Current through Register Vol. XLI, No. 50, December 13, 2024
Section 85-2-3 - Definitions As used in this exempt legislative rule, the following terms have the stated meanings unless the context of a specific use clearly indicates another meaning is intended.
3.1. "Commissioner" means the Insurance Commissioner of West Virginia as provided in W. Va. Code § 33-2-1, or any designated third-party administrator of the Insurance Commissioner.3.2. "EDI" is the Electronic Data Interchange Project of the International Association of Industrial Accident Boards and Commissions ("IAIABC"), Release 3 standards.3.3. "Industrial Council" means the Industrial Council created pursuant to W. Va. Code § 23-2C-5.3.4. "Private carrier" means any insurer authorized by the Commissioner to provide workers' compensation insurance pursuant to chapters twenty-three and thirty-three of the West Virginia Code and any third-party administrator designated by the private carrier to adjust West Virginia workers' compensation claims.3.5. "Self-insured employer" means an employer who is eligible and has been granted self-insured status pursuant to the provisions of W. Va. Code § 23-2-9 and the rules promulgated thereunder, and any third-party administrator designated by the self-insured employer to adjust West Virginia workers' compensation claims.3.6. "Special Funds," mean all workers' compensation related funds created in W. Va. Code § 23-2C-1 et seq., and administered by the Commissioner, which are responsible for paying certain West Virginia workers' compensation benefits, and any third-party administrator designated by the Commissioner to adjust West Virginia workers' compensation claims on behalf of such funds.3.7. "WV OIC EDI IG" is the West Virginia Offices of the Insurance Commissioner's EDI Implementation Guide.3.8. "Workers' Compensation Claims Index" or "claims index" is a method for indexing claims of injured workers filing for West Virginia workers' compensation benefits that will make information concerning West Virginia's injured workers available to insurers or self-insured employers, as required by the Industrial Council pursuant to W. Va. Code § 23-2C-5(c)(8).3.9. "West Virginia workers' compensation" means workers' compensation coverage which provides workers' compensation benefits to injured employees consistent with chapter twenty-three of the West Virginia Code and the rules promulgated thereunder.