FOR IMMEDIATE RELEASE
The Commission on Health and Safety and Workers' Compensation Approves Draft Revised Claims Adjuster and Bill Reviewer Training and Certification Report, Insurance Code Section 11761
OAKLAND -- The Commission on Health and Safety and Workers' Compensation (CHSWC) has approved for circulation and comment the Draft Revised Claims Adjuster and Bill Reviewer Training and Certification Report, Insurance Code section 11761 and that the final report should be posted within a month if no comments are made.
The California Department of Insurance (CDI) is directed by statute to require insurers to assure that the individuals responsible for handling their claims will meet a minimum standard of training or experience. “Insurer” is defined for this purpose to mean a workers’ compensation insurance carrier, a self-insured employer, or a third-party administrator (TPA) for a self-insured employer. The regulations allow those insurers to manage the training and to designate as trained or experienced the individuals who have received the required training, including continuing education. An advisory group addressed the issue of whether there is sufficient oversight of the program and if not, what enforcement needs to be implemented. This report updates the December 2008 CHSWC report that reviewed the regulations, compliance and enforcement of claims adjuster and bill reviewer training and certification and includes information from the advisory group.
CHSWC is charged with overseeing the health and safety and workers’ compensation systems in California and recommending administrative or legislative modifications to improve their operation. The Commission was established to conduct a continuing examination of the workers’ compensation system and of the state’s activities to prevent industrial injuries and occupational illnesses and to examine those programs in other states.
Information about the Draft Revised Claims Adjuster and Bill Reviewer Training and Certification Report and CHSWC is available at www.dir.ca.gov/chswc and by writing to the Commission on Health and Safety and Workers' Compensation, 1515 Clay Street, Room 901, Oakland, CA 94612, by calling (510) 622-3959, by faxing a request to (510) 622-3265, or by emailing firstname.lastname@example.org.