92623 2008 WC IIC REFERENCE
User Manual: 92623
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2008 Worker's Comp Industrial Insurance Carriers - TABLE OF CONTENTS - I. WORKER'S COMP DEPARTMENT OF INDUSTRIAL RELATIONS BRANCH OFFICES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pg. 1a - 3a II. WORKER'S COMP INDUSTRIAL INSURANCE CARRIERS LISTINGS ( A thru Z) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pg. 1 - 31 III. NOTES & COMMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pg. 32 - 33 MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 Fax: (800) 975-1653 Worker's Comp Department of Industrial Relations - BRANCH OFFICES ANAHEIM OFFICE - AHM GOLETA OFFICE - GOL 1661 N. Raymond Ave., Suite 202 6755 Hollister Ave., Suite 100 Anaheim, CA 92801-1162 Goleta, CA 93117-5551 Main: (714) 738-4041 Main: (805) 968-0258 Disability Evaluation Unit: (714) 738-4040 Disability Evaluation Unit: (805) 485-4423 Information & Assistance Unit: (714) 738-4038 Information & Assistance: (805) 968-4158 Rehabilitation Unit: (714) 738-4046 Rehabilitation Unit: (805) 968-7678 SIF Unit: (916) 263-2774 SIF Unit: (916) 263-2774 UEF Claims Unit: (213)-576-7300 UEF Claims Unit: (916) 263-2774 BAKERSFIELD OFFICE - BAK GROVER BEACH OFFICE - GRO 1800 - 30th Street, Suite 100 1562 W. Grand Avenue Bakersfield, CA 93301-1929 Grover Beach, CA 93433-2261 Main: (661) 395-2723 Main: (805) 481-4912 Disability Evaluation Unit: (559) 445-6427 Disability Evaluation Unit: (805) 485-4423 Information & Assistance Unit: (661) 395-2514 Information & Assistance: (805) 481-3296 Rehabilitation Unit: (559) 445-5066 Rehabilition Unit: (805) 968-7678 SIF Unit: (916) 263-2774 SIF Unit: (916) 263-2774 UEF Claims Unit: (510) 286-7067 286 7067 UEF Claims Unit: (916) 263-2774 263 2774 EUREKA OFFICE - URE LONG BEACH OFFICE - LBO 100 "H" Street, Suite 202 300 Oceangate, Room 200 Eureka, CA 95501-0481 Long Beach, CA 90802-4304 Main: (707) 445-6518 Main: (562) 590-5001 Disability Evaluation Unit: (530) 225-3179 Disability Evaluation Unit: (562) 590-5017 Information & Assistance: (707) 441-5723 Information & Assistance: (562) 590-5001 Rehabilitation Unit: (530) 225-2859 Rehabilitation Unit: (562) 590-5033 SIF Unit: (916) 263-2774 SIF Unit: (916) 263-2774 UEF Claims Unit: (916) 263-2774 UEF Claims Unit: (213)-576-7300 FRESNO OFFICE - FRE LOS ANGELES OFFICE - LAO 2550 Mariposa Street, Suite 4078 320 W. Fourth Street, Ninth Floor Fresno, CA 93721-2280 Los Angeles, CA 90013-2329 Main: (559) 445-5051 Main: (213) 576-7426 Disability Evaluation Unit: (559) 445-6427 Audit Unit: (213) 620-2312 Information & Assistance: (559) 445-5355 Disability Evaluation Unit: (213) 576-7426 Reabilitation Unit: (559) 445-5066 Information & Assistance: (213) 576-7389 SIF Unit: (916) 263-2774 SIF Unit: (916) 263-2774 UEF Claims Unit: (510) 286-7067 UEF Claims Unit: (213)-576-7300 MATRIX DOCUMENT IMAGING, INC. www.legal-records.com - [ 1a ] - Toll Free: (800) 737-8840 Fax: (800) 975-1653 Worker's Comp Department of Industrial Relations - BRANCH OFFICES MARINA DEL REY OFFICE - MDR REDDING OFFICE - RDG 4720 Lincoln Blvd., Second Floor 2115 Civic Center Drive., Suite 15 Marina Del Rey, CA 90292 Redding, CA 96001-2740 Main: (310) 482-3868 Main: (530) 225-2845 Disability Evaluation Unit: (310) 482-3868 Disability Evaluation Unit: (530) 225-3179 Information & Assistance: (310) 482-3858 Rehabilitation Unit: (909) 623-8767 Rehabilitation Unit: (310) 482-3858 SIF Unit: (916) 263-2774 SIF Unit: (916) 263-2774 UEF Claims Unit: (916) 263-2774 UEF Claims Unit: (213)-576-7300 RIVERSIDE OFFICE - RIV OAKLAND OFFICE - OAK 3737 Main Street, Suite 300 1515 Clay Street, 6th Floor Riverside, CA 92501-3337 Oakland, CA 94612-1402 Main: (951) 782-4269 Disability Evaluation Unit: (510) 622-2859 Diability Evaluation Unit: (951) 782-4345 Information & Assistance Unit: (510) 622-2861 Information & Assistance Unit: (951) 782-4347 Rehabilitation Unit: (510) 622-2860 Rehabilitation Unit: (951) 782-4867 SIF Unit: (916) 263-2774 SIF Unit: (916) 263-2774 UEF Claims Unit: (510) 286-7067 UEF Claims Unit: (213) 576-7300 OXNARD OFFICE - OXN SACRAMENTO OFFICE - SAC 2220 E. Gonzales Rd., Suite 100 2424 Arden Way, Suite 230 Oxnard, CA 93036-8293 Sacramento, CA 95825-2404 Main: (805) 485-4423 Main: (916) 263-2735 Disability Evaluation Unit: (805) 485-4423 Audit Unit: (916) 263-2710 Information & Assistance Unit: (805) 485-3528 Disability Evaluation Unit: (916) 263-2767 Rehabilitation Unit: (805) 485-3144 Information & Assistance Unit: (916) 263-2741 SIF Unit: (916) 263-2774 SIF Unit: (916) 263-2774 UEF Claims Unit: (213)-576-7300 UEF Claims Unit: (916) 263-2774 POMONA OFFICE - POM SALINAS OFFICE -SAL 732 Corporate Center Drive 1880 North Main Street., Suite 100 and 200 Pomona, CA 91768-2653 Salinas, CA 93906-2037 Main: (909) 623-4301 Main: (831) 443-3060 Disability Evaluation Unit: (909) 623-4301 Disability Evaluation Unit: (831) 443-3222 Disability Evaluation Unit: (530) 225-3179 Information & Assistance Unit: (831) 443-3058 Rehabilitation Unit: (909) 623-8767 Rehabilitation Unit: (831) 443-3021 SIF Unit: (916) 263-2774 SIF Unit: (916) 263-2774 UEF Claims Unit: (213)-576-7300 UEF Claims Unit: (510) 286-7067 MATRIX DOCUMENT IMAGING, INC. www.legal-records.com - [ 2a ] - Toll Free: (800) 737-8840 Fax: (800) 975-1653 Worker's Comp Department of Industrial Relations - BRANCH OFFICES SAN BERNARDINO OFFICE - SBR SANTA ANA - ANA 464 W. Fourth Street, Suite 249 28 Civic Center Plaza., Suite 451 San Bernardino, CA 92401-1426 Santa Ana, CA 92701-4033 Main: (909) 383-4341 Main: (714) 558-4121 Disability Evaluation Unit: (909) 383-6363 Disability Evaluation Unit: (714) 558-4113 ext. 6749 Information & Assistance: (909) 383-4522 Information & Assistance: (714) 558-4597 Rehabilitation Unit: (909) 383-4073 Rehabilitation Unit: (714) 558-4581 SIF Unit: (916) 263-2774 SIF Unit: (916) 263-2774 UEF Claims Unit: (213)-576-7300 UEF Claims Unit: (213) 576-7300 SAN DIEGO OFFICE - SDO SANTA ROSA OFFICE - SRO 7575 Metropolitan Drive, Suite 202 50 "D" Street, Suite 420 San Diego, CA 92108-4424 Santa Rosa, CA 95404-47771 Main: (619) 767-2083 Main: (707) 576-2391 Disability Evaluation Unit: (619) 767-2086 Disability Evaluation Unit: (707) 576-2374 Information & Assistance Unit: (619) 767-2082 Information & Assistance: (707) 576-2452 Rehabilition Unit: (619) 767-2085 Rehabilitation Unit: (415) 703-5031 SIF Unit: (916) 263-2774 SIF Unit: (916) 263-2774 UEF Claims Unit: (213)-576-7300 (213) 576 7300 UEF Claims Unit: (510) 286-7067 286 7067 SAN FRANCISCO OFFICE - SFC STOCKTON OFFICE - STK 455 Golden Gate Ave., 2nd Floor 31 E. Channel St., Room 344 San Francisco, CA 94102-7014 Stockton, CA 95202-2314 Main: (415) 703-5011 Main: (209) 948-7759 Disability Evaluation Unit: (415) 703-5030 Disability Evaluation Unit: (209) 948-3651 Information & Assistance: (415) 703-5020 Information & Assistance: (209) 948-7980 Rehabilitation Unit: (415) 703-5031 Rehabilitation Unit: (916) 263-2930 SIF Unit: (916) 263-2774 SIF Unit: (916) 263-2774 UEF Claims Unit: (510) 286-1067 UEF Claims Unit: (916) 263-2774 SAN JOSE OFFICE - SJO VAN NUYS OFFICE - VNO 100 Paseo de San Antonio., Room 241 6150 Van Nuys Blvd., Suite 105 San Jose, CA 95113-1402 Van Nuys, CA 91401-3370 Main: (408) 277-1246 Main: (818) 901-5367 ext. 3501 Disability Evaluation Unit: (408) 277-2024 Disability Evaluation Unit: (818) 901-5376 ext. 5 Information & Assistance: (408) 277-1292 Info. & Assistance: (818) 901-5367 ext. 3541 Rehabilitation Unit: (408) 277-1102 Rehabilitation Unit: (818) 901-5367 ext. 3601 SIF Unit: (916) 263-2774 SIF Unit: (916) 263-2774 UEF Claims Unit: (510) 286-7067 UEF Claims Unit: (213) 576-7300 MATRIX DOCUMENT IMAGING, INC. www.legal-records.com - [ 3a ] - Toll Free: (800) 737-8840 Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers -AAARLA (See American All -Risk Loss Administrators) AETNA CASUALTY & SURETY COMPANY (See Travelers) ACCA, INC. (See American Commercial Claims Administrators) AID INSURANCE COMPANY (Mutual) (See Allied Insurance) ACCELERATED CLAIMS SERVICES, INC. P.O. Box 14190 Irvine, CA 92623-4190 Main: (714) 647-1120 (Third Party Administrators. Claims Processed by Injured's Name for all of California) AIG DOMESTIC CLAIMS, INC. (Costa Mesa Office) P.O. Box 25978 Shawnee Mission, KS 66225-5978 Main: (714) 4365-5100 (Claims Processed for Central and Southern California) ACCLAIM RISK MANAGEMENT, INC. (See Frank Gates Acclaim, Inc.) AIG DOMESTIC CLAIMS, INC. (San Diego Office) 3131 Camino Del Rio North San Diego, CA 92108 (Mailing Address) P.O. Box 25978 Shawnee Mission, KS 66225-5978 Main: (800) 736-6671 - (619) 688-3700 Fax: (866) 739-6981 (Claims Processed for all of California) ACE USA (Northern California Regional Claims Center) 39300 Civic Center Drive., Suite 300 Fremont, CA 94538 (Mailing Address) P.O. Box 31083 Tampa, FL 33631-3083 Main: (866) 751-3239 751 3239 - (510) 790-4600 790 4600 Fax: (800) 366-0570 (Claims Processed by Employer's name for all Counties North of Bakersfield to the Oregon Stateline) AIG DOMESTIC CLAIMS, INC. (San Ramon Office) P.O. Box 25978 Shawnee Mission, KS 66225-5978 Main: (800) 428-0906 Fax: (925) 901-2200 (Claims Processed for Northern California) ACE USA (Southern California Regional Claims Center) 21860 Burbank Blvd., Suite 200 Woodland Hills, CA 91367 (Mailing Address) P.O. Box 31051 Tampa, FL 33631-3051 Main: (800) 654-5374 - (818) 712-6300 Fax: (800) 350-8299 (Claims Processed by Employer's Name for Orange, Los Angeles, San Diego, Riverside, San Bernardino Ventura, Santa Barbara, Kern Counties, and Hawaii) AIMS ACCLAMATION INSURANCE MANAGEMENT SERVICES P.O. Box 28100 Fresno, CA 93729 Main: (559) 227-9891 Fax: (559) 227-1579 (Third Party Administrators) AIMS ACCLAMATION INSURANCE MANAGEMENT SERVICES P.O. Box 269120 Sacramento, CA 95826-9120 Main: (800) 444-6157 - (916) 563-1900 Fax: (916) 563-1919 (Third Party Administrators) ADMINSURE, INC. 1470 S. Valley Vista Drive., Suite 230 Diamond Bar, CA 91765 Main: (909) 861-0816 (Self Insured Adminstrators. Claims Processed by Employer's Name) ADVENTIST HEALTH SYSTEM WEST P. O. Box 619028 Roseville, CA 95661-9028 Main: (916) 781-4649 Fax: (916) 774-7320 (Self-Insured / Self Administered) AIMS ACCLAMATION INSURANCE MANAGEMENT SERVICES P.O. Box 937 Santa Clarita, CA 91380-0937 Main: (661) 705-2900 Fax: (661) 705-2999 (Third Party Administrators) MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 -(1)- Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers ALASKA NATIONAL INSURANCE COMPANY P.O. Box 193970 San Francisco, CA 94119 Main: (866) 355-2642 - (415) 245-5030 Fax: (415) 248-5035 www.alaskanational.com (Claims Processed by Injured's Name for all of California) AMERICAN ALL-RISK LOSS ADMINISTRATORS AARLA 4274 W. Richert Avenue Fresno, CA 93722 (Mailing Address) P.O. Box 9783 Fresno, CA 93794-9783 Main: (800) 500-3744 - (559) 277-4960 Fax: (559) 277-4961 (Third Party Administrators. Claims Processed by Employer's name for all of California) ALLIANZ GLOBAL CORPORATE & SPECIALTY 2350 Empire Avenue Burbank, CA 91504-3350 (Mailing Address) P.O. Box 7782 Burbank, CA 91510-7782 Main: (818) 260-7500 Fax: (818) 260-7218 (Claims Processed by Injured's Name for all of California) AMERICAN ASSOCIATED INSURANCE COMPANY: AMERICAN AUTO INSURANCE COMPANY (See Fireman's Fund Insurance Companies) AMERICAN CASUALTY COMPANY ALLIED INSURANCE, A MEMBER OF NATIONWIDE INS. 1601 Exposition Blvd. Sacramento, CA 