Report a Claim

REPORTING INSTRUCTIONS

The following are instructions on how to report any claims and/or request for medical records.

 

CLAIMS

You should report/send to The Littleton Group the following, immediately or as soon as possible:

  • All claims or demands for money
  • All lawsuits
  • All letters from attorneys
  • All subpoenas
  • All records request
  • All letters from any federal and/or state agencies in relation to fines and penalties, if you have Administrative Procedures Protection insurance coverage included in your policy
  • You will receive a response from The Littleton Group within 24 hours.

 

Form

 

MEDICAL RECORDS

To facilitate prompt and accurate defense of any suit, or the processing of any claim made against you, it is imperative that you either maintain your medical records in English, or when submitting such records to the Claims Administrators the records should first be translated to English.

The Littleton Group Contacts
Adam Payton – Sr. Claims Analyst
Donna Gutierrez – Director of Captive and Healthcare Programs

Address: 1250 S. Capital of Texas Highway Building 1, Suite 550, Austin, TX 78746
Phone: 512-328-4447 or 800-663-4981
Fax: 512-328-2017 or 800-533-4142
E-mail: alf@littleton-group.com
Webpage: www.littleton-group.com/incidentreport.php

 


 

Report Incident

REPORTING INSTRUCTIONS

The following are instructions on how to report any incidents and/or request for medical records.

 

INCIDENTS

NOTE: REPORTING ANY AMOUNT OF INCIDENTS DOES NOT MEAN THAT YOUR PREMIUMS WOULD INCREASE OR YOUR POLICY WOULD BE CANCELLED

Reportable incidents include, but are not limited to the following:

  • Falls, with or without injury
  • Lacerations, skin tears, burns, bruises, etc.
  • Resident to resident abuse
  • Staff to resident abuse
  • Treatment/medication errors
  • Unexplained injury
  • Behavioral occurrences
  • Unexplained or unplanned death
  • Facility-acquired pressure ulcers, ulcers that do not heal or advance in staging
  • Resident/family complaints that cannot be satisfactorily resolved
  • Elopements
  • Severe weight loss
  • Dehydration
  • Facility acquired serious infection

You are required to report all incidents to our Claims Administrators, The Littleton Group, by completing the attached Incident/Claim Report form (please make copies for future use), and sending it to them by either fax, e-mail or regular mail as stated below, or you can go to The Littleton Group site to submit your report.

 

FORM

 

MEDICAL RECORDS

To facilitate prompt and accurate defense of any suit, or the processing of any claim made against you, it is imperative that you either maintain your medical records in English, or when submitting such records to the Claims Administrators the records should first be translated to English.

The Littleton Group Contacts
Adam Payton – Sr. Claims Analyst
Donna Gutierrez – Director of Captive and Healthcare Programs

Address: 1250 S. Capital of Texas Highway Building 1, Suite 550, Austin, TX 78746
Phone: 512-328-4447 or 800-663-4981
Fax: 512-328-2017 or 800-533-4142
E-mail: alf@littleton-group.com
Webpage: www.littleton-group.com/incidentreport.php