1. (1) The department will:

   1. (a) Follow these reimbursement limitations when determining reimbursement amounts for the caregiver reimbursement program claims:

      1. (i) The total amount the department will pay as the result of one occurrence must not exceed:

         1. (A) $10,000 for all property damages and losses;
         2. (B) $3,000 for claims related to the ownership and operation of a motor vehicle;
         3. (C) $1,000 for emergency medical expenses; and
         4. (D) $500 for emergency veterinary expenses;
      2. (ii) For damage caused over a period of time, the date of the occurrence is the last date the damages occurred;
      3. (iii) The total reimbursement cost is assessed for each occurrence separately and includes the costs for each item in the occurrence;
      4. (iv) The limitations for each occurrence must apply regardless of whether there are multiple claims from the same occurrence;

      5. (v) The total reimbursement cost for property damages or loss and emergency medical expenses are limited to the costs:

         1. (A) Not covered in any insurance policies, up to the maximum occurrence costs in (a)(i) of this subsection;
         2. (B) Of the insurance policy deductible and any out-of-pocket expenses, up to the maximum occurrence costs in (a)(i) of this subsection; and
      6. (vi) Dental or vision appliances are limited to comparable replacements up to the maximum occurrence costs in (a)(i) of this subsection; and
   2. (b) Consider damages from the same occurrence claimed by one or more caregivers in the same household as a single occurrence;

   3. (c) Pay comparable replacement costs only if the:

      1. (i) Item cannot be cleaned or repaired; or
      2. (ii) The comparable replacement cost of the item is less than the cleaning or repair cost;
   4. (d) Reimburse for labor expenses for the amount payable to a licensed business;
   5. (e) Reimburse caregivers or household members that complete repairs for materials only;
   6. (f) Not require caregivers to use their insurance policy but will only consider reimbursement for the insurance deductible, coinsurance amounts, and any out-of-pocket expenses up to the limit of the occurrence in (a)(i) of this subsection;
   7. (g) Limit veterinary expenses to animal emergency medical expenses; and
   8. (h) Pay the replacement value for animal loss, not to exceed the substantiated value of the animal or maximum per occurrence, whichever is less.

2. (2) Caregivers must:

   1. (a) Notify the department if their property damages or losses were paid, will be paid, or are covered by a homeowners', motor vehicles, or other public, personal, or business insurance policy; and
   2. (b) Provide detailed medical bills and insurance statements or explanation of benefits showing the amount covered for emergency medical expenses.

[Statutory Authority: RCW 74.13.031 and 74.13.335. WSR 26-09-128, s 110-50-1060, filed 4/21/26, effective 5/22/26. WSR 18-14-078, recodified as § 110-50-1060, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 74.13.031. WSR 01-08-047, § 388-25-0370, filed 3/30/01, effective 4/30/01.]