W. Va. Code R. § 85-18-11 - Self-Administration of Claims

11.1. All self-insured employers shall administer their own claims consistent with the provisions of chapter twenty-three of the West Virginia Code and the rules promulgated thereunder. An injured worker who is an employee of a self-insured employer is entitled to all of the workers' compensation benefits, pursuant to chapter twenty-three of the West Virginia Code and the rules promulgated thereunder, as those afforded to injured workers whose claims are paid and administered by private workers' compensation insurance carriers. These same benefits include the proper and timely payment of medical bills and compensation.

11.2. Notifications.

a. Each new self-insured employer shall within five (5) working days notify, in writing, the following persons, entities or adjudicatory bodies involved in active claims matters that the self-insured employer is self-administering its claims:

1. Claimants;

2. Claimant representatives;

3. All parties to the claim;

4. All adjudicatory bodies that are currently proceeding in the claim; and

5. Vendors who are rendering services in the claim.

b. Each self-insured employer shall within five (5) days notify its employees that it is self-administering its claims. This notice must be posted at each of the employer's places of business within the State.

c. The self-insured employer is required to state in each notice, whether the notice is individually written or posted, that the self-insured employer, and not the previously utilized private carrier, is the primary contact for submitting invoices, claims inquiries, legal notices, medical reports and other communications concerning the claim.

11.3. Claims Contact. The self-insured employer shall provide to and maintain with the Commissioner a current name, address and telephone number of the contact person responsible for administering payments on behalf of the injured employees.

Notes

W. Va. Code R. § 85-18-11