OR Posts Insurer Notice Regarding Non-Disabling Claims Reimbursement
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Portland, OR (CompNewsNetwork) - The Oregon's Workers’ Compensation Division recently investigated an insurer for its failure to notify employer policyholders about the option to reimburse the insurer for medical service costs on non-disabling claims. This notification is required in Oregon Administrative Rule (OAR) 436-060-0055(2).
The non-disabling claims reimbursement option offers Oregon employers an opportunity to pay medical service costs up to $1,600 on accepted, non-disabling claims. Those costs cannot in any way be used to affect the employer’s experience rating modification or otherwise be charged against the employer, thereby potentially reducing the employer’s premium expenses. Insurers must notify their policyholders of this option at the inception of the policy and before each policy year.
The reimbursement is optional for employers, but insurers are required to notify employers of the option and to participate in the program if the employer chooses to participate. Failure to do so may result in civil penalties against the insurer. The rules describing the requirements for insurers and employers to participate are in OAR 436-060-0055 and can be found on the Web at http://www.cbs.state.or.us/wcd/policy/rules/rules.html.
The Oregon's Workers’ Compensation Division will include notification requirements in future focused audits to ensure that employers are properly advised of potential benefits.
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