A “Sample Letter To Termination Agreement With Workers Compensation Carrier” is a formal way to end an agreement. This usually involves a workers’ compensation claim. You might need this if an injured employee returns to work. It is also needed if a settlement is reached.
Need to write this type of letter? You are in the right place. We are sharing letter templates. These samples will make writing easier.
Our goal is simple. We want to give you clear examples. Use these samples as a starting point. Tailor them to fit your specific situation.
Sample Letter To Termination Agreement With Workers Compensation Carrier
[Your Name/Company Name]
[Your Address]
[City, State, Zip Code]
[Date]
[Workers Compensation Carrier Name]
[Carrier Address]
[City, State, Zip Code]
**Subject: Termination of Workers Compensation Agreement**
Dear [Contact Person Name],
This letter serves as formal notification that [Your Name/Company Name] is terminating our workers compensation agreement, policy number [Policy Number], effective [Date of Termination].
We have secured alternative coverage with [New Insurance Carrier Name], policy number [New Policy Number], effective [Effective Date of New Policy].
Please provide us with written confirmation of this termination and details regarding any necessary final audits or outstanding balances. We also request information on how to obtain proof of prior coverage for our employees, should it be needed in the future.
Thank you for your services.
Sincerely,
[Your Name/Title]
How to Write Letter To Termination Agreement With Workers Compensation Carrier
Subject Line: Clarity is Paramount
- Start with a concise and unambiguous subject line.
- Example: “Termination of Workers Compensation Claim – [Claim Number] – [Employee Name]”
- Ensuring immediate recognition can expedite the processing.
Salutation: Addressing the Right Person
- Identify the correct individual. Initiate contact with a punctual salutation.
- If known, use a direct salutation: “Dear Mr./Ms. [Adjuster’s Last Name],”
- If the adjuster’s name is unknown, use: “To Whom It May Concern:”
Opening Paragraph: Declare Intentions
- State your intent unequivocally.
- Example: “This letter serves as formal notification of our intention to terminate the workers compensation claim associated with [Employee Name], claim number [Claim Number].”
- Be upfront; circumlocution has no place here.
Body: Articulating the Rationale
- Provide a succinct, defensible rationale for termination.
- Reasons could include:
- Employee’s return to work without restrictions.
- Settlement agreement reached and executed.
- Independent Medical Examination (IME) findings deeming the employee fit.
- Example: “This termination is predicated upon [Employee Name]’s full return to work on [Date] without any medical restrictions, as certified by [Doctor’s Name].”
Supporting Documentation: Substantiate Claims
- Mention any enclosed documents that corroborate your request.
- Examples:
- Return-to-work certification
- Settlement agreement
- IME report
- Clearly state: “Attached you will find [Document Name] supporting this termination request.”
Closing Paragraph: Express Anticipation
- Reiterate your request and express anticipation for a swift resolution.
- Example: “We trust that this information is sufficient to process the termination. We anticipate your prompt acknowledgment and closure of this claim.”
- A polite, yet assertive tone is advantageous.
Closing: Professional Sign-Off
- End with a formal closing, demonstrating professionalism.
- Acceptable closings:
- Sincerely,
- Respectfully,
- Yours truly,
- Follow with your full name, title, and contact information.
Frequently Asked Questions: Termination Agreement with Workers’ Compensation Carrier
This section provides answers to common questions regarding sample termination letters for agreements with workers’ compensation carriers.
It is intended for informational purposes only and should not be considered legal advice.
What is a termination agreement with a workers’ compensation carrier?
A termination agreement formally ends the contractual relationship between an employer and a workers’ compensation insurance carrier.
Why would an employer want to terminate an agreement with a workers’ compensation carrier?
Reasons may include securing a more favorable rate with a different carrier, dissatisfaction with the current carrier’s service, or a change in business needs.
What should a termination letter include?
The letter should clearly state the intent to terminate, the effective date of termination, policy numbers, and any specific instructions regarding outstanding claims or audits.
Is there a specific format for a termination letter?
While there’s no legally mandated format, the letter should be professional, concise, and clearly communicate the necessary information. Consult with legal counsel for specific requirements.
When should the termination letter be sent?
The letter should be sent with sufficient notice as stipulated in the existing agreement, typically 30 to 90 days before the desired termination date.