95815 (Mailing Address) 3820 - 109th Street., Dept. 5577 Des Moines, IA 50391-5577 Main: (800) 552-2437 Fax: (800) 742-1341 (Claims Processed by Employer Employer'ss Name for all of California) AMERICAN COMMERCIAL CLAIMS ADMINISTRATORS ACCA, INC. P.O. Box 85479 San Diego, CA 92186-5479 Main: (800) 661-6029 Fax: (800) 661-6984 (Third Party Administrators, Claims Processed by Injured's Name for all of California) AMERICAN COMMERCIAL CLAIMS ADMINISTRATORS ACCA, INC. P.O. Box 881716 San Francisco, CA 94188-1716 Main: (800) 661-6029- (415) 782-3800 Fax: (800) 661-6984 (Third Party Administrators. Claims Processed by Injured's Name for all of California) ALLIED INSURANCE COMPANY (MUTUAL) (See Allied Insurance) ALLSTATE INSURANCE COMPANY (See Specialty Risk Services, LLC) ALPHA FUND 2969 Prospect Park Drive., Suite 250 Rancho Cordova, CA 95670 (Mailing Address) P.O. Box 419068 Rancho Cordova, CA 95741-9068 Main: (800) 655-2667 - (916) 266-6100 Fax: (916) 266-0314 (Self- Insured administrators. Claims Administered for District Hospitals in California) AMERICAN FIRE & CASUALTY COMPANY (See Ohio Casualty Group or Ins. Companies) AMERICAN GUARANTEE & LIABILITY COMPANY (See Zurich North America) AMERICAN HARDWARE INSURANCE GROUP 5605 Green Circle Drive Minnetonka, MN 55343 (Mailing Address) P.O. Box 435 Minneapolis, MN 55440-0435 Main: (800) 544- 8400 Fax: (800) 841- 5339 (Claims Processed by both Employers and Injured's Names for all of California) ALTERNATIVE SERVICE CONCEPTS (ASC) 5620 Birdcage St., Suite 130 Citrus Heights, CA 95610-7691 Main: (800) 640-2264 - (916) 962-3190 Fax: (916) 962-3195 (Third Party Administrators. Claims Processed by both Employer's and Injured's Names) AMERICAN HOME ASSURANCE COMPANY (See AIG Domestic Claims, Inc.) MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 -(2)- Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers AMERICAN INTERNATIONAL ADJUSTMENT CO., INC. (See Broadspire) ASSOCIATION CALIFORNIA HEALTHCARE DISTRICTS (See Alpha Fund) AMERICAN INSURANCE COMPANY (THE) (See Fireman's Fund Insurance Companies) ATHENS ADMINISTRATORS P.O. Box 696 Concord, CA 94522 Main: (866) 826-3535 - (925) 826-1000 Fax: (925) 671-9183 (Claims Processed for all of California) AMERICAN MOTORISTS INSURANCE COMPANY (See Broadspire) AMERICAN PROFESSIONAL RISK SERVICES, INC. P.O. Box 897 Clovis, CA 93613-0897 Main: (559) 299-2571 Fax: (559) 299-2572 (Third Party Administrators) AXIA SERVICES, INC. (See Travelers) -BBEAVER INSURANCE COMPANY (See Cambridge Integrated Services Group, Inc.) AMERICAN PROTECTION INSURANCE COMPANY (See Broadspire) BERKSHIRE HATHAWAY HOMESTATE COMPANIES Worker's Compensation Specialty Division 3452 E. Foothill Blvd., Suite 600 Pasadena, CA 91107 (Mailing Address) P.O. Box 7008 Pasadena, CA 91109 Main: (800) 339-9809 - (626) 356-1700 Fax: (626) 356-1717 AMERON INTERNATIONAL 245 S. Los Robles Avenue Pasadena, CA 91101-2820 (Mailing Address) P.O. Box 7007 Pasadena, CA 91101-7007 Main: (626) 683-4000 (Self-Insured/Self-Administered) APPLIED RISK SERVICES CALIFORNIA INSURANCE COMPANY P.O. Box 3804 Omaha, NE 68103 Main: (877) 234-4424 Fax: (402) 827-7955 (Claims Processed by Employer's Name for all of California) BERKSHIRE HATHAWAY HOMESTATE COMPANIES Worker's Compensation Specialty Division P.O. Box 85479 San Diego, CA 92186-5479 Main: (800) 661-6029 Fax: (866) 820-0398 BERKSHIRE HATHAWAY HOMESTATE COMPANIES Worker's Compensation Specialty Division P.O. Box 881716 San Francisco, CA 94188-1716 Main: (800) 661-6029 - (415) 782-3800 Fax: (800) 661-6984 ARCMI ARKANSAS CLAIMS MANAGEMENT, INC. (See Frank Gates Service Company) [El Dorado Hills] Main: (800) 339-1109 ARGONAUT INSURANCE COMPANY 5250 N. Palm Ave., Suite 210 Fresno, CA 93704 (Mailing Address) P.O Box 563 Fresno, CA 93755 Main: (559) 447-7100 Fax: (559) 447-7180 (Claims Processed by both Employer's and Injured's Names for all of California) ASSOCIATED CLAIMS MANAGEMENT, INC. (See Tristar Risk Management) BIERLY AND ASSOCIATES (See Cambridge Integrated Services Group, Inc.) GREGORY B. BRAGG & ASSOCIATES, INC. 100 E. Cypress Ave., Suite 100 Redding, CA 96000-1749 (Mailing Address) P.O. Box 491749-1749 Redding, CA 96049-1749 Main: (530) 223-2574 Fax: (530) 223-2679 (Third Party Administrators) ASSOCIATED INDEMNITY CORPORATION (See Fireman's Fund Insurance Companies) MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 -(3)- Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers BROADSPIRE P.O. Box 2458 Brea, CA 92822-2458 Main: (866) 780-4075 - (714) 579-8100 Fax: (770) 777-6415 www.choosebroadspire.com (Third Party Administrators. Claims Processed by Employer's Name for all of California) BROADSPIRE (Sacramento Claims Office) 2920 Kilgore Rd., Suite 110 Rancho Cordova, CA 95670 (Mailing Address) P.O. Box 10001 Van Nuys, CA 91410-0001 Main: (866) 817-4354 - (916) 636-4800 Fax: (770) 777-6417 www.choosebroadspire.com (Third Party Administrators. Claims Processed by Employers Name for all of Northern California) BROADSPIRE 1390 Willow Pass Rd., Suite 500 Concord, CA 94520 (Mailing Address) P.O. Box 4124 Concord, CA 94524-4124 Main: (925) 677-3400 Fax: (770) 777-6413 www.choosebroadspire.com (Third Party Administrators. Claims Processed by Employer's Name for Northern California) BROADSPIRE 4180 Ruffin Rd., Suite 185 San Diego, CA 92123 Main: (858) 514-1340 Fax: (770) 777-6420 www.choosebroadspire.com (Third Party Administrators. Claims Processed by Employers Name for all of southern California) BROADSPIRE 9131 Oakdale Avenue Chatsworth, CA 91311 (Mailing Address) P.O. Box 10001 Van Nuys, Nuys CA 91410-0001 Main: (866) 817-4226 - (818) 407-2800 Fax: (770) 777-6468 (Third Party Administrators. Claims Processed by Employers Name for all of California) BROADSPIRE 5 Hutton Centre Drive, Suite 300 Santa Ana, CA 92707 (Mailing Address) P O Box 66017 P.O. Anaheim, CA 92816-6017 Main: (714) 428-7100 Fax: (770) 777-6415 www.choosebroadspire.com (Third Party Administrators. Claims Processed by Employer's Name for Southern California) BROADSPIRE P.O. Box 24016 Fresno, CA 93779 Main: (559) 271-3800 Fax: (559) 274-0270 (Third Party Administrators. Claims Processed by Employers Name for all of California) BUCKEYE CLAIMS ADMINISTRATORS, INC. P.O. Box 3177 Cerritos, CA 90703 Main: (800) 584-8187 - (562) 926-8002 Fax: (562) 926-1254 www.buckeyeclaims.com (Third Party Administrators. Claims Processed by Injured's Name) BROADSPIRE (Rancho Cordova Claims Office) 2920 Kilgore Rd., Suite 100 Rancho Cordova, CA 95670 (Mailing Address) P.O. Box 15810 Sacramento, CA 95852-0810 Main: (916) 851-7500 Fax: (770) 777-6414 www.choosebroadspire.com (Third Party Administrators. Claims Processed by Employer's Name for all of California) -CCALCOMP CALIFORNIA COMPENSATION INSURANCE COMPANY (See Broadspire) CALIFORNIA FAIR SERVICES AUTHORITY P.O. Box 15518 Sacramento, CA 95852-0518 Main: (916) 263-6172 Fax: (916) 263-6159 CALIFORNIA INDEMNITY INSURANCE COMPANY (See GAB Robins) MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 -(4)- Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers CALIFORNIA INSURANCE COMPANY (See Applied Risk Services) CAMBRIDGE INTEGRATED SERVICES GROUP, INC. 5751 Copley Dr., Suite "A" San Diego, CA 92111 (Mailing Address) P.O. Box 719025 San Diego, CA 92171 Main: (800) 327-6072 - (858) 514-1800 Fax: (858) 569-0342 (Third Party Administrators. Claims also processed for Worker's Compensation and Indemnity Company of California, Citation Insurance Company, Fremont Indemnity Company, and Fremont Compensation Insurance Group) CALIFORNIA INSURANCE GUARANTEE ASSOCIATION P.O. Box 29066 Glendale, CA 91209-9066 Main: (818) 844-4300 Fax: (818) 291-1863 www.caiga.org CAMBRIDGE INTEGRATED SERVICES GROUP, INC. 901 Civic Center Dr., Suite 230 Santa Ana, CA 92703-2561 (Mailing Address) P.O. Box 1738 Santa Ana, CA 92702 Main: (714) 547-0955 Fax: (714) 547-0473 (Third Party Administrators) CANNON COCHRAN MANAGEMENT SERVICES, INC. 1800 Sutter St., Suite 200 Concord, CA 94520 Main: (925) 685-0653 Fax: (925) 685-0725 (Third Party Administrators) CAMBRIDGE INTEGRATED SERVICES GROUP, INC. 2300 Clayton Rd., Suite 900 Concord, CA 94520 (Mailing Address) P.O. Box 4142 Concord CA 94524-4142 Concord, Main: (925) 603-5500 Fax: (925) 603-5581, 5502 (Third Party Administrators) CHEVRON CORPORATION 6001 Bollinger Canyon Road San Ramon, CA 94583 (Mailing Address) P.O. Box 6022 San Ramon, Ramon CA 94583-0722 Main: (925) 842-8184 Fax: (925) 842-8185 (Claims Processed for all of California) CAMBRIDGE INTEGRATED SERVICES GROUP, INC. 2923 Bradley Street Pasadena, CA 91107 (Mailing Address) P.O. Box 29106 Glendale, CA 91209-9106 Main: (800) 542-7597 - (626) 296-4200 Fax: (626) 296-4220 (Third Party Administrators) CHUBB GROUP OF INSURANCE COMPANIES 801 S. Figueroa St., Suite 2400 Los Angeles, CA 90017-5556 (Mailing Address) P.O. Box 30850 Los Angeles, CA 90030-0850 Main: (800) 262-4459 - (213) 612-0880 Fax: (213) 612-5746 (Claims Processed by Injured's name for Los Angeles, Ventura, Santa Barbara, Kern, Orange, Riverside, San Bernandino, San Diego and Imperial Counties, plus the states of Arizona and Hawaii) CAMBRIDGE INTEGRATED SERVICES GROUP, INC. 11030 White Rock Rd., Suite 110 Rancho Cordova, CA 95670 (Mailing Address) P.O. Box 15901 Sacramento, CA 95852 Main: (800) 597-7677 - (916) 638-8300 Fax: (916) 635-6431 (Third Party Administrators) CHUBB GROUP OF INSURANCE COMPANIES 5050 Hopyard Rd., Suite 400 Pleasanton, CA 94588 Main: (925) 598-6000 Fax: (925) 598-6146 (Claims Processed by Employer's Name for San Luis Obispo, Tulare and Inyo Counties North to the Oregon Border) CHUBB/PACIFIC INDEMNITY COMPANY (See Chubb Group of Insurance Companies) CIGNA COMPANIES (See ACE USA) MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 -(5)- Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers CITATION INSURANCE COMPANY (See Cambridge Integrated Services Group, Inc. - San Diego office) CITY OF MODESTO 1010 - 10th St., Suite 5600 Modesto, CA 95354 (Mailing Address) P.O. Box 642 Modesto, CA 95353 Main: (209) 577-5411 Fax: (209) 576-7069 (Self-Insured/Self-Administered. Claims Processed by Injured's Name for City of Modesto Employees only) CITY OF ANAHEIM Risk Management Workers' Compensation 201 S. Anaheim Blvd., Suite 1002 Anaheim, CA 92805 Main: (714) 765-5113 Fax: (714) 765-5245 (Self-Insured. Claims Processed for City of Anaheim only) CITY OF OCEANSIDE 300 N. Coast Highway Oceanside, CA 92054-2885 Main: (760) 435-3510 (Self-Insured/Self-Administered) CITY OF BURBANK W/C Risk Management Department 275 E. Olive Avenue Burbank, CA 91502 Main: (818) 238-5010 Fax: (818) 238-5019 (Self-Insured/Self-Administered. Claims Processed for City of Glendale Employee's only) CITY OF PASADENA 100 N. Garfield Ave., Room N123 Pasadena, CA 91109 (Mailing Address) P.O. Box 7115 Pasadena, CA 91109-7215 Main: (626) 744-4362 Fax: (626) 744-4260 (Self-Insured/Self-Administered) CITY OF GLENDALE Risk Management Division/W.C. Section 613 E. Broadway, Room 100 Glendale, CA 91206 Main: (818) 548-2101 (Self-Insured/Self-Administered Claims Processed for (Self-Insured/Self-Administered. City of Glendale Employees only) CITY OF POMONA Workers' Comp. Department 505 S. Garey Avenue Pomona, CA 91766 Main: (909) 620-2291 Fax: (909) 620- 2295 (Self-Insured/Self-Administered) CITY OF HUNTINGTON BEACH Worker's Comp. Department 2000 Main Street Huntington Beach, CA 92648-2702 (Mailing Address) P.O. Box 906 Huntington Beach, CA 