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MEDICAL AUTHORIZATION FORM - Zenith Insurance Company 2025

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The document is a Medical Authorization Form that outlines the procedures for employers and employees in the event of a workplace injury. It specifies that employers must complete and retain the form, provide copies to the injured employee and their treating physician, and ensure that medical providers are part of the Zenith Medical Provider Network (ZMPN) unless a personal physician has been pre-designated by the employee.

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Click ‘Get Form’ to open the MEDICAL AUTHORIZATION FORM in the editor.
Begin by entering the name of the injured employee in the designated field labeled 'Name of Injured'.
Fill in the 'Date of Injury' field with the appropriate date when the injury occurred.
In the section addressed to the physician, write down the name of the M.D. who will be providing care.
The employer must complete their information, including 'Employer', 'Date', and sign off with their name and title.
Ensure that all fields are filled accurately before saving or printing your completed form for distribution.

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is a medical authorization form?

Zenith is the premier specialist in workers compensation nationally, and a leader in property and casualty insurance for the California agriculture industry. We combine depth of expertise with a forward-thinking approach to achieve the highest level of service and outcomes for our clients.

What insurance is Zenith?

If you need to report a claim, you may do so online at TheZenith.com or by calling 800-440-5020.

What is the phone number for Zenith insurance claim?

To be the trusted and best provider of insurance and financial services.

What kind of company is Zenith American?

As a leading third-party benefits administration company, we understand the value and impact of comprehensive benefits. This knowledge drives our mission to deliver exceptional benefits solutions to our clients, ensuring their workforce is supported and empowered.

Is Zenith a TPA?

Based in Tampa, FL, Zenith, is the largest third-party administrator to Taft-Hartley multi-employer funds in the US. The company serves over 260 customers, enabling the delivery of complex Health Welfare and Retirement Pension benefits to members.

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Who is Zenith Insurance part of?

Zenith Insurance goes all the way back to 1937, when it was established as a motor syndicate at Lloyds of London. It has been part of the Markerstudy Group of companies since 2010.

How good is Zenith car insurance?

Why get car insurance from Zenith? With a 3-star Defaqto rating for its car insurance policies, Zenith isnt the highest-rated insurer on the market, but its range of benefits still make it a popular choice for consumers. Gibraltar-based Zenith has been providing insurance services to UK customers for over 80 years.

MEDICAL AUTHORIZATION FORM - Zenith Insurance Company 2025

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Is Zenith a TPA?

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