Section 203 IAC 1-1-5 - Investigation of claims; notice of determinationsAuthority: IC 5-2-6.1-46
Affected: IC 5-2-6.1
Sec. 5.
(a) A claim, when accepted as complete or when set for hearing, shall be investigated by the division as to its validity, regardless of whether the alleged perpetrator has been apprehended for, prosecuted for, or convicted of any crime based upon the same alleged incident.(b) All claimants under IC 5-2-6.1 shall cooperate with claims analysts and other representatives of the division in order to be eligible for an award. In the event that such cooperation is refused or denied, the division may, in the discretion of the director, deny such claims.(c) The division shall obtain written verification of all events, claims, and sums of money alleged by the claimant to the greatest degree possible through the following: (2) Providers of medical assistance and funeral services.(5) Any other relevant source. If discrepancies arise, the division may interview the claimant, or victim if other than the claimant, in order to establish such verifications and consistency of the record of the claim.
(d) After receipt of all information necessary to process a claim, a claims analyst shall prepare a written case report and preliminary determination recommendation on the claim. The case report shall be delivered to the director, or the director's designee, and shall:(1) contain a statement of the facts alleged by the claimant;(2) describe the verifications and discrepancies; and(3) make a recommendation as to whether or not assistance should be provided, the amounts payable, including reasonable attorney's fees, if any, and a rationale of the recommendation. The director, or the director's designee, shall then review the entire file together with the case report and preliminary determination recommendation. If the director, or the director's designee, disagrees with the claims analyst's preliminary determination recommendation in whole or in part, the director, or the director's designee, shall remand the claim for further investigation or request that the matter be set for hearing.
(e) If the director, or the director's designee, agrees with the claims analyst's recommendation to deny the claim, the director, or the director's designee, shall issue to the claimant a preliminary determination stating the reason or reasons for the denial. The preliminary determination shall be sent by first class United States mail to the claimant's last known address. A claimant who disagrees with the preliminary determination may request a hearing. This request must be made in writing within thirty (30) days from the date of the preliminary determination. The claimant's failure to timely request a hearing shall constitute a waiver of the hearing and a consent to the agency action described in the preliminary determination, and a notice of final determination will then be issued to the claimant. Where timely requested, a hearing will be set and will be limited to the reason or reasons for the denial stated in the preliminary determination.(f) If the director, or the director's designee, agrees with the claims analyst's recommendation to award the claim, the director, or the director's designee, shall issue a notice of award stating the amount of the award and its allocation. If a claimant disagrees with the notice of award, the claimant may request a hearing. This request must be made in writing within thirty (30) days from the date of the notice of award.Victim Services Division; 203 IAC 1-1-5; filed Aug 26, 2004, 1:30 p.m.: 28 IR 6; readopted filed Dec 2, 2010, 2:29 p.m.: 20101229-IR-203100660RFAReadopted filed 11/30/2017, 1:38 p.m.: 20171227-IR-203170441RFAReadopted filed 6/22/2023, 11:34 a.m.: 20230719-IR-203230221RFA