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SWIF Complaint Policy

Purpose:

The purpose of the State Workers Insurance Funds Complaint Policy is to maintain a complete and accurate record of all complaints received by SWIF will be kept on file.

Definition:

A complaint is defined as any written communication primarily expressing a grievance.

Procedure:

All signed written complaints including those from the Legislature, Insurance Commission, PCRB, legal department, policy holders and claimants shall be forwarded to the SWIF Director’s clerical staff at the time they are received. Information forwarded should include:

  • Policy/Claim number/Bill Number
  • Source of complaint (Insurance Commission, Legislature, Claimant, Vendor, Policyholder, Petition, etc.)
  • Complainant name (Name on Policy/Claim/Bill)
  • Nature of complaint
  • Date of complaint received
  • Manner transmitted (mail, email)
  • Complaint resolution
  • Date complaint resolved
  • SWIF Employee name

Clerical staff will maintain a record of all written complaints and resolutions and will be responsible to ensure all complaints are resolved in accordance with applicable statutes, rules, regulations and contract language and the complainant notified within ten (10) business days.