Workers Compensation
| PENNSYLVANIA INSURANCE COMPANY | |||
| DBA Name: APPLIED ASSURANCE COMPANY | |||
| PO BOX 3646 | |||
| OMAHA, NE 68103-0646 | |||
| 888-421-2111 | |||
| Workers' Compensation Complaint and Requests for Action Contact Information |
| Part 1: Complaints and Requests for Action (CRA) If you are seeking information about your workers' compensation insurance policy, or if you have a dispute with your insurance carrier about how its rating plan was applied to your policy (e.g. a dispute about a classification assignment or experience modification applied to your policy) you must first submit a Complaint and Request for Action (CRA) to the workers' compensation insurance company using the address below. |
| Phone Number: | 402-393-1984 Ext: |
| FAX: | 402-393-8558 |
| E-Mail: | jeffreysilver@silver-law.net |
| WEB Address: | |
| Company Contact: | Jeffrey A. Silver |
| Mailing Address: | P.O. Box 3646 Omaha NE 681030646 |
| Contact Notes: |
| Part 2: Appeals to the Department of Insurance You may appeal your workers' compensation insurance company's written decision on your CRA to the Insurance Commissioner. Mail your appeal to the CDI's Administrative Hearing Bureau, 45 Fremont Street, San Francisco, CA 94105. You also must mail a copy of your appeal to your workers' compensation insurance company using the address below. |
| Phone Number: | 402-393-1984 Ext: |
| FAX: | 402-393-8558 |
| E-Mail: | jeffreysilver@silver-law.net |
| WEB Address: | |
| Company Contact: | Jeffrey A. Silver |
| Mailing Address: | P.O. Box 3646 Omaha NE 681030646 |
| Appeals Notes: |
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