92648-0797 Main: (714) 374-5378 Fax: (714) 374-1597 (Self-Insured/Self-Administered) CITY OF REDDING Risk Management 777 Cypress Avenue Redding, CA 96001-2718 Main: (530-225-4348 Fax: (530) 225-4337 (Self-Insured/Self-Administered) CITY OF LONG BEACH Workers' Compensation Office 333 W. Ocean Blvd., Eighth Floor, City Hall Long Beach, CA 90802-4664 Main: (562) 570-2245 Fax: (562) 570-2220 (Self-insured. Claims Processed for City of Long Beach only) CITY OF RIVERSIDE 3780 Market Street Riverside, CA 92501 Main: (951) 826-5559 Fax: (951) 826-2529 (Self-Insured/Self-Administered. Claims Processed by Injured's Name) CITY OF LOS ANGELES Personnel Department Workers' Compensation Division 700 E. Temple St., Room 210 Los Angeles, CA 90012 Main: (213) 473-3400 Fax: (213) 473-3333 (Self-Insured. Claims Processed for all City of Los Angeles Employees except for the Department of Water and Power, and uniformed Fire and Police Employees-TPA) MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 -(6)- Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers CITY OF TORRANCE Human Resources Risk Management Division W/C Program 3231 Torrance Boulevard Torrance, CA 90503-5055 Main: (310) 618-2950 Fax: (310) 618-2927 (Self-Insured/Self-Administered) CITY OF SANTA ANA W/C Risk Management Department P.O. Box 1988 M-41 Santa Ana, CA 92702 Main: (714) 647-6942 (Self-Insured/Self-Administered) CITY OF SIMI VALLEY 2929 Tapo Canyon Road Simi Valley, CA 93063 Main: (805) 583-6394 (Self-Insured/Self-Administered. Claims Processed by Injured's Name for Los Angeles and Ventura Counties) CITY OF SACRAMENTO Workers Compensation HR Dept. City Hall 915 "I" St., Fourth Floor Sacramento, CA 95814-2604 Main: (916) 808-5741 Fax: (916) 808-8216 Email: eyoung@cityofsacrament.org (Self-Insured/Self-Administered) CLAIMQUEST, INC. 675 Brea Canyon Rd., Suite 4 Walnut, CA 91789 Main: (909) 594-9400 Fax: (909) 594-5544 (Third Party Administrators. Claims Processed by Employer's Name for all Counties) CITY OF SAN BERNARDINO Risk Management Department 300 N. "D" Street San Bernardino, CA 92418-0001 Main: (909) 384-5173 (Self-Insured. Claims Processed for City of San Bernardino and City of San Bernardino Water Department) CLAIMS MANAGEMENT, INC. P.O. Box 16339 Fresno, CA 93755-6339 Main: (559) 221-2820 Fax: (559) 222-7453 (Third Party Administrators) CITY OF SAN DIEGO Risk Management Department 1200 Third Ave., Suite 1000 San Diego, CA 92101 (Mailing Address) P.O. Box 129013 San Diego, CA 92112 -9013 Main: (619) 236-6395 Fax: (619) 236-6106 (Self-Insured/Self-Administered. Claims Processed for City of San Diego Only) CLAIMS MANAGEMENT, INC. 2868 Prospect Park Dr., Suite 600 Rancho Cordova, CA 95670 (Mailing Address) P.O. Box 3042 Sacramento, CA 95812-3042 Main: (916) 631-1250 Fax: (916) 635-6288 (Third Party Administrators) CITY AND COUNTY OF SAN FRANCISCO W/C Division 30 Van Ness Ave., Suite 3300 San Francisco, CA 94102 Main: (415) 575-5600 (Self-Insured/Self-Administered) CLAIMS SOLUTIONS (See LWP Claims Solutions, Inc.) CLARENDON NATIONAL INSURANCE COMPANY (See American All-Risk Loss Administrators) C.N.A. STANDARD LINES Claims 675 Placentia Avenue Brea, CA 92821-6167 (Mailing Address) P.O. Box 6500 Brea, CA 92822-6500 Main: (800) 262-8714 - (714) 255-7300 Fax: (714) 255-2554 www.cnacentral.com (Claims Processed by Employer's Name for Southern California) CITY OF SAN JOSE W/C Risk Management 200 E. Santa Clara Street San Jose, CA 95113-1903 Main: (408) 535-1285 Fax: (408) 292-6447 (Self-Insured. Claims Processed for City of San Jose Only) MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 -(7)- Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers C.N.A. STANDARD LINES CLAIMS 405 Howard St., Suite 600 San Francisco, CA 94105 (Mailing Address) P.O. Box 880670 San Francisco, CA 94188-0670 Main: (415) 932-7500 Fax: (415) 932-7454 www.cnacentral.com (Claims Processed by Employer's Name for Northern California) COUNTY OF KERN Kern County Risk Management 1115 Truxtun Ave., Fourth Floor Bakersfield, CA 93301-4639 Main: (661) 868-3801 Fax: (661) 868-3875 (Self-Insured/Self-Administered. Claims Processed by Injured's Name for Kern County) COUNTY OF LOS ANGELES Risk Management Branch Workers' Compensation Program 3333 Wilshire Blvd., Suite 820 Los Angeles, CA 90010 Main: (213) 738-2154 Fax: (213) 252-0404 (Claims Processed by the following Third Party Administrators: Tristar Risk Management*, Intercare Insurance Services**, and AIMS***) *Tristar Risk Management, (Irvine) P.O. Box 19775 Irvine, CA 92623-9775 Main: (800) 782-5888 *Tristar Risk Management (Santa Ana) P.O. Box 11967 Santa Ana, CA 92711-1967 Main: (800) 377-3487 **Intercare Insurance Services (Orange) P.O. Box 14243 Orange, CA 92863-4243 Main: (866) 221-2968 *** AIMS (Santa Clarita) P.O. Box 937 Santa Clarita, CA 91380-0937 Main: (866) 511-2467 (The above TPA's are also listed in the book) COLEN AND LEE (See AdminSure, Inc.) COMCO MANAGEMENT, INC. P.O. Box 577 Sierra Madre, CA 91025-0577 Main: (800) 788-2662 - (626) 836-5817 Fax: (626) 836-5827 (Self-Insured Administrators. Claims Processed by Employer's Name) COMPLINK 2100 Main St., Suite 350 Irvine CA 92614-9265 Irvine, (Mailing Address) P.O. Box 19619 Irvine, CA 92623-9619 Main: (949) 852-4871 Fax: (949) 223-0657 (Third Party Administrators) CONSTITUTION STATE SERVICE COMPANY (See Travelers) CONTINENTAL CASUALTY COMPANY (See CNA) COUNTY OF RIVERSIDE Workers' Compensation Division P.O. Box 1120 Riverside, CA 92502 Main: (951) 955-3530 (Self-Insured. Claims Processed by Injured's Name for Riverside County Employees only) CONTINENTAL LOSS ADJUSTING SERVICES (See CNA) CONTINENTAL RISK MANAGEMENT SERVICES (See CNA]) COUNTY OF SACRAMENTO P.O. Box 276130 Sacramento, CA 95827 Main: (916) 876-5251 (Self-Insured/Self-Administered) CONTRA COSTA COUNTY Risk Management Division 2530 Arnold Dr., Suite 140 Martinez, CA 94553 Main: (925) 335-1400 Fax: (925) 335-1420 (Self-Insured. Claims Processed by Injured's Name for County of Contra Costa) MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 -(8)- Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers COUNTY OF SAN BERNARDINO Department of Risk Management 222 W. Hospitality Lane, Third Floor San Bernardino, CA 92415-0016 Main: (909) 386-8655 Fax: (909) 386-8711 (Self-Insured. Claims Processed by Department for County of San Bernardino) CRAWFORD & COMPANY INSURANCE ADJUSTERS 900 E. Washington St., Suite 350 Colton, CA 92324 Main: (909) 825-8730 Fax: (909) 825-5349 (Claims Processed by Employer's Name for Riverside and San Bernardino Counties) CRAWFORD & COMPANY INSURANCE ADJUSTERS 1515 W. 190th St., Suite 500 Gardena, CA 90248 Main: (310) 380-6000 Fax: (310) 380-6029 (Claims Processed by both Employer's and Injured's Name for all of California) COUNTY OF SAN DIEGO - DHR Workers' Compensation Office 444. W. Beech St., Third Floor San Diego, CA 92101-2942 Main: (619) 578-5700 Fax: (619) 578-5740 (Self-Insured/Self-Administered. Claims Processed by Injured's Name for County of San Diego) CRAWFORD & COMPANY INSURANCE ADJUSTERS 1900 Alameda De Las Pulgas, Suite 103 San Mateo, CA 94403 Main: (650) 357-6242 Fax: (650) 357-8983 (Claims Processed by both Employer's and Injured's Names for San Francisco, San Mateo, Marin, Sonoma and Solano Counties) COUNTY OF SANTA BARBARA W/C Risk Management Department 1 E. Anapamu St., Second Floor Santa Barbara, CA 93101-2704 Main: (805) 884-6860 Fax: (805) 884-6861 (Self-Insured/Self-Administered) CRUM & FORSTER UNITED STATES FIRE INSURANCE COMPANY THE NORTH RIVER INSURANCE COMPANY One City Blvd. West, Suite 350 Orange, CA 92868 (Mailing Address) P.O. Box 14217 Orange, CA 92863 Main: (714) 244-1023 Fax: (714) 244-1050 (Claims Processed for All of California) COUNTY OF SANTA CLARA Workers' Compensation Division 2310 N. First St., Suite 205 San Jose, CA 95131-1032 Main: (408) 441-4300 (Self-Insured. Claims Processed by Injured's Name for Santa Clara and Santa Clara County Central Fire District) COUNTY OF SHASTA 1450 Court St., Room 348 Redding, CA 96001-1676 Main: (530) 225-5141 Fax: (530) 225-5251 (Self-Insured/Self-Administered) CUNNINGHAM LINDSEY U.S., INC. (See Broadspire) CYPRESS INSURANCE COMPANY (See Berkshire Hathaway Homestate Companies [BHHC] ) COUNTY SANITATION DISTRICTS OF THE COUNTY OF LOS ANGELES 1955 Workman Mill Road Whittier, CA 90601 (Mailing Address) P.O. Box 4998 Whittier, CA 90607-4998 Main: (562) 699-7411 Fax: (562) 692-3056 (Claims Processed by Injured Employee's Name and Date of Injury for the County Sanitation Districts of Los Angeles County) -DDANIELSON NATIONAL INSURANCE COMPANY (See Tristar Risk Management - Los Angeles) JOHN DEERE INSURANCE COMPANY (See Sentry Insurance) MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 -(9)- Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers DEPARTMENT OF WATER AND POWER City of Los Angeles Workers' Compensation Section 111 N. Hope St., Room 553 Los Angeles, CA 90012 (Mailing Address) P.O. Box 51111, Room 553 Los Angeles, CA 90051-0100 Main: (213) 367-1942 Fax: (213) 367-3636 (Self-Insured) EMPLOYERS INSURANCE OF WAUSAU (See Wausau Insurance Companies) EOS / GROUP (See Tristar Risk Management) ESIS, INC. (See ACE USA) EVEREST NATIONAL INSURANCE COMPANY 1111 Broadway, Suite 2050 Oakland, CA 94607 (Mailing Address) P.O. Box 70160 Oakland, CA 94612-0160 Main: (800) 529-1354 Fax: (510) 267-0752 (Claims Processed for All of California) THE WALT DISNEY COMPANY Workers' Compensation 700 W. Ball Road Anaheim, CA 92802 (Mailing Address) P.O. Box 3909 Anaheim, CA 92803 Main: (714) 781-1680 Fax: (714) 781-1670 (Self-Insured) EVEREST NATIONAL INSURANCE COMPANY 725 W. Town & Country Rd., 4th Floor Orange, CA 92868 Main: (714) 371-9600 Fax: (714) 371-9677 (Claims Processed for All of California) DYNAMIC CLAIMS SERVICES, INC. P.O. Box 29080 Glendale, CA 91209 Main: (818) 247-3662 Fax: (818) 247-7018 (Third Party Administrators) EXPLORER INSURANCE COMPANY (See Insurance Company of the West) -F- -E- FARA / F.A RICHARD & ASSOCIATES 2525 Cherry Ave., Suite 350 Signal Hill, CA 90755-2054 Main: (562) 426-9800 Fax: (562) 426-4848 (Self-Insured Administrators and Independent Adjusters) EAGLE INSURANCE GROUP, INC. (See SeaBright Insurance Company) EMPLOYERS P.O. Box 539004 Henderson, NV 89053-9004 Main: (888) 682-6671 (Claims Processed by Employer's Name for All of California) FARMERS INSURANCE GROUP 11555 Dublin Canyon Rd., 4th Floor Pleasanton, CA 94588 (Mailing Address) P.O. Box 5040 Pleasanton, CA 94566 Main: (925) 847-3141 - Fax: (925) 416-0948 (Same as Truck Insurance Exchange. Claims Processed by Injured's Name for Northern California) EMPLOYERS COMPENSATION INSURANCE COMPANY (See Employers) EMPLOYER'S DIRECT INSURANCE COMPANY P.O. Box 5042 Thousand Oaks, CA 91359-5042 Main: (818) 575-8500 Fax: (818) 575-8575 (Claims Processed by Employer's Name for All of California) FARMERS INSURANCE GROUP 3707 W. Garden Grove Blvd., Ste 202 Orange, CA 92868-4803 (Mailing Address) P. O. Box 928 Santa Ana, Ca 92707-0928 Main: (888) 274-2165 - (714) 740-2165 Fax: (714) 750-1942 (Same as Truck Ins. Exchange. Claims Processed by Injured's Name Orange, San Bernardino, Riverside, San Diego and Imperial Counties) EMPLOYERS FIRST INSURANCE (See Cambridge Integrated Services Group, Inc.) EMPLOYERS INSURANCE GROUP (See Employers) MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 - ( 10 ) - Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers FARMERS INSURANCE GROUP (L.A. Centralized WC Claims Office) 3041 Cochran Street Simi Valley, CA 93065 (Mailing Address) P. O. Box 10149 Van Nuys, CA 91410-0149 Main: (888) 486-1451 - (805) 583-7567 Fax: (805) 583-7467 (Same as Truck Insurance Exchange. Claims Processed by Injured's Name for Los Angeles, Ventura, Santa Barbara and San Luis Obispo Counties) -GGAB BUSINESS SERVICES, INC. (See GAB Robins) GAB ROBINS GAB ROBINS NORTH AMERICA, INC. 100 E. Tujunga Avenue Burbank, CA 91502 (Mailing Address) P. O. Box 7858 Burbank, CA 91510-7858 Main: (800) 841-5297 - (818) 846-5297 Fax: (818) 846-1153 (Claims Processed by Employer's Name for all of California) FREMONT EMPLOYER'S INSURANCE COMPANY (See Employers) FREMONT INDEMNITY COMPANY (See Cambridge Integrated Services Group, Inc. - San Diego Office) GAB ROBINS GAB ROBINS NORTH AMERICA, INC. 3350 Shelby St., Suite 300 Ontario, CA 91764 Main: (909) 980-0498 Fax: (909) 980-0458 (Claims Processed by Employer's Name for all of California) FRYE CLAIMS CONSULTATION & ADMIN. 