Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-5-4 - SERVICE ORGANIZATIONS › Section 480-5-4-.01 - Self-Insurance Service Company

Current through Register Vol. 42, No. 9, June 28, 2024
An individual, partnership, or corporation engaged in the
				business of servicing a fund shall have a full-time office in the State of
				Alabama which has full authority to investigate and pay claims under the
				provisions of the law. Service companies shall make application to the Director
				prior to entering into a contract and shall satisfy the Director that they have
				adequate facilities and competent personnel to service a fund or self-insured
				employer in such a manner to fulfill the employer's obligations under the Law
				and rules. Prerequisites to approval being granted by the Director for engaging
				in this type of business are:
(a) The
			 owners of the business, including members of a partnership and the officers of
			 a corporation, shall be persons of good moral character with reputations for
			 honesty and fair dealings, and in the case of an individual ownership, the
			 owner shall have had at least five (5) years of satisfactory experience and
			 training in underwriting and claims adjusting in the field of workers'
			 compensation. In the case of a partnership or corporation, at least one member
			 of the firm shall have had the experience and training mentioned above.
			 However, the owner of the business or any member of the firm not having the
			 required experience and training in claims underwriting and adjusting may in
			 lieu thereof employ personnel or contract with persons meeting such
			 qualifications. The Director shall be furnished with the names of such
			 employees and/or persons under contract prior to their performing such
			 services.
(b) The service company
			 shall file with the Department copies of all contracts entered into with the
			 self-insured employers or fund. The contract shall include those services
			 necessary to fulfill the employers' obligations under the Alabama Workers'
			 Compensation Law and rules.
(c)
			 Upon compliance to the satisfaction of the Director with the above provisions,
			 a certificate of approval as a recognized and authorized service organization
			 shall be issued to the applicant.
(d) Failure to comply with any of the
			 foregoing rules or any order of the Department within the time prescribed shall
			 be considered good cause for withdrawal of the certificate of approval. The
			 Department shall give prior written notice of such withdrawal. The service
			 company shall have fifteen (15) days from the date of mailing to request a
			 hearing. Failure to request a hearing within the time prescribed shall result
			 in withdrawal becoming effective thirty (30) days from the date of mailing of
			 the original notice. In no event shall withdrawal of the certificate of
			 approval be effective prior to the date that the hearing on the question is
			 scheduled. Such notice shall be served personally or by certified or registered
			 mail, upon all interested parties.
(e) In the event the Department shall
			 withdraw the Certificate of Approval and said withdrawal become effective, then
			 the service company shall have the right to appeal the final withdrawal of
			 certificate to the Circuit Court of Montgomery County, Alabama, within thirty
			 (30) days of the withdrawal becoming effective.
Author:
Wilbon S. Spates, Chief, Workers'
				Compensation Division
Statutory Authority:
Code of Ala.
				  1975
, §
										25-2-2(6).