Web• Submit this form, via fax to 1-866-336-8352, or send it to your local BWC customer service office. Settlement Agreement and Application for. Approval of Settlement Agreement. for state-fund claims only. BWC-1372 (Rev. Sept. 2, 2024) C-240 WebIf you need assistance comp leting this form, contact your agent, broker, or insurance company. b) Application mu st be received by the Rating ... Compensation Insurance Rating Board, 733 Third Avenue, 4 th floor, New York, NY 10017 Attention: Audit Division. When submitting via email or regular mail please make sure the application is signed ...
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Webnew york fillable c240 STATE OF NEW YORK THIS AGENCY EMPLOYS AND SERVES PEOPLE WITH DISABILITIES WITHOUT DISCRIMINATION. WORKERS … WebFor claims and claim-related documents: How To Submit Claims-Related Forms And Documents To WCB Individuals seeking to serve legal papers on the Board should file … bus from aberdeen md to ac
Employers Workers
WebSettlement Agreement and Application for Approval of Settlement Agreement. (C-240) Introduction. A settlement is an agreement between the employer, the injured worker, and BWC for a specific amount of money to settle one or more claims. When a claim is fully settled, the injured worker receives a lump sum payment. Web• You must complete this form in its entirety, including the correct claim number. • You must file a separate authorization for each claim and for each application, motion or order. BWC will not honor an authorization that is not completed in its entirety, is altered but not initialed by the party altering the form or is not timely filed. WebIf you are unable to work because of a non-occupational disease or injury, you may be entitled to disability benefits. Employer’s Statement of Wage Earnings Form C-240. This … bus from aberdeen to forres