3500 Breakwater Ct., Bldg., "A" Hayward, CA 94545 Main: (800) 322-3793 - (510) 782-9882 Fax: (800) 455-3793 (Third Party Administrators) GAB ROBINS GAB ROBINS NORTH AMERICA, INC. P O. P. O Box 269037 Sacramento, CA 95827-9037 Main: (916) 853-6600 Fax: (916) 853-8183 (Claims Processed by Employer's Name for all of California) FUNDS INSURANCE COMPANIES (See Fireman Fireman'ss Fund Insurance Companies) F.I.R.M. SOLUTIONS (See Tristar Risk Management) FIRE INSURANCE EXCHANGE (See Farmers Insurance Group) GALLAGHER BASSETT SERVICES, INC. P.O. Box 70003 Anaheim, CA 92825-0003 Main: (714) 938-0172 Fax: (714) 938-1067 (Workers' Compensation Self-Insured Claims Admins.) FIREMAN'S FUND INSURANCE COMPANIES 2995 Prospect Park Dr., Suite 200 Rancho Cordova, CA 95670 (Mailing Address) P. O. Box 13340 Sacramento, CA 95813 Main: (800) 662-3750 Fax: (888) 387-3196 (Claims Processed for All of California) GALLAGHER BASSETT SERVICES, INC. P. O. Box 9875 Calabasas, CA 91372-0875 Main: (818) 746-9925 Fax: (818) 880-4213 (Workers' Compensation Self-Insured Claims Admins.) FIRST NATIONAL INSURANCE COMPANY (See Safeco Insurance Group) GALLAGHER BASSETT SERVICES, INC. P. O. Box 6900 Corona, CA 92878-6900 Main: (951) 279-0073 Fax: (951) 279-6632 (Workers' Compensation Self-Insured Claims Admins.) FOSTER POULTRY FARMS WORKER'S COMPENSATION P. O. Box 277 Livingston, CA 95334-0277 Main: (866) 566-4556 Fax: (209) 668-6613 (Self Insured / Self-Administered) GALLAGHER BASSETT SERVICES, INC. P. O. Box 1390 Elk Grove, CA 95759 Main: (916) 683-5550 (Workers' Compensation Self-Insured Claims Admins.) FREMONT COMPENSATION INSURANCE GROUP (See Cambridge Integrated Services Group Inc.) MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 - ( 11 ) - Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers GALLAGHER BASSETT SERVICES, INC. P. O. Box 2290 Gold River, CA 95741-2290 Main: (916) 403-1600 Fax: (916) 403-1619 (Workers' Compensation Self-Insured Claims Admins. E & J GALLO WINERY 600 Yosemite Boulevard Modesto, CA 95354-9972 (Mailing Address) P.O. Box 1130 Modesto, CA 95353 Main: (209) 341-3782 (Self-Insured / Self-Administered) GALLAGHER BASSETT SERVICES, INC. (Metro Office) P. O. Box 30840 Laguna Hills, CA 92654-0840 Main: (949) 458-0181 Fax: (949) 588-8931 (Workers' Compensation Self-Insured Claims Admins.) FRANK GATES SERVICES COMPANY 2400 E. Katella Ave., Suite 650 Anaheim, CA 92806 Main: (800) 994-4611 - (714) 978-1351 Fax: (714) 978-1651 (Claims Processed by Employer's Name for all of California) GALLAGHER BASSETT SERVICES, INC. P. O. Box 14260 Orange, CA 92863 Main: (714) 939-0877 Fax: (714) 938-1036 (Workers' Compensation Self-Insured Claims Admins. GALLAGHER BASSETT SERVICES, INC. P. O. Box 4200 Rancho Cucamonga, CA 91729-4200 Main: (866) 517-6782 - (909) 581-1919 Fax: (909) 581-1996 (Workers' Compensation Self-Insured Claims Admins.) FRANK GATES SERVICE COMPANY P.O. Box 4530 El Dorado Hills, CA 95762-0020 Main: (916) 939-8011 Fax: (916) 939-8230 (Claims Processed by Employer's Name for all of California. For Wal-Mart and Sam's Club, Mail Claim to: P.O. Box 1288 Bentonville, AR 72712) Main: (800) 339-1109 Fax: (479) 204-9537 (Third Party Admistrators) GALLAGHER BASSETT SERVICES, INC. P. O. Box 4040 Sacramento, CA 95812-4040 Main: (866) 481-0962 - (916) 576-8200 Fax: (916) 576-8206 (Workers' Compensation Self-Insured Claims Admins.) FRANK GATES ACCLAIM, INC. 19800 MacArthur Blvd., Suite 430 Irvine, CA 92612-8441 Main: (800) 337-0314 - (949) 851-8955 Fax: (949) 851-8960 (Third Party Admistrators) GALLAGHER BASSETT SERVICES, INC. (Regional Office) P. O. Box 255397 Sacramento, CA 95865-5397 Main: (916) 929-7581 Fax: (916) 929-3791 (Workers' Compensation Self-Insured Claims Admins.) FRANK GATES ACCLAIM, INC. P.O. Box 120431 San Diego, CA 92112-0431 Main: (619) 595-0255 Fax: (619) 595-1689 (Third Party Admistrators) GATES, McDONALD & COMPANY (See Cambridge Integrated Services Group, INC. Concord and Santa Ana offices) GALLAGHER BASSETT SERVICES, INC. P. O. Box 85013 San Diego, CA 92186-5013 Main: (619) 471-1219 Fax: (619) 471-1250 (Workers' Compensation Self-Insured Claims Admins.) GENERAL ELECTRIC COMPANY (See Sedgwick, CMS) GENERAL INSURANCE COMPANY OF AMERICA (See Safeco Insurance Group) GALLAGHER BASSETT SERCVICES, INC. P.O. Box 4511 Woodland Hills, CA 91365-4511 Main: (818) 226-9071 Fax: (818) 226-9982 (Workers' Compensation Self-Insured Claims Admins.) GOLDEN EAGLE INSURANCE CORPORATION (See Liberty Mutual Insurance Company - Orange office) GRANITE STATE INSURANCE COMPANY (See AIG Domestic Claims, Inc.) MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 - ( 12 ) - Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers -H- GREAT AMERICAN INSURANCE COMPANY (Walnut Creek Office) P.O. Box 5432 Cincinnati, OH 45201-5432 Main: (800) 759-0036 Fax: (888) 223-1317 (Claimes Processed for the State of California and Arizona) HAMMERMAN & GAINER, INC. P.O. Box 368 Banning, CA 92220 Main: (951) 922-2828 Fax: (951) 922-2016 (Third Party Administrators) GREAT STATES INSURANCE COMPANY (See Intercare Insurance Services) THE HARTFORD HARTFORD ACCIDENT & INDEMNITY COMPANY 12009 Foundation Place Rancho Cordova, CA 95670 (Mailing Address) P.O. Box 13835 Sacramento, CA 95853-4835 Main: (866) 401-9222 - (916) 294-1000 Fax: (916) 294-1600 GREGORY B. BRAGG & ASSOCIATES, INC. One Sierra Gate Plaza, Suite 250B Roseville, CA 95678 (Mailing Address) P.O. Box 619058 Roseville, CA 95661-9058 Main: (800) 422-7244 - (916) 783-0100 Fax: (916) 783-0338 (Third Party Administrators) HARTFORD INSURANCE GROUP (See The Hartford) GREGORY B. BRAGG & ASSOCIATES, INC. 4512 Feather River Dr., Suite B Stockton, CA 95219 (Mailing Address) P.O. Box 7245 Stockton CA 95267-0245 Stockton, Main: (209) 956-2119 Fax: (209) 956-2638 (Third Party Administrators) (See Cambridge Integrated Services Group, Inc.) HAZELRIGG RISK MANAGEMENT SERVICES, INC. (See HRMS / A Corvel Company) C.E. HEATH COMPENSATION & LIABILITY INSURANCE COMPANY (See Intercare Insurance Services) HEALTHCARE ALLICANCE CORPORATION (See Alpha Fund) GREGORY B. BRAGG & ASSOCIATES, INC. 150 N. Wiget Lane, Suite 212 Walnut Creek, CA 94598 (Mailing Address) P.O. Box 5372 Walnut Creek, CA 94596-5372 Main: (925) 933-2992 Fax: (925) 933-2994 (Third Party Administrators) HELMSMAN MANAGEMENT SERVICES, INC. (See Liberty Mutual Insurance Company) HERTZ CLAIM MANAGEMENT (See Cambridge Integrated Services Group, Inc.) HIH INSURANCE (See Intercare Insurance Services) HOME INDEMNITY COMPANY (See Risk Enterprise Management Limited) GROCERS AND MERCHANTS INSURANCE SERVICE (See Springfield Insurance Company / GMIS) HOME INSURANCE COMPANY (See Risk Enterprise Management Limited) GUIDEONE INSURANCE 2351 Sunset Blvd., Suite 170, PMB # 305 Rocklin, CA 95765 Main: (800) 647-9324 - (916) 624-3288 Fax: (800) 676-4457 HOME INSURANCE COMPANY, NEW YORK (See Risk Enterprise Management Limited) HRMS / A CORVEL COMPANY 751 E. Daily Dr., Suite 400 Camarillo, CA 93010 (Mailing Address) P.O. Box 5166 Oxnard, CA 93031 Main: (866) 785-2835 - (805) 389-4200 (Third Party Administrators) GULF INSURANCE COMPANY (See Travelers (800) 994-3890) MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 - ( 13 ) - Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers HRMS / A CORVEL COMPANY 14275 Pipeline Avenue Chino, CA 91710 (Mailing Address) P.O. Box 669 Chino, CA 91708 Main: (805) 993-0340 Fax: (909) 627-9751 (Third Party Administrators) INNOVATIVE CLAIM SOLUTIONS, INC. P.O. Box 5128 San Ramon, CA 94583-5138 Main: (925) 327-8050 Fax: (925) 327-8078 (Third Party Administrators) INTERCARE INSURANCE SERVICES 1120 Forest Ave., Box 339 Pacific Grove, CA 93950 Main: (831) 655-2155 Fax: (831) 655-2755 (Third Party Administrators) HRMS / A CORVEL COMPANY P.O. Box 277550 Sacramento, CA 95827 Main: (916) 379-5560 Fax: (916) 379-5598 (Third Party Administrators) INTERCARE INSURANCE SERVICES P.O. Box 7111 Pasadena, CA 91109-7211 Main: (866) 785-6819 - (626) 304-1200 Fax: (626) 304-1249 (Third Party Administrators) HRMS / A CORVEL COMPANY 8787 Complex Dr., Third Floor San Diego, CA 92123 (Mailing Address) 5694 Mission Center Rd., #700 San Diego, CA 92108 Main: (800) 757-7100 - (858) 300-2500 Fax: (858) 300-2560 (Third Party Administrators) INTERCARE INSURANCE SERVICES P.O. Box 579 Roseville, CA 95661 Main: (916) 677-2500 Fax: (916) 677-2608 (Third Party Administrators) -I- INTERCARE INSURANCE SERVICES P.O. Box 348180 Sacramento, CA 95834-8180 Main: (800) 394-9304 - (916) 920-5800 Fax: (916) 920-5588 (Third Party Administrators. Claims Processed by Injured's Name for all of California) ICS (See Innovative Claim Solutions, Inc.) ICW GROUP (See Insurance Company of the West) INDEMNITY INSURANCE COMPANY OF NORTH AMERICA (See ACE USA) INTERSTATE BRANDS CORPORATION 7807 Convoy Ct., Suite 110 San Diego, CA 92111 Main: (858) 569-7311 Fax: (858) 569-1525 (Self -Insured / Self-Administered. Claims Processed by Injured's Name for all of California and Washington) INDUSTRIAL INDEMNITY (See Cambridge Integrated Services Group, Inc.) INNOVATIVE CARE SYSTEMS, INC. (See Innovate Claim Solutions, Inc.) IRISC-CAMBRIDGE INTEGRATED SERVICES GROUP,INC. (See Cambridge Integrated Services Group, Inc.) INNOVATIVE CLAIM SOLUTIONS, INC. 11030 White Rock Rd., Suite 210 Rancho Cordova, CA 95670-6055 (Mailing Address) P.O. Box 2070 Rancho Cordova, CA 95741 Main: (916) 852-8588 (Third Party Administrators) ITT HARTFORD (See The Hartford) ITT SPECIALTY RISK SERVICES (See Specialty Risk Services, LLC) INSURANCE COMPANY OF NORTH AMERICA / ESIS, INC. / CIGNA COMPANIES (See ACE USA) MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 - ( 14 ) - Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers INSURANCE COMPANY OF THE WEST / EXPLORER INSURANCE COMPANY (Home Office - W.C. Claims) 11455 El Camino Real San Diego, CA 92130-2045 (Mailing Address) P.O. Box 85563 San Diego, CA 92186-5563 Main: (800) 877-1111 - (858) 350-2400 Fax: (858) 350-2755 (Claims Processed by Employer's Name for All of California) JT2 INTEGRATED RESOURCES P.O. Box 51462 Ontario, CA 91761 Main: (909) 390-1115 Fax: (909) 390-1135 (Self-Insured Administrators. Claims Processed for all of Southern California) JT2 INTEGRATED RESOURCES 231 Market Pl., PMB # 381 San Ramon, CA 94583-4743 Main: (925) 556-7012 Fax: (925) 556-7032 (Self-Insured Administrators) INTEGRATED CLAIMS ADMINISTRATORS, INC. P.O. Box 3189 Torrance, CA 90510-3189 Main: (310) 542-5130 