Md. Code Regs. 14.09.12.03

Current through Register Vol. 51, No. 24, December 2, 2024

Section 14.09.12.03 - Handling and Adjusting Disputed Claims

A. An insurer that provides workers' compensation insurance in Maryland shall have in the State competent individuals who:

(1) Handle and adjust each disputed workers' compensation claim for the insurer;

(2) Have authority to resolve claims without having to routinely contact an out-of-State representative of the insurer; and

(3) Possess the knowledge and experience to handle and adjust each disputed claim.

B. If an insurer files issues to dispute a claim, the filing shall be done in the State by competent individuals who:

(1) Handle and adjust each disputed workers' compensation claim for the insurer;

(2) Have authority to resolve claims without having to routinely contact an out-of-State representative of the insurer; and

(3) Possess the knowledge and experience to handle and adjust each disputed claim.

C. Within 10 days of an insurer filing issues to dispute a claim, the insurer shall have an attorney complete and file an entry of appearance form in accordance with COMAR 14.09.04.01C(2).

D. Each insurer shall register with the Commission the contact information for a designated representative who can identify the competent individual handling and adjusting each disputed claim.

E. Upon inquiry, the designated individual shall provide the name, address, telephone number, and email address of the competent individual handling and adjusting a claim within 2 business days.

F. If any of the information in §D of this regulation changes, the insurer shall notify the Commission immediately.

G. An insurer that provides workers' compensation insurance in Maryland shall establish a toll-free telephone number through which an insured or claimant, or a representative of an insured or claimant, may make direct telephone inquiries during regular business hours.

H. An insurer that provides workers' compensation insurance in Maryland shall register with CompHub to file and receive papers with the Commission.

Md. Code Regs. 14.09.12.03

Effective date: 41:4 Md. R. 303, eff.3/3/2014 ; amended effective 45:5 Md. R. 288, eff. 3/12/2018; amended effective 48:20 Md. R. 890, eff. 10/18/2021