28 Tex. Admin. Code § 114.10
Claims Contractor Requirements
Effective Jan 6, 201944 TexReg 99Source Note: The provisions of this §114.10 adopted to be effective January 1, 1993, 17 TexReg 7896; amended to be effective May 9, 2004, 29 TexReg 4186; amended to be effective January 6, 2019, 44 TexReg 99.Texas Secretary of State
- (a) Claims administration must be performed by an adjuster licensed in Texas to handle workers' compensation claims.
- (b) Each proposed contract to provide claims services to a certified self-insurer must be approved by the division prior to recommending approval of an application to self-insure or, if a certified self-insurer is changing from one claims contractor to another, prior to the effective date of the new contract.
- (c) An applicant must ensure that a current signed claims administration contract remain on file with the division at all times.
- (d) The claims contractor must promptly investigate each reportable injury and either pay benefits or controvert, as required by the Texas Workers' Compensation Act and division rules.
Source Note:The provisions of this §114.10 adopted to be effective January 1, 1993, 17 TexReg 7896; amended to be effective May 9, 2004, 29 TexReg 4186; amended to be effective January 6, 2019, 44 TexReg 99.