Spanish
Pre-designation of Personal Physician – English / Spanish
Pre-designation of Personal Chiropractor or Personal Acupuncturist – English / Spanish

MunichRe - American Modern Home Ins. Company

Covered Employee Notification of Rights – English / Spanish
MPN Implementation Notice to Employees – English / Spanish
Employee Notification Affidavit – English / Spanish
Instructions for Implementing the MPN – English / Spanish
Pre-designation of Personal Physician – English / Spanish
Pre-designation of Personal Chiropractor or Personal Acupuncturist – English / Spanish

California Contractors Network, Inc.

Covered Employee Notification of Rights – English / Spanish
MPN Implementation Notice to Employees – English / Spanish
Employee Notification Affidavit – English / Spanish
Instructions for Implementing the MPN – English / Spanish
Pre-designation of Personal Physician –  English / Spanish
Pre-designation of Personal Chiropractor or Personal Acupuncturist – English / Spanish

DS Services

Covered Employee Notification of Rights – English / Spanish
MPN Implementation Notice to Employees – English / Spanish
Employee Notification Affidavit – English / Spanish
Instructions for Implementing the MPN – English / Spanish
Pre-designation of Personal Physician –  English / Spanish
Pre-designation of Personal Chiropractor or Personal Acupuncturist – English / Spanish

El Camino Hospital

Covered Employee Notification of Rights – English / Spanish
MPN Implementation Notice to Employees – English / Spanish
Employee Notification Affidavit – English / Spanish
Instructions for Implementing the MPN – English / Spanish
Pre-designation of Personal Physician – English / Spanish
Pre-designation of Personal Chiropractor or Personal Acupuncturist – English / Spanish

Everest National Insurance Company MPN Forms

Medical Provider Packet for Employers, English/Spanish
Initial Written Employee Notification Re: Medical Provider Network, English/Spanish
Pre-designation of Personal Physician – English / Spanish
Pre-designation of Personal Chiropractor or Personal Acupuncturist – English / Spanish

Glatfelter Companies MPN Forms

Covered Employee Notification of Rights – English / Spanish
MPN Implementation Notice to Employees – English / Spanish
Employee Notification Affidavit – English / Spanish
Instructions for Implementing the MPN – English / Spanish
Pre-designation of Personal Physician –  English / Spanish
Pre-designation of Personal Chiropractor or Personal Acupuncturist – English / Spanish

Manufacturers Alliance Ins. Co.

Covered Employee Notification of Rights – English / Spanish
MPN Implementation Notice to Employees – English / Spanish
Employee Notification Affidavit – English / Spanish
Instructions for Implementing the MPN – English / Spanish
Pre-designation of Personal Physician – English / Spanish
Pre-designation of Personal Chiropractor or Personal Acupuncturist – English / Spanish

PMA Insurance Company MPN Forms

Covered Employee Notification of Rights – English / Spanish
MPN Implementation Notice to Employees – English / Spanish
Employee Notification Affidavit – English / Spanish
Instructions for Implementing the MPN – English / Spanish
Pre-designation of Personal Physician – English / Spanish
Pre-designation of Personal Chiropractor or Personal Acupuncturist – English / Spanish

PMA Indemnity Company

Covered Employee Notification of Rights – English / Spanish
MPN Implementation Notice to Employees – English / Spanish
Employee Notification Affidavit – English / Spanish
Instructions for Implementing the MPN – English / Spanish
Pre-designation of Personal Physician –  English / Spanish
Pre-designation of Personal Chiropractor or Personal Acupuncturist – English / Spanish

CRMBC Forms

Covered Employee Notification of Rights – English / Spanish
MPN Implementation Notice to Employees – English / Spanish
Employee Notification Affidavit – English / Spanish
Instructions for Implementing the MPN – English / Spanish
Pre-designation of Personal Physician – English / Spanish
Pre-designation of Personal Chiropractor or Personal Acupuncturist – English / Spanish

Tower Insurance Company MPN Forms

Covered Employee Notification of Rights – English / Spanish
MPN Implementation Notice to Employees – English / Spanish
Employee Notification Affidavit – English / Spanish
Instructions for Implementing the MPN – English / Spanish
Pre-designation of Personal Physician – English / Spanish
Pre-designation of Personal Chiropractor or Personal Acupuncturist – English / Spanish

Sparta Insurance Company MPN Forms

Covered Employee Notification of Rights – English / Spanish
MPN Implementation Notice to Employees – English / Spanish
Employee Notification Affidavit – English / Spanish
Instructions for Implementing the MPN – English / Spanish
Pre-designation of Personal Physician –  English / Spanish
Pre-designation of Personal Chiropractor or Personal Acupuncturist – English / Spanish

United Wisconsin Insurance Company - Accident Fund MPN Forms

Covered Employee Notification of Rights – English / Spanish
MPN Implementation Notice to Employees – English / Spanish
Employee Notification Affidavit – English / Spanish
Instructions for Implementing the MPN – English / Spanish
Pre-designation of Personal Physician –  English / Spanish
Pre-designation of Personal Chiropractor or Personal Acupuncturist – English / Spanish

Work First

Covered Employee Notification of Rights – English / Spanish
MPN Implementation Notice to Employees – English / Spanish
Employee Notification Affidavit – English / Spanish
Instructions for Implementing the MPN – English / Spanish
Pre-designation of Personal Physician – English / Spanish
Pre-designation of Personal Chiropractor or Personal Acupuncturist – English / Spanish

Zurich - American Guarantee & Liability Company MPN Forms

Covered Employee Notification of Rights – English / Spanish
MPN Implementation Notice to Employees – English / Spanish
Employee Notification Affidavit – English / Spanish
Instructions for Implementing the MPN – English / Spanish
Pre-designation of Personal Physician –  English / Spanish
Pre-designation of Personal Chiropractor or Personal Acupuncturist – English / Spanish

Zurich - American Ins. Co.

Covered Employee Notification of Rights – English / Spanish
MPN Implementation Notice to Employees – English / Spanish
Employee Notification Affidavit – English / Spanish
Instructions for Implementing the MPN – English / Spanish
Pre-designation of Personal Physician –  English / Spanish
Pre-designation of Personal Chiropractor or Personal Acupuncturist – English / Spanish

  California Contractors Network, Inc.
  CRMBC
  DS Services
  El Camino Hospital
  Everest National Insurance Company
  Glatfelter Public Practice
  • MunichRe – Glatfelter (GPP) American Alternative Ins. Corp. (AAIC)
  • MunichRe – Glatfelter (GPP) American Family Home Ins. Corp. (AFHIC)
  • MunichRe – Glatfelter (GPP) American Modern Home Ins. Corp. (AMHIC)
  Munich Re Companies
  • American Alternative Insurance Company
  • American Family Home Insurance Company
  • American Modern Home Insurance Company
  Pennsylvania Manufacturers' Association (PMA)
  • Manufacturers Alliance Insurance Company (AAIC)
  • Pennsylvania Manufacturers Assoc. Insurance Co. (AFHIC)
  • Pennsylvania Manufacturers Indemnity Company (AMHIC)
  Sparta
  Tower - Preserver Insurance Company
  United Wisconsin Insurance Company - Accident Fund
  Work First
  Zurich - American Guarantee & Liability Company

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