Section R20-5-725. Service Companies; Qualifications; Contracts; Transfer of Claims

A.      A pool shall obtain the services of a service company to pro- cess the pool’s workers’ compensation claims unless the pool

obtains permission to process its own workers’ compensation claims from the Commission under R20-5-726.

B.       Qualifications of a service company.

1.        A service company shall have facilities and equipment to manage, process, and store workers’ compensation claims;

2.        If required by law, a service company shall ensure that a licensed claims adjuster processes all workers’ compen- sation claims. If a licensed claims adjuster is not required by law to process claims, then the service company shall ensure that workers’ compensation claims are processed by persons with experience, training, and knowledge of the following:

a.        Processing   of   Arizona   workers’    compensation claims; and

b.        Arizona Worker’s Compensation Act;

3.        Service company personnel processing workers’ compen- sation claims shall attend and complete training provided by the Commission Claims Division.

C.      A service company shall process and pay each worker’s com- pensation claim in compliance with the Arizona Workers’ Compensation Act and the rules. A contract between a pool and service company shall include this requirement.

D.      Transfer of claims from one service company to another ser- vice company.

1.        The transfer of claims from one service company to another service company shall be handled in a way that does not interfere with or interrupt the processing of a worker’s compensation claim.

2.        A service company transferring a worker’s compensation claim shall communicate to the new service company the historical claims processing activity associated with the worker’s compensation claim, and shall provide an origi- nal or copy of every document required for continued processing of the worker’s compensation claim.

3.        A pool shall immediately provide written notice to the Industrial Commission Claims Division of any transfer of a worker’s compensation claim from one service com- pany to another.

Historical Note

Adopted effective September 9, 1998 (Supp. 98-3).