Fax: (310) 542-7310 (Third Party Administrators) JT2 INTEGRATED RESOURCES (Lathrop California Office) 231 Market Pl., PMB #381 San Ramon, CA 94583-4743 Main: (800) 582-4671 - (209) 491-7031 Fax: (209) 491-7039 (Self-Insured Administrators) IHDS INTEGRATED HEALTH DELIVERY SERVICES (See Cambridge Integrated Services Group, Inc.) -K- INTERCARE INSURANCE SERVICES P.O. Box 40009 Fresno, CA 93755-0009 Main: (559) 447-1029 (Third Party Administrators) KAISER PERMANENTE MEDICAL CARE PROGRAM (California Workers Workers' Compensation Department) P. O. Box 12927 Oakland, CA 94604-2927 Main: (510) 625-2496 Fax: (510) 625-3345 (Self-Insured, Claims Processed for all of California) INTERCARE INSURANCE SERVICES P.O. Box 19544 Irvine, CA 92623 Main: (800) 394-9308 - (949) 752-7170 Fax: (949) 752-7189 (Third Party Administrators) KANSAS CITY FIRE & MARINE INSURANCE COMPANY (See CNA) INTERCARE INSURANCE SERVICES P.O. Box 14243 Orange, CA 92863-4243 Main: (714) 480-0105 Fax: (714) 480-0041 (Third Party Administrators - Claims Processed for County of Los Angeles) KEENAN AND ASSOCIATES 320 " I " Street Eureka, CA 95501 Main: (707) 268-1616 Fax: (707) 268-8963 (Claims Processed by Injured's Name for Northern California) -J- KEENAN AND ASSOCIATES 5776 Stoneridge Mall Rd., Suite 130 Pleasanton, CA 94588 (Mailing Address) P. O. Box 2486 Dublin, CA 94568-0766 Main: (925) 225-0611 Fax: (925) 225-1280 (Claims Processed by Injured's Name for Northern California) JENKINS / ATHENS INSURANCE SERVICES (See Athens Administrators) JT2 INTEGRATED RESOURCES P.O. Box 70410 Oakland,CA 94612 Main: (510) 844-3100 Fax: (510) 844-3201 (Self-Insured Administrators) MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 - ( 15 ) - Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers -L- KEENAN AND ASSOCIATES 2882 Prospect Park Dr., Suite 200 Rancho Cordova, CA 95670 (Mailing Address) P.O. Box 1538 Rancho Cordova, CA 95741 Main: (800) 343-0694 - (916) 859-4900 Fax: (916) 859-7166 (Claims Processed by Injured's Name for Northern California) LINDSEY MORDEN CLAIMS MANAGEMENT, INC. (See Broadspire) LOMA LINDA UNIVERSITY MEDICAL CENTER Department of Risk Management 11161 Anderson St., Suite # 200 Loma Linda, CA 92354-2825 (Mailing Address) P.O. Box 1770 Loma Linda, CA 92354-0570 Main: (909) 558-4389 Fax: (909) 558-7974 (Self Insured / Self Administured.Claims Processed Loma Linda University Medical Center, Faculty Medical Group-School of Medicine, Loma Linda Faculty Medical Physicians & Surgeons, Loma Linda University, Loma Linda Loma Linda Univ Health Care, Behavioral Medicine Cntr, Loma Linda Univ Adventist Health Science Center, Inc. and Loma Linda University Health Services) KEENAN AND ASSOCIATES 1791 Broadway Redwood City, CA 94063 (Mailing Address) P.O. Box 5218 Redwood City, CA 94063 Main: (650) 306-0616 Fax: (650) 306-0620 (Claims Processed by Injured's Name for San Mateo County) KEENAN AND ASSOCIATES 3550 Vine St., Suite 200 Riverside, CA 92507 Main: (800) 654-8347 - (951) 788-0330 Fax: (951) 788-8013 (Claims Processed by Injured's Name for Imperial, Riverside San Bernardino and San Diego Counties) Riverside, LUBERMENS MUTUAL CASUALTY COMPANY (See Broadspire) LWP CLAIMS SOLUTIONS, SOLUTIONS INC INC. P.O. Box 10640 Glendale, CA 91209-0640 Main: (818) 245-1860 Fax: (818) 245-1861 (Third Party Administrators. Claims Processed by Employer's Name for all of California) KEENAN AND ASSOCIATES 1740 Technology Dr., Suite 300 San Jose, CA 95110 Main: (800) 334-6554 - (408) 441-0876 Fax: (408) 436-9306 (Claims Processed by Employer's Name for Alameda, Contra Costa, Monterey, San Benito, San Mateo, Santa Clara Santa Cruz, San Luis Obispo and Stanislaus Counties) LWP CLAIMS SOLUTIONS, INC. P.O. Box 349016 Sacramento, CA 95834-9016 Main: (800) 565-5694 - (916) 609-3600 Fax: (916) 609-3637 (Third Party Administrators. Claims Processed by Employer's Name for all of California) KEENAN AND ASSOCIATES 2355 Crenshaw Blvd., Suite 200 Torrance, CA 90501 (Mailing Address) P.O. Box 4328 Torrance, CA 90510 Main: (800) 654-8102 - (310) 212-3344 Fax: (310) 328-6793 LEGION INSURANCE COMPANY Main: (800) 255-6738 LIBERTY MUTUAL INSURANCE COMPANY 330 N. Brand Blvd., Suite 500 Glendale, CA 91203 (Mailing Address) P.O. Box 29073 Glendale, CA 91209-9073 Main: (818) 240-1234 (Claims Processed by Employer's Name for Los Angeles, Ventura, San Luis Obispo and Santa Barbara Counties) KEMPER EMPLOYER'S CLAIMS SERVICES (See Broadspire) KEMPER INSURANCE COMPANIES (See Broadspire) KM ADMINISTRATIVE SERVICES, INC. (See Cambridge Integrated Services Group, Inc.) MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 - ( 16 ) - Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers LIBERTY MUTUAL INSURANCE COMPANY 333 City Boulevard West, Suite 300 Orange, CA 92868 (Mailing Address) P.O. Box 11025 Orange, CA 92856-1125 Main: (714) 937-1400 Fax: (603) 334-0249 (Claims Processed by Employer's Name for Orange, San Bernardino, Riverside, San Diego and Imperial Counties) MAJESTIC INSURANCE COMPANY P.O. Box 270769 San Diego, CA 92198 Main: (877) 829-6305 - (858) 385-4040 Fax: (858) 487-6908 (Claims Processed by Employer's Name for San Diego, Imperial Counties, and Inland Empire) MAJESTIC INSURANCE COMPANY 101 California St., 22nd Floor San Francisco, CA 94111 (Mailing Address) P.O. Box 2359 San Francisco, CA 94126-2359 Main: (415) 362-7000 Fax: (415) 247-7290 (Claims Processed by Employer's Name for Northern California) LIBERTY MUTUAL INSURANCE COMPANY 6130 Stoneridge Mall Rd., Suite 400 Pleasanton, CA 94588 (Mailing Address) P.O. Box 11025 Orange, CA 92856-1125 Main: (800) 676-6514 - (925) 734-9200 Fax: (603) 334-0249 (Claims Processed by Injured's Name for Alameda, Contra Costa, Lake, Marin, Monterey, Napa, San Benito San Benito, San Francisco, San Mateo, Santa, Clara, Santa Cruz, and Sonoma Counties) MANAGEDCOMP, INC. (See Pinnacle Risk Management Services, Inc.) MARRIOTT INTERNATIONAL, INC. 3130 S. Harbor Blvd., Suite 550 Santa Ana, CA 92704 (Mailing Address) P O Box 29210 P.O. Hot Springs, AR 71903-9210 Main: (714) 545-5261 (Self-Insured) LIBERTY MUTUAL INSURANCE COMPANY 1750 Howe Ave., Suite # 400 Sacramento CA 95825 Sacramento, (Mailing Address) P.O. Box 989000 West Sacramento, CA 95798-9000 Main: (916) 564-1792 Fax: (603) 334-0231 MARYLAND CASUALTY COMPANY (See Zurich North America) -M- MARYLAND INSURANCE GROUP (See Zurich North America) MACY'S CORPORATE SERVICES 1801 Hawthorne Blvd., Suite 1 Redondo Beach, CA 90278-3494 (Mailing Address) P.O. Box 8012 Redondo Beach, CA 90277-8012 Main: (310) 793-3400 Fax: (866) 421-8313 (Self - Insured Administrators. Claims Processed for Macy's) MATRIX ABSENCE MANAGEMENT, INC. 3602 Inland Empire Blvd., Suite C-318 Ontario, CA 91764-4966 (Mailing Address) P.O. Box 788 Rancho Cucamonga, CA 91729-0788 Main: (800) 660-0588 - (909) 466-9663 Fax: (909) 483-6324 (Third Party Administrators) MAJESTIC INSURANCE COMPANY 5001 Airport Plaza Dr., Suite 200 Long Beach, CA 90815 (Mailing Address) P.O. Box 7549 Long Beach, CA 90807-0549 Main: (800) 432-2107 - (562) 627-1400 Fax: (562) 429-9017 (Claims Processed by Employer's for Los Angeles Orange, San Bernadino, Santa Barbara and Ventura Counties) MATRIX ABSENCE MANAGEMENT, INC. 2208 Plaza Dr., Suite 100 Rocklin, CA 95765 Main: (866) 560-1447 - (916) 773-5737 Fax: (408) 361-9112 (Third Party Administrators) MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 - ( 17 ) - Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers -N- MATRIX ABSENCE MANAGEMENT, INC. 5225 Hellyer Ave., Suite 210 San Jose, CA 95138-1001 (Mailing Address) P.O. Box 11035 San Jose, CA 95103 Main: (800) 980-1006 - (408) 360-8370 Fax: (408) 360-9441; 9442 (Third Party Administrators) NATIONAL AMERICAN INSURANCE COMPANY OF CALIFORNIA (See Tristar Risk Management - Los Angeles) NATIONAL INDEMNITY INSURANCE COMPANY (See Berkshire Hathaway Homestate Companies [BHHC] ) METRO RISK MANAGEMENT, LLC 720 East "E" Street Wilmington, CA 90744-6014 (Mailing Address) P.O. Box 547 Wilmington, CA 90748-0547 Main: (310) 816-6633 Fax: (310) 816-6644 (Claims Processed by both Employer's and Injured's Names for all of California) NATIONAL LOSS CONTROL SERVICE CORPORATION (See Broadspire) NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURG, PENNSYLVANIA (See AIG Domestic Claims, Inc.) METROPOLITAN STEVEDORE COMPANY (See Metro Risk Management, LLC) NATIONAL UNION INSURANCE COMPANIES (See AIG Domestic Claims, Inc.) MID-CENTURY INSURANCE COMPANY (See Farmers Insurance Group) NATIONWIDE INSURANCE (See Wausau Insurance Companies) MIDDLESEX MUTUAL INSURANCE COMPANY (See Sentry Insurance) NEW YORK UNDERWRITERS INSURANCE COMPANY (See Hartford) MISSION AMERICAN INSURANCE COMPANY (See Tristar Risk Management- Los Angeles) THE NOETICS GROUP (See Tristar Risk Management) MITSUI SUMITOMO MARINE MANAGEMENT (USA), INC. 10 Universal City Plaza, Suite 1700 Universal City, CA 91608 Main: (800) 365-4671 - (818) 942-3900 Fax: (818) 760-3824 (Claims Processed by Employer's Name for all of California) NORDSTROM RISK MANAGEMENT W/C Claims Department P.O. Box 25799 Santa Ana, CA 92799-5799 Main: (714) 513-4771 Fax: (714) 513-4778 (Self-Insured) NATIONAL SURETY INSURANCE COMPANY (See Fireman's Fund Insurance Companies) THE NORTH RIVER INSURANCE COMPANY (See Crum & Forster) MTA Los Angeles County Metropolitan Transportation Authority One Gateway Plaza, Mail Stop 99-10-2 Los Angeles, CA 90012-2952 Main: (213) 922-3806 Fax: (213) 922-4351 (Self-Insured / Self-Administered) NORTHERN INSURANCE COMPANY OF NEW YORK (See Zurich North America) NORTHERN CLAIMS MANAGEMENT P.O. Box 6385 Santa Rosa, CA 95406 Main: (707) 575-8887 (Third Party Administrators) MURPHY AND BEANE, INC. 5901 Green Valley Cir., Suite 145 Culver City, CA 90230 Main: (800) 553-1955 - (310) 649-4470 Fax: (310) 649-0209 (Self-Insured Administrators) MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 - ( 18 ) - Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers NOVPRO RISK SOLUTIONS, L.P. 17862 E. 17th St., Suite 111 Tustin, CA 92780 (Mailing Address) P.O. Box 2422 Tustin, CA 92781 Main: (714) 544-0980 Fax: (714) 544-1979 (Claims Processed by Employer's Name for California or Nation-Wide, Depending on Account) PAULA INSURANCE COMPANY PAN PACIFIC BENEFIT ADMINISTRATORS (See Intercare Insurance Services) PEGASUS RISK MANAGEMENT, INC. 642 Galaxy Way Modesto, CA 95356 (Mailing Address) P.O. Box 5038 Modesto, CA 95352-5038 Main: (888) 312-5246 - (209) 574-2800 Fax: (209) 574-2900 (Third Party Administrators) -OOAK RIVER INSURANCE COMPANY (See Berkshire Hathaway Homestate Companies [BHHC]) PINNACLE RISK MANAGEMENT SERVICES, INC. One Sierra Gate Plaza, Suite A-200 Roseville, CA 95678 (Mailing Address) P.O. Box 120 Rocklin, CA 95677 Main: (916) 780-9250 Fax: (916) 780-9251 (Third Party Administrators) OCTAGON RISK SERVICES, INC. (See Sedgwick CMS) OHIO CASUALTY GROUP OF INSURANCE COMPANIES 136 N. Third Street Hamilton, OH 45025 Main: (800) 821-2010 - (513) 867-3900 Fax: (800) 830-5257 (Claims Processed by Employer's Name for All of California) POWER & ASSOCIATES P.O. Box 4068 Paso Robles, Robles CA 93447-4068 Main: (805) 239-3706 Fax: (805) 239-3690 (Third Party Administrators / Independent Adjusters) -PPACIFIC COMPENSATION INSURANCE COMPANY (See Cambridge Integrated Services Group, Inc.) PREFERRED EMPLOYERS INSURANCE COMPANY P.O. Box 85838 San Diego, CA 92186-5838 Main: (619) 688-3900 Fax: (619) 688-3913 (Claims Processed by Employer's Name