Internal Claims Review

The internal claims review (ICR) addresses reports of injuries related to personal accidents that occur at Northern Illinois University. The ICR will account for the settlement process managed in-house for minor injuries sustained by students, faculty, staff or other third-party visitors on campus or on property under the control of NIU, and for which there is justification on the part of the university for the reimbursement of expenses.

The office of Risk Management considers requests for reimbursement of medical expenses for injuries related to personal accidents on an NIU campus. However, these reimbursements are subject to the ICR and, therefore, not guaranteed. Additionally, only out-of-pocket medical expenses are considered up to a maximum of $500. Out-of-pocket costs are those paid by the individual after medical insurance, or all other sources for financial reimbursement/coverage for such medical expenses has covered its portion. This process does not consider equipment coverage, lost wages or other incidentals as part of the request.

This process is not intended to replace or supplement workers' compensation. If an individual is injured while performing work duties, they should contact Human Resource Services at their respective employer. This process does not include damage to personal property as NIU does not assume responsibility for personal property brought on campus.

Process

The review process consists of the following:

• The requester completes and submits an incident report.
• Risk Management will follow up with additional information and to answer any questions.
• The requester provides, when available, the exact, full amount of compensation being requested along with supporting documentation for the figure (bills, invoices, explanation of benefits, statements, receipts, etc.)
  • Please note NIU does not need medical history or detailed medical reports. This process only needs confirmation of the requester's financial responsibility and confirmation the visit was connected to the injury in question.
• The request is reviewed by Risk Management and, when necessary, the vice president for administration and finance and CFO and other applicable parties. If the payment seems appropriate, the requester will be notified and asked to sign a settlement agreement waiving rights to all future claims against NIU in connection with the incident.
• The maximum reimbursement payout is $500. If the claim is denied or $500 will not cover out-of-pocket costs and the individual does not wish to settle, the requester has the right to file with the Court of Claims.

It is important to note that NIU will only consider a one-time payout amount. For injuries that include ongoing treatment, it is common practice to submit the final request (exact figure) once treatment is completed, and the requester has a record of all their patient costs. Once payment has been issued, future payouts will not be considered.

NIU reserves the right to consider claims greater than $500 under extenuating circumstances.