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296-15-340  <<  296-15-350 >>   296-15-360

Handling of claims.

What elements must a self-insurer have in place to ensure appropriate handling of claims? Every self-insurer must:
(1) Establish procedures for securing the confidentiality of claim information.
(2) Have sufficient numbers of certified claims administrators to ensure uninterrupted administration of claims.
(a) There must be at least one certified claims administrator involved in the daily management of the employer's claims.
(b) If claims are administered in more than one location, there must be at least one certified claims administrator in each location where claims are managed.
(3) Designate one certified claims administrator as the department's primary contact person for claim issues.
(4) Designate one address for the mailing of all claims-related correspondence. The self-insurer is responsible for forwarding documents to the appropriate location if an employer's claims are managed by more than one organization.
(5) Establish procedures to answer questions and address concerns raised by workers, providers, or the department.
(6) Ensure claims management personnel are informed of new developments in workers' compensation due to changes in statute, case law, rule, or department policy.
(7) Include the department's claim number in all claim-related communications with workers, providers, and the department.
(8) Legibly date stamp incoming correspondence, identifying both the date received and the location or entity that received it.
(9) Ensure a means of communicating with all injured workers.
[Statutory Authority: RCW 51.04.020, 51.14.030. WSR 14-02-121, § 296-15-350, filed 1/2/14, effective 2/2/14. Statutory Authority: RCW 51.04.020, 51.14.020, 51.32.190, 51.14.090, and 51.14.095. WSR 06-06-066, § 296-15-350, filed 2/28/06, effective 4/1/06.]