for All of California) PACIFIC EAGLE INSURANCE GROUP, INC. (See Sea Bright Insurance Company) PACIFIC EMPLOYERS INSURANCE COMPANY (See ACE USA) PACIFIC GAS AND ELECTRIC COMPANY Safety, Health and Claims Department 77 Beale St., 23rd Floor, B23H San Francisco, CA 94105 (Mailing Address) P.O. Box 7779 San Francisco, CA 94120-7779 Main: (415) 973-8700, Option # 2 Fax: (415) 973-7828 (Self-Insured) PREFERRED RISK GROUP (See Guideone Insurance) PRESIDUIM, INC. (See Cambridge Integrated Services Group, Inc.) PRIVATE ADJUSTING CLAIMS SERVICES 9570 Center Avenue Rancho Cucamonga, CA 91730-5814 (Mailing Address) P.O. Box 2849 Rancho Cucamonga, CA 91729-2849 Main: (909) 481-4111 Fax: (909) 481-4110 (Third Party Administrators) THE PACIFIC RIM ASSURANCE COMPANY (See Broadspire) PACIFIC STATES CASUALTY COMPANY (See Ulico Insurance Group) -Q- PAN AMERICAN UNDERWRITERS, INC. (See Intercare Insurance Services) MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 - ( 19 ) - Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers -R- REPUBLIC WESTERN INSURANCE COMPANY 2721 N. Central Ave. Phoenix, AZ 85004 Main: (800) 528-7134 - (602) 263-6520 Fax: (602) 745-6436 (Claims Processed by Employer's Name for Entire State of California) RECON ADMINISTRATIVE SERVICES, INC. (See Hammerman & Gainer, Inc.) REDWOOD EMPIRE SCHOOLS INS. GROUP 5760 Skylane Blvd., Suite 100 Windsor, CA 95492-9742 Main: (707) 836-0779 Fax: (707) 836-9479 (Claims Processed by Injured's Name for Sonoma County School Districts) F.A. RICHARD & ASSOCIATES (See FARA / F.A. Richard & Associates) RICOMP CLAIMS MANAGEMENT CORPORATION P.O. Box 2837 Seal Beach, CA 90740 Main: (714) 503-1186 Fax: (714) 503-1006 (Third Party Administrators) REDWOOD FIRE & CASUALTY INS. COMPANY (See Berkshire Hathaway Homestate Companies [BHHC]) RELIANCE / UNITED PACIFIC INSURANCE COMPANIES (See Cambridge Integrated Services Group, Inc. Pasadena and Rancho Cordova offices) RISK ENTERPRISE MANAGEMENT LIMITED 3230 E. Imperial Hwy., Suite 300 Brea, CA 92821 (Mailing Address) P.O. Box 2314 Brea, CA 92822-2314 Main: (800) 347-2509 - (714) 579-2500 (Claims Processed by both Employer's and Injured's Names for Entire State of California) RENAISSANCE RISK MANAGEMENT (See Aims) REPUBLIC INDEMNITY COMPANY OF AMERICA 15821 Ventura Blvd., Suite 370 Encino, CA 91436-2936 (Mailing Address) P.O. Box 20036 Encino, CA 91416-0036 Main: (818) 990-9860 Fax: (818) 382-1252 (Claims Processed by Employer's Name for Los Angeles, Orange Counties, the Northern Portion of San Bernardino County, plus the following 3-digit Zip Code areas: 932, 933, 936, 937,938, 942, 952, 956, 957 958, 959, 960 and 961) ROSS & CASTILLO (See Tristar Risk Management - Fresno office) REPUBLIC INDEMNITY COMPANY OF AMERICA 4995 Murphy Canyon Rd., Suite 401 San Diego, CA 92123-4366 (Mailing Address) P.O. Box 85590 San Diego, CA 92186-5590 Main: (858) 292-7002 - Fax: (858) 292-4816 (Claims Processed by Injured's Address for Riverside, San Bernardino, Imperial and San Diego Counties) REPUBLIC INDEMNITY COMPANY OF AMERICA 4995 Murphy Canyon Rd., Suite 401 San Diego, CA 92123-4366 (Mailing Address) P.O. Box 85590 San Diego, CA 92186-5590 Main: (858) 292-7002 - Fax: (858) 292-4816 (Claims Processed by Injured's Address for Riverside, San Bernardino, Imperial and San Diego Counties) 938, 942, 952, 956, 957, 958, 959, 960 and 961) ROYAL & SUN ALLIANCE (Arrowpoint Capital Corp.) Main: (800) 526-6235 RSKCO (See Broadspire) REPUBLIC INDEMNITY COMPANY OF AMERICA 100 Pine St., Suite 1400 San Francisco, CA 94111-5167 (Mailing Address) P.O. Box 7878 San Francisco, CA 94120-7878 Main: (415) 981-3200 Fax: (415) 954-1178 (Claims Processed by Injured's Name for the following 3-digit Zip Code areas: 939,940.941.943,944, 946, 947, 948,949, 950, 951, 954 and 955) MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 - ( 20 ) - Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers -S- SEABRIGHT INSURANCE COMPANY 681 S. Parker St., Suite 220 Orange, CA 92868-4719 (Mailing Address) P.O. Box 11027 Orange, CA 92856-8127 Main: (800) 664-9420 - (714) 918-5900 Fax: (714) 918-5972 (Claims Processed by Insured's Name) ST. PAUL FIRE & MAINE INSURNACE COMPANY (See Travelers) ST. PAUL TRAVELERS (See Travelers) SAFECO INSURANCE GROUP P.O. Box 515097 Los Angeles, CA 90051-5097 Main: (800) 332-3226 (Claims Processed for All of California) SEDGWICK CMS SEDGWICK CLAIMS MANAGEMENT SERVICES, INC. (Long Beach Office) P.O. Box 14563 Lexington, KY 40512-4563 Main: (562) 981-1700 Fax: (562) 981-1745 (Third Party Administrators. Claims Processed by Employer's Name for all of California) SAFEWAY, INC. P.O. Box 9077 Pleasanton, CA 94566-9077 Main: (800) 535-0009 - (925) 469-7900 Fax: (925) 469-7011 (Self-Insured. Claims Processed by Injured's Name for Northern California, Northern Nevada and Hawaii) SEDGWICK CMS SEDGWICK CLAIMS MANAGEMENT SERVICES, INC. (Formerly Octagon Risk Services, Inc.) P.O. Box 956914 Los Angeles, CA 90095-6914 Main: (310) 794-8247 Fax: (310) 794-8269 (Claims Handled for Regents of University of California, University of California at Los Angeles University of California at Santa Barbara, UCLA Medical Center, UCLA, NPI/NPH and Santa Monica UCLA Medical Center) SAN DIEGO GAS & ELECTRIC (Sempra Energy) 8306 Century Park Ct., Suite 41C San Diego, CA 92123-9831 Main: (858) 636-5511; 5513 Fax: (858) 636-5510 (Claims Processed by Injured's Name for San Diego and Orange Counties) SANTA ANA UNIFIED SCHOOL DISTRICT 1601 E. Chestnut Avenue Santa Ana, CA 92701 Main: (714) 558-5856 Fax: (714) 480-5320 (Self-Insured) SEDGWICK CMS SEDGWICK CLAIMS MANAGEMENT SERVICES, INC. (Formerly Octagon Risk Services, Inc.) P.O. Box 2063 Oakland, CA 94604-2063 Main: (510) 302-3180 Fax: (510) 302-3277 (Claims Handled for Regents of University of California Office of The President University of California at Berkley University of California at Merced University of California at San Francisco University of California at Santa Cruz Lawrence Berkley Laboratory and Lawrence Livermore Laboratory) SCHOOLS INSURANCE AUTHORITY 9800 Old Placerville Rd. Sacramento, CA 95827 (Mailing Address) P.O. Box 276710 Sacramento, CA 95827-6710 Main: (916) 364-1281 Fax: (916) 362-2824 (Self-Insured Claims Administrators. Claims Processed for Various School Districts throughout Northern California) SCOTT WETZEL SERVICES, INC. (See Novapro Risk Solutions, L.P.) SEDGWICK CMS SEDGWICK CLAIMS MANAGEMENT SERVICES, INC. (Formerly Octagon Risk Services, Inc.) P.O. Box 2066 Oakland, CA 94604-2066 Main: (510) 302-3000 Fax: (510) 302-3263 (Claims Processed by Employer's Name for Catholic Healthcare West [CHW]) MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 - ( 21 ) - Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers SEDGWICK CMS SEDGWICK CLAIMS MANAGEMENT SERVICES, INC. (Formerly Octagon Risk Services, Inc.) P.O. Box 2078 Oakland, CA 94604-2078 Main: (888) 777-0012 - (510) 302-3000 Fax: (510) 302-3267 (Claims Processed by Employer's Name for CSU Campuses in Bakersfield, Dominguez Hills, Hayward, Humboldt, Long Beach, Monterey Bay, Pomona, San Francisco, San Jose, San Marcos, Sonoma, and Maritime Academy) SEDGWICK CMS SEDGWICK CLAIMS MANAGEMENT SERVICES, INC. (Formerly Octagon Risk Services, Inc.) P.O. Box 3110 Rancho Cordova, CA 95741-3110 Main: (916) 851-8000 Fax: (916) 851-8078 (Third Party Administrators for all of California) SEDGWICK CMS SEDGWICK CLAIMS MANAGEMENT SERVICES, INC. (Formerly Octagon Risk Services, Inc.) P.O. Box 3170 Rancho Cordova, CA 95741-3170 Main: (916) 851-8000 Fax: (916) 851-8079 (Claims Processed by Employer's Name for CSU Campuses in Channel Islands, Chico, Fresno, Fullerton, Los Angeles Northridge, Sacramento, San Diego, San Luis Obispo, and the Chancellor's office) SEDGWICK CMS SEDGWICK CLAIMS MANAGEMENT SERVICES, INC. (Ontario Office) P.O. Box 14627 Lexington, KY 40512-4627 Main: (909) 477-5500 Fax: (866) 224-4607 (Third Party Administrators. Claims Processed by Employers Name for all of California) SEDGWICK CMS SEDGWICK CLAIMS MANAGEMENT SERVICES, INC. (Riverside Office) P.O. Box 14440 Lexington, KY 40512-4440 Main: (866) 568-8924 - (951) 248-8800 Fax: (951) 248-8765 (Third Party Administrators. Claims Processed by Employer's Name for all of California) SEDGWICK CMS SEDGWICK CLAIMS MANAGEMENT SERVICES, INC. (Orange Office) P O Box 14442 P.O. Lexington, KY 40512-4442 Main: (800) 854-6188 - (714) 258-5000 Fax: (714) 258-5001 (Third Party Administrators. Claims Processed by Employers Name for all of California) SEDGWICK CMS SEDGWICK CLAIMS MANAGEMENT SERVICES, INC. (Sacramento Office) P.O. Box 14433 Lexington, KY 40512-4433 Main: (916) 771-2900 Fax: (916) 771-2990 (Third Party Administrators. Claims Processed by Employers Name for all of California) SEDGWICK CMS SEDGWICK CLAIMS MANAGEMENT SERVICES, INC. (Formerly Octagon Risk Services, Inc.) P.O. Box 14237 Orange, CA 92863 Main: (714) 634-3451 Fax: (714) 937-5900 (Claims Handled for Regents of University of California at Irvine and UCI Medical Center) SEDGWICK CMS SEDGWICK CLAIMS MANAGEMENT SERVICES, INC. (Formerly Octagon Risk Services, Inc.) P.O. Box 526012 Sacramento, CA 95852-6012 Main: (916) 929-3506 Fax: (916) 925-2673 (Claims Handled for Regents of University of California and University of California at Davis and UCD Medical Center) SEDGWICK CMS SEDGWICK CLAIMS MANAGEMENT SERVICES, INC. (Pasadena Office) P.O. Box 14623 Lexington, KY 40512-4623 Main: (626) 397-9200 Fax: (626) 397-9250 (Third Party Admin. Claims Processed by Injured's Name for Los Angeles Unified School Dist. [LAUSD] only) MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 - ( 22 ) - Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers SEDGWICK CMS SEDGWICK CLAIMS MANAGEMENT SERVICES, INC. (Formerly Octagon Risk Services, Inc.) P.O. Box 639028 San Diego, CA 92163-9028 Main: (619) 294-2178 (Claims Handled for Regents of University of California and University of California at San Diego, UCSD Medical Center, University of California at Irvine UCI Medical Center and Univ. of California at Riverside) SENTRY INSURANCE (Sentry Claims Center) P.O. Box 11524 Santa Ana, CA 92711-1524 Main: (800) 253-8672 Fax: (949) 930-6111 (Claims Processed by Employer's Name for all of California) SENTRY INSURANCE (Sentry Claims Center) 9060 E. Via Linda Blvd. Scottsdale, AZ 85258 (Mailing Address) P.O. Box 29466 Phoenix, AZ 85038-9466 Main: (800) 833-2244 - (480) 860-7000 Fax: (480) 860-7987 (Claims Processed by both Employer's and Injured's Names for the Entire States of Arizona, California, Hawaii, Idaho, Alaska Colorado, New Mexico, Texas, Oregon, Oklahoma, Wyoming, and Utah) SEDGWICK CMS SEDGWICK CLAIMS MANAGEMENT SERVICES, INC. (Formerly Octagon Risk Services, Inc.) 2800 W. March Lane, Suite 480 Stockton, CA 95219 Main: (209) 957-5419 Fax: (209) 957-5325 (Claims Processed by Employer's Name for Catholic Healthcare West Hospitals, Northern California only) SEDGWICK CMS SEDGWICK CLAIMS MANAGEMENT SERVICES, INC. (Formerly Octagon Risk Services, Inc.) P.O. Box 1027 Van Nuys, CA 91408-1027 Main: (818) 997-3500 (Third Party Administrators. Claims Processed for Southern California and Arizona) SENTRY INSURANCE (Sentry Claims Center) P.O. Box 8032 Stevens Point, WI 54481 Main: (800) 739-3344 - (715) 346-6000 Fax: (715) 346-9708 (Claims Processed by both Employer's Names for all of California) SEDGWICK CMS SEDGWICK CLAIMS MANAGEMENT SERVICES, INC. (Walnut Creek Office) P.O. Box 14421 Lexington, KY 40512-44421 Main: (925) 933-9560 Fax: (925) 933-9559 (Third Party Administrators. Claims Processed by Employer's Name for all of California) SOUTHERN CALIFORNIA EDISON COMPANY 8631 Rush St., Fourth Floor Rosemead, CA 91770-3738 Main: (626) 302-6890 Fax: (626) 302-4790 (Self-Insured. Claims Processed by Injured's Name) SOUTHERN CALIFORNIA GAS COMPANY (Sempra Energy) 555 W. Fifth St., M.L. 16CO Los Angeles, CA 90013 (Mailing Address) P.O. Box 30937 Los Angeles, CA 90030-0937 Main: (213) 244-3145 (Self-Insured / Self Administered) SELF-INSURED MANAGEMENT SERVICES (See Tristar Risk Management ) SELF-INSURED SCHOOLS OF CALIFORNIA 1300 - 17th Street Bakersfield, CA 93301 (Mailing Address) P.O. Box 1847 Bakersfield, CA 93303-1847 Main: (661) 636-4710 Fax: (661) 636-4721 (Claims Processed by [Member] School Districts for Kern, Inyo, and Mono Counties, plus Trona School District in San Bernardino County) MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 - ( 23 ) - Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers SOUTHERN CALIFORNIA RISK MANAGEMENT ASSOCIATES, INC. 18625 Sutter Blvd., Suite 500 Morgan Hill, CA 95037-2862 Main: (408) 782-1074 Fax: (408) 776-9001 (Claims Processed by Employer's, then Injured's Name) SPECIALTY RISK SERVICES, LLC P.O. Box 591 Burbank, CA 91503-0591 Main: (800) 999-3945 - (818) 525-2400 Fax: (818) 955-9925 (Third Party Administrators. Claims Processed by Employer's Name for California, Colorado and Utah) SOUTHERN CALIFORNIA RISK MANAGEMENT ASSOCIATES, INC. 1801 N. Solar Dr., Suite 190 Oxnard, CA 93030-8226 Main: (805) 288-4100 Fax: (805) 988-9101 (Claims Processed by Employer's, then Injured's Name) SPECIALTY RISK SERVICES, LLC 6140 Stoneridge Mall Rd., Suite 245 Pleasanton, CA 94588-3233 (Mailing Address) P.O. Box 8116 Pleasanton, CA 94588 Main: (877) 809-9478 - (925) 225-8400 Fax: (925) 227-0996 (Claims Processed by Account Name, Statewide) SOUTHERN CALIFORNIA RISK MANAGEMENT ASSOCIATES, INC. 313 E. Foothill Blvd. Upland, CA 91786-3952 Main: (909) 608-7171 Fax: (909) 608-7165 (Claims Processed by Employer's, then Injured's Name) SPECIALTY RISK SERVICES, LLC (Inland Empire) 1420 Iowa Ave., Suite 200 Riverside, CA 92507 (Mailing Address) P.O. Box 59907 Riverside, CA 92517 Main: (888) 737-7726 - (951) 715-3948 Fax: (951) 715-2701 (Claims Processed by Account Name, Statewide) Bakersfield, CA 93311 (Mailing Address) P.O. Box 3171 Suisun City, CA 94585-6171 Main: (661) 664-4000 Fax: (661) 664-4101 (Claims Processed by Employer's Name for All of Kern County) SOUTHERN CALIFORNIA RISK MANAGEMENT ASSOCIATES, INC. 28235 Newhall Ranch Rd., Rd Suite 250 Valencia, CA 91355-0986 Main: (661) 775-9550 Fax: (661) 775-9554 (Claims Processed by Employer's, then Injured's Name) SOUTHLAND CLAIMS SERVICE, INC. 7761 Garden Grove Blvd. Garden Grove, CA 92841 (Mailing Address) P.O. Box 958 Garden Grove, CA 92842-0958 Main: (714) 772-1933 Fax: (714) 772-7718 (Claims Processed for all of California) SPRINGFIELD INSURANCE COMPANY/GMIS 874 S. Village Oaks Drive Covina, CA 91724-3614 (Mailing Address) P.O. Box 3029 Covina, CA 91722-9029 Main: (800) 821-3364 - (626) 915-1951 Fax: (626) 967-2548 (Claims Processed by Employer's Name for All of California) SPECIALTY RISK SERVICES, LLC One Pointe Dr., Suite 220 Brea, CA 92821 (Mailing Address) P.O. Box 7007 La Habra, CA 90632-7007 Main: (800) 221-5473 - (714) 674-1000 Fax: (714) 674-4602 (Claims Processed by Account Name, Statewide) STATE COMPENSATION INSURANCE FUND (Bakersfield District Office) 9801 Camino Media Bakersfield, CA 93311 (Mailing Address) P.O. Box 3171 Suisun City,CA 94585-6171 Main: (661) 664-4000 Fax: (661) 664-4101 (Clains Processed by Employer's Name for Kern County.) MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 - ( 24 ) - Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers STATE COMPENSATION INSURANCE FUND STATE CONTRACT SERVICES 400 Citadel Dr., Suite 100 Commerce, CA 90040 (Mailing Address) P.O. Box 910932 Commerce, CA 90091-0932 Main: (323) 727-5600 Fax: (323) 727-5710 (Claims Processed for State of California Employees only, including all State Agencies) STATE COMPESATION INSURANCE FUND (State Contract Services) 2901 N. Ventura Road, Suite 100 Oxnard, CA 93030 (Mailing Address) P.O. Box 9230 Oxnard, CA 93031-9045 Main: (805) 988-8600 Fax: (805) 981-3410 (Claims Processed for State of California Employees only, including all State Agencies) STATE COMPENSATION INSURANCE FUND (Eureka District Office & State Contract Services) 2440 Sixth Street Eureka, CA 95501 (Mailing Address) P.O. Box 4973 Eureka, CA 95502-4973 Main: (707) 443-9721 (Claims Processed by Employees Name for Humboldt and Del Norte Counties, plus the State of California Employees, including all State Agencies) STATE COMPENSATION INSURANCE FUND (Bay Area Claims Services) 5880 Owens Drive Pleasanton, CA 94588 (Mailing Address) P.O. Box 3171 Suisan City, CA 94585-6171 Main: (925) 523-5200 (Claims Processed by Employer's Name for Alameda, Contra Costa, San Francisco and San Mateo Counties, plus the Vallejo City area) STATE COMPENSATION INSURANCE FUND (Fresno District Office) 10 River Park Place East, East Third Floor Fresno, CA 93720 (Mailing Address) P.O. Box 65005 Pinedale, CA 93650-5005 Main: (559) 433-2700 (Claims Processed by Employer's Name for all of Fresno, Kings, Madera, and Tulare, Counties) STATE COMPENSATION INSURANCE FUND (Redding District Office) 2175 Shasta View Drive Redding, CA 96003 (Mailing Address) P.O. Box 3171 Suisun City, CA 94585-6171 Main: (530) 223-7000 Claims Processed by employer's Name for Butte, Glenn, Tehama, Shasta, Trinity, Plumas, Modoc, Siskiyou and Lassen Counties) STATE COMPENSATION INSURANCE FUND (Los Angeles Claims Services) 655 N. Central Ave., Suite 200 Glendale, CA 91203-1400 (Mailing Address) P.O. Box 92622 Los Angeles, CA 90009-2622 Main: (818) 291-7000 - Fax: (818) 291-7300 (Claims Processed by Employer's Name for Los Angeles, plus San Fernando, Santa Clarita, Antelope and San Gabriel Valleys) STATE COMPENSATION INSURANCE FUND (Riverside District Office) 6301 Day Street Riverside, CA 92507 (Mailing Address) P.O. Box 92622 Los Angeles, CA 90009-2622 Main: (951) 656-8300 Fax: (951) 653-1597 (Claims Processed by Employer's Name for Riverside County) STATE COMPENSATION INSURANCE FUND (Oxnard District Office) 2901 N. Ventura Rd. Oxnard, CA 93030 (Mailing Address) P.O. Box 65005 Pinedale, CA 93650-5005 Main: (805) 988-5300 Fax: (805) 988-5528 (Claims Processed by Employer's name for Ventura, Santa Barbara and San Luis Obispo Counties) STATE COMPENSATION INSURANCE FUND (State Contract Services) 6301 Day Street Riverside, CA 92507-0902 (Mailing Address) P.O. Box 59901 Riverside, CA 92517-1901 Main: (951) 697-7300 Fax: (951) 697-7301 (Claims Processed for State of California Employees only, including all State Agencies) MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 - ( 25 ) - Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers STATE COMPENSATION INSURANCE FUND (State Contract Services) 5900 State Farm Drive., Suite 200 Rohnert Park, CA 94928-2149 (Mailing Address) P.O. Box 1609 Rohnert Park, CA 94927-1609 Main: (707)586-5000 Fax: (707) 586-5199 (Claims Processed for State of California Employees only, including all State Agencies) STATE COMPESATION INSURANCE FUND Claims Management Service (TPA Program) 451 E. Vanderbilt Way, Suite 200 San Bernardino, CA 92408 (Mailing Address) P. O. Box 1806 San Bernardino, CA 92402-1806 Main: (909) 380-7488 Fax: (909) 380-7495 STATE COMPESATION INSURANCE FUND (San Diego District Office) 10105 Pacific Heights Blvd. San Diego, CA 92121-4214 (Mailing Address) P. O. Box 65005 Pinedale, CA 93650-5005 Main: (858) 552-7100 Fax: (858) 552-7110 (Claims Processed by Employer's Name for Imperial and San Diego Counties) STATE COMPENSATION INSURANCE FUND (Sacramento District Office) 2275 Gateway Oaks Drive., Third floor Sacramento, CA 95833 (Mailing Address) P.O. Box 3171 Suisun City, CA 94585-6171 Main: (916) 924-5100 (Claims Processed by Employer's name for Sacramento, Solano, Yolo, Colusa, Sutter, Yuba, Nevada, Sierra, Placer and El Dorado Counties) STATE COMPESATION INSURANCE FUND (San Jose District Office) 6203 San Ignacio Avenue San Jose, CA 95119 (Mailing Address) P. O. Box 3171 Suisun City, CA 94585-6171 Main: (408) 363-7400 Fax: (408) 363-7866 (Claims Processed by Employer's Name for Santa Clara, Santa Cruz, San Benito and Monterey Counties) STATE COMPENSATION INSURANCE FUND (State Contract Services) 2450 Venture Oaks Way., Way Suite 500 Sacramento, CA 95833 (Mailing Address) P.O. Box 659011 Sacramento, CA 95865-9011 Main: (916) 567-7500 Fax: (916) 567-7511 (Claims Processed for State of California Employees only, including all State Agencies) STATE COMPESATION INSURANCE FUND Orange County Claims Services 1750 E. Fourth St., Third Floor Santa Ana, CA 92705 (Mailing Address) P. O. Box 65005 Pinedale, CA 93650-5005 Main: (714) 565-5000 Fax: (714) 565-5801 (Claims Processed by Employer's Name for Orange County) STATE COMPENSATION INSURANCE FUND Claims Management Service (TPA Program) 2450 Venture Oaks Way., Suite 230 Sacramento, CA 95833 (Mailing Address) P.O. Box 255127 Sacramento, CA 95865-5127 Main: (916) 567-7775 Fax: (916) 567-7776 STATE COMPENSATION INSURANCE FUND (San Bernardino District Office) 375 W. Hospitality Lane San Bernardino, CA 92408 (Mailing Address) P.O. Box 92622 Los Angeles, CA 90009-2622 Main: (800) 342-7214 - (909) 384-4500 Fax: (909) 384-4646 (Claims Processed by Employer's name for San Bernardino, and Inyo Counties) STATE COMPESATION INSURANCE FUND Claims Management Service (TPA Program) (Main Office of CMS) 1750 E. Fourth St., Suite 260 Santa Ana, CA 92705 (Mailing Address) P.O. Box 11828 Santa Ana, CA 92711-1828 Main: (714) 565-7000 Fax: (714) 565-7001 MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 - ( 26 ) - Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers STATE COMPESATION INSURANCE FUND (Santa Rosa District Office) 1450 Neotomas Avenue Santa Rosa, CA 95405 (Mailing Address) P. O. Box 65005 Pinedale, CA 93650-5005 Main: (707) 573-6300 (Claims Processed by Employer's Name for Marin, Sonoma, Mendocino, Lake and Napa Counties) TOKIO MARINE MANAGEMENT / TOKIO MARINE AND FIRE INSURANCE COMPANY, LTD. AND TRANSPACIFIC INSURANCE COMPANY (Western Regional Claims Division) 800 E. Colorado Blvd. Pasadena, CA 91101 (Mailing Address) P. O. Box 7127 Pasadena, CA 91109-7127 Main: (626) 568-7600 (Claims Processed by Employer's Name for all States West of the Rocky Mountains, plus Texas, Alaska and Hawaii) STATE COMPESATION INSURANCE FUND (Stockton District Office) 3247 W. March Lane Stockton, CA 95219 (Mailing Address) P. O. Box 3171 Suisin, CA 94585-6171 Main: (209) 476-2600 Fax: (209) 476-2750 (Claims Processed by Employer's Name for San Joaquin, Stanislaus, Alpine, Mono, Merced, Amador, Calaveras, Mariposa and Tuolumne Counties) TOPA INSURANCE COMPANY P. O. Box 67810 Los Angles, CA 90067 Main: (310) 201-0451 Fax: (310) 286-7495 (Claims Processed by Employer's Name for all California) TRANSCONTINENTAL INSURANCE COMPANY (See CNA) STATE FARM FIRE & CASUALTY COMPANY 900 Old River Rd. Bakersfield CA 93311-6000 Bakersfield, Main: (661) 663-5634 (800) 749-9703 Fax: (661) 663-5705 (Claims Processed by Employer's Name for all California) TRANSPACIFIC INSURANCE COMPANY (see Tokyo Marine Management / Tokyo Marine and Fire Insurance Company, ltd.) TRAVELERS THE TRAVELERS COMPANIES, INC. 21688 Gateway Center Drive Diamond Bar, CA 91765-8511 (Mailing Address) P. O. Box 6510 Diamond Bar, CA 91765-8510 Main: (800) 258-3710 - (909) 612-3000 Fax: (877) 801-9677 (Claims Processed by Employer's Name for Los Angeles, Orange, Riverside, San Diego, San Bernardino, Imperial, Ventura, Santa Barbara and San Luis Obispo Counties) STERLING ADMINISTRATIVE SERVICES, INC. (See Cambridge Integrated Services Group, INC. - Pasadena and Rancho Cordova offices) SUPERIOR NATIONAL INSURANCE COMPANY (See Broadspire) SUPERIOR PACIFIC INSURANCE GROUP (See Broadspire) SUTTER HEALTH 1014 W. North Market Blvd., Suite 40 Sacramento, CA 95834 (Mailing Address) P.O. Box 160066 Sacramento, CA 95816 Main: (916) 561-6500 Fax: (916) 561-6501 (Self Insured/Self-Administered) TRAVELERS THE TRAVELERS COMPANIES, INC. 333 City Blvd. West, Suite 1100 Orange, CA 92868 (Mailing Address) P. O. Box 14246 Orange, 92863-1246 Main: (800) 221-3974 - (714) 620-1200 Fax: (866) 577-8331 (Claims processed by both Employer's and Injured's Names for all of California) -TTIG INSURANCE COMPANY (See Risk Enterprise Management Limited) MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 - ( 27 ) - Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers TRAVELERS THE TRAVELERS COMPANIES, INC. P. O. Box 13089 Sacramento. CA 95813-4089 Main: (800) 727-3995 Fax: (877) 749-0077 (Claims processed by Employer's Name for Northern California) TRISTAR RISK MANAGEMENT 3333 Camino Del Rio So., Suite 340 San Diego, CA 92108 (Mailing Address) P. O. Box 880287 San Diego, Ca 92168-0287 Main: (619) 238-5888 Fax: (619) 299-1315 (Claims processed by Injured's Name for all of California) TRAVELERS THE TRAVELERS COMPANIES, INC. 215 Lennon Lane Walnut Creek, CA 94596 (Mailing Address) P. O. Box 8112 Walnut Creek, CA 94596-8112 Main: (800) 842-7354 - (925) 945-4000 Fax: (877) 801-9679 (Claims processed by Employer's Name for Northern California) TRISTAR RISK MANAGEMENT 8665 Gibbs Dr., Suite 200 San Diego, CA 92123 (Mailing Address) P. O. Box 600630 San Diego, CA 92160 Main: (877) 715-8044 - (858) 715-8800 Fax: (858) 715-8801 (Claims Processed by Injured's Name for all of California) TRAVELERS INSURANCE COMPANY (See Travelers) THE TRAVELERS PROPERTY CASUALTY CORPORATION (See Travelers) TRISTAR RISK MANAGEMENT 744 E. Bullard Ave. Fresno, CA 93710 Main: (559) 432-1260 Fax:(559) 432-1267 (Claims processed by Injured's name for all California) TRISTAR RISK MANAGEMENT 390 N. Wiget Lane Walnut Creek, CA 94598-2489 (Mailing Address) P. O. Box 9350 Walnut Creek, CA 94598-0950 Main: (925) 930-9883 Fax: (925) 930-0550 (Claims Processed by Injured's Name for all of California) TRISTAR RISK MANAGEMENT (L. A. County Claims - Sheriffs' Dept. only) P. O. Box 19775 Irvine, CA 92623-9775 Main: (800) 782-5888 - (949) 635-3125 Fax: (949) - 635-3175 (Self-Insured. Claims processed for County of Los Angeles [ Sheriffs' Department only ] ) TRUCK INSURANCE EXCHANGE (See Farmers Insurance Group) TWIN CITY FIRE INSURANCE COMPANY (See The Hartford) -U- TRISTAR RISK MANAGEMENT P. O. Box 512028 Los Angeles, CA 90051-2028 Main: (562) 506-0300 Fax: (562) 981-0804 (Claims processed by Injured's Name for all of California) ULICO INSURANCE GROUP P. O. Box 5131 Chino, CA 91708-5131 Main: (800) 408-7222 - (909) 393-5100 Fax: (909) 393-5110 TRISTAR RISK MANAGEMENT P. O. Box 277490 Sacramento, CA 95827-7490 Main: (916) 631-0415 Fax: (916) 638-5090 (Claims processed by Injured's Name for all of California) ULICO STANDARD OF AMERICA (See Ulico Insurance Group) UNDERWRITERS ADJUSTING COMPANY (See CNA) MATRIX DOCUMENT IMAGING, INC. www.legal-records.com TRISTAR RISK MANAGEMENT P. O. Box 11967 Santa Ana, CA 92711-1967 Main: (714) 543-0700 Fax: (714) 542-7617 (Claims Processed by Injured's name for all of California) Toll Free: (800) 737-8840 - ( 28 ) - Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers UNICARE INSURANCE COMPANY (See Cambridge Integrated Services Group, Inc.) UNITED STATES DEPARTMENT OF LABOR …cont'd Division of Federal Employees' Compensation Mailing addr. for medical reports, bills and case corresp.: U. S. Department of Labor DFEC Central Mailroom - District 13 P. O. Box 8300 London, KY 40742-8300) Division of Longshore & Harbor Workers' Compensation P. O. Box 193770 San Francisco, CA 94119-3770 Main: (415) 625-7669 Fax (415) 625-7470 (Claims processed by Injured's Name for States of California, Arizona, Nevada and Hawaii) Division of Longshore & Harbor Workers' Compensation 401 E. Ocean Blvd., Suite # 720 Long Beach, CA 90802 Main: (562) 980-3577 Fax: (562) 980-3587 (Claims processed by Injured's Name for States of California, Arizona, Nevada and Hawaii) UNIGARD INSURANCE COMPANY 15805 N.E. 24th St. Bellevue, WA 98008-2409 (Mailing Address) P. O. Box 90701 Bellevue, WA 98009-0701 Main: (800) 777-1757 - (425) 562-5264 Fax: (425) 562-5258 (Claims processed by Injured's Name for all California) UNINSURED EMPLOYERS BENEFIT TRUST FUND CLAIMS UNIT 320 W. Fourth St., Suite 690 Los Angeles, CA 90013 Main: (213) 576-7300 Fax: (213) 576-7304 (Claims Processed by Injured's Name for all of Southern California) U. S. FIDELITY AND GUARANTY COMPANY (See Travelers) UNINSURED EMPLOYERS BENEFIT TRUST FUND CLAIMS UNIT 1515 Clay Street., 17th Floor Oakland CA 94142-9397 Oakland, (Mailing Address) P.O. Box 429397 San Francisco, CA 94142-9397 Main: (510) 286-7067 Fax: (510) 286-6997 (Claims processed by Injured's Name) UNITED STATES FIRE INSURANCE COMPANY (See Crum & Forster) UNIVERSAL UNDERWRITERS GROUP (See Zurich Direct Underwriters) USA CASUALTY (See Ulico Insurance Group) UNINSURED EMPLOYERS BENEFIT TRUST FUND SUBSEQUENT INJURIES FUND CLAIMS UNIT 2424 Arden Way, Suite 355 Sacramento, CA 95825 Main: (916) 263-2774 Fax: (916) 263-0971 (Claims Processed by Injured's Name) UTICA NATIONAL INSURANCE COMPANY P. O. Box 6554 Utica, NY 13504-6554 Main: (800) 678-8422, (972) 677-6700 Fax: (315) 266-4127 (Claims Processed for 19 Western States, including California and Texas) UNITED PACIFIC-RELIANCE INSURANCE COMPANY (See Cambridge Integrated Services Group, Inc. - Pasadena and Rancho Cordova Offices) VIGILANT INSURANCE COMPANY (See Chubb Group of Insurance companies) -V- VONS, A SAFEWAY COMPANY (Risk Management Department) (W.C. Claims Unit) 618 Michillinda Ave. Arcadia, CA 91007-1734 (Mailing Address) P. O. Box 60008 Arcadia, CA 91066-6008 Main: (626) 821-7149 Fax: (626) 821-7915 (Self-Insured Administrators. Claims Processed by Injured's Name for All of California) UNITED STATES DEPARTMENT OF LABOR (Office of Worker's Compensation Programs) 90 Seventh St., Suite 15300 San Francisco, CA 94103-6716 (Mailing Address) P. O. Box 193769 San Francisco, Ca 94119-3769 Main: (415) 625-7500 Fax: (415) 625-7450 MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 - ( 29 ) - Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers -W- -Y- WARD NORTH AMERICA, INC. (See Novapro Risk Solutions, L.P.) YASUDA FIRE & MARINE INSURANCE COMPANY OF AMERICA (See Broadspire - Fresno office) WARNER BROTHERS STUDIOS FACILITIES (Workers' Compensation Department) 4000 Warner Blvd. Burbank, CA 91522 Main: (818) 977-3232 Fax: (818) 977-6787 -ZZENITH INSURANCE COMPANY 7440 N. Palm Ave., Suite 103 Fresno, CA 93711-5729 (Mailing Address) P. O. Box 12546 Fresno, CA 93778-2546 Main: (800) 508-9910 - (559) 432-6660 Fax: (559) 436-8839 (Claim Processed by Employer's Name for Fresno, Inyo, Kern Kings, Madera, Mariposa, Merced, Mono, San Luis Obispo, Stanislaus, Tulare and Tuolumne Counties) WASAU INSURANCE COMPANIES P. O. Box 4025 Beaverton, OR 97076-4025 Main: (800) 424-0054 - (503) 626-4100 Fax: (603) 334-0307 (Claims Processed by Employer's Name for California, Nevada and Hawaii) ZENITH INSURANCE COMPANY 4309 Hacienda Dr., Suite 200 Pleasanton, CA 94588 (Mailing Address) P. O. Box 8002 Pleasanton, CA 94588-8602 Main: (925) 460-0600 (Claims Processed by Employer's Name for Alameda, Alpine, Amador, Butte, Calaveras, Colusa,Contra Cosrta, Del Norte, El Dorado, Glenn, Humboldt, Lake Lassen, Marin, Mendocino, Modoc, Monterey, Napa, Nevada, Placer, Plumas, Sacramento, San Benito, San Francisco, San Joaquin, San Luis Obispo, San Mateo, Santa Clara, Santa Cruz, Sierra, Siskiyoiu, Solano, Sonoma, Shutter, Tehoma, Truinity, Yolo and Yuba Counties) WEAR AND WOOD, INC. (See Tristar Risk Management - San Diego office [ Camino Del Rio So. ] ) WEST AMERICAN INSURANCE COMPANY (See Ohio Casualty Group of Ins. Ins Companies) WESTERN GROWERS INSURANCE COMPANY (See Intercare Insurance Services) WESTERN SELF-INSURANCE SERVICES 619 Fifth St. Eureka, CA 95501 Main: (707) 445-5496 Fax: (707) 445-5498 ZENITH INSURANCE COMPANY (Mission Valley Office) 7676 Hazard Center Dr., Suite 1200 San Diego, CA 92108 Main: (619) 299-6252 Fax: (800) 533-6212 (Claims Processed by Employer's Name for Central and South San Diego County [ South of the 56 Freeway ] plus Imperial County) WILLIS ADMINISTRATIVE SERVICES CORPORATION (See ASC) WILLIS CORRON ADMINISTRATIVE SERVICES CORP. (See ASC) WCA WORKERS' COMPENSATION ADMINISTRATORS 265 E. Donovan Road Santa Maria, CA 93454 Main: (805) 922-9157 Fax: (805) 349-2816 ZENITH INSURANCE COMPANY 420 Stevens Ave., Suite 300 Solana Beach, CA 92075 (Mailing Address) 7676 Hazard Center Dr., #1200 San Diego, CA 92108 Main: (858) 509-6100 (Claims Processed by Employer's Name for North San Diego County [ North of the 56 Freeway]) WORKERS COMPENSATION AND INDEMNITY COMPANY OF CALIFORNIA (See Cambridge Integrated Services Group, Inc San Diego Office) -X- MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 - ( 30 ) - Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers ZENITH INSURANCE COMPANY 21255 Califa Street Woodland Hills, Ca 91367-5021 (Mailing Address) P. O. Box 9055 Van Nuys, CA 91409-9055 Main: (800) 448-4356 - (818) 713-1000 Fax: (818) 713-8296 (Claims Processed by Employer's Name for Los Angeles, Orange, Riverside, San Bernardino, Santa Barbara and Ventura Counties) ZURICH - AMERICAN INSURANCE COMPANIES (See Zurich North America) ZURICH DIRECT UNDERWRITERS P. O. Box 2904 Shawnee Mission, KS 66201-1304 Main: (877) 549-3905 Fax: (877) 331-1700 (Claims Processed by Injured's Name for all of California) ZURICH NORTH AMERICA 3249 Quality Dr., Suite 300 Rancho Cordova, CA 95670-6098 (Mailing Address) P O. P. O Box 981030 West Sacramento, CA 95798 Main: (800) 239-4829 Fax: (800) 547-2487 (Claims Processed by Employer's Name for all of California) ZURICH NORTH AMERICA 560 Mission St., 24th Floor San Francisco, CA 94105 (Mailing Address) P. O. Box 7774 San Francisco, CA 94120-7774 Main: (800) 701-4926 - (415) 538-7100 Fax: (415) 538-7150 (Claims Processed for Northern California, plus States of Alaska, Hawaii, Oregon and Idaho) ZURICH NORTH AMERICA 21300 Victory Blvd., Tenth Floor Woodland Hills, CA 91367 (Mailing Address) P. O. Box 92566 Los Angeles, CA 90009-2566 Main: (818) 227-1700 Fax: (818) 227-1740 (Claims Processed by Employer's Name for Southern California and Arizona) ZURICH U.S. (See Zurich North America) MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 - ( 31 ) - Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers - NOTES & COMMENTS - MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 - ( 32 ) - Fax: (800) 975-1653 2008 Worker's Comp Industrial Insurance Carriers - NOTES & COMMENTS - MATRIX DOCUMENT IMAGING, INC. www.legal-records.com Toll Free: (800) 737-8840 - ( 33 ) - Fax: (800) 975-1653
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