Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-36 - WORKERS' COMPENSATION INSURANCE STATISTICAL AGENT - FORMS AND RATING PLANS › Rule 120-2-36-.06 - Insurers Required to Provide Statistics, Data and Information to Statistical Agent and Insured

Current through Rules and Regulations filed through June 27, 2024
(1) As a condition to continuing to transact
				insurance in the State of Georgia, every Insurer authorized to transact
				Worker's Compensation insurance shall provide to the authorized statistical
				agent worker's compensation data, statistics including loss ratios and all
				other relevant information. The foregoing shall be submitted in such a manner
				(including statistical plan and data collection procedures) as is required by
				the current statistical plan filed with and approved by the Commissioner by
				that authorized statistical agent.
(2) The Insurer shall verify with the
				Insured, the data to be submitted to the Statistical Agent who shall determine
				the experience modification factor. Verification of such data shall be
				accomplished in accordance with this regulation:
(a) The Insurer shall provide the Insured
				with a copy of the statistical data being submitted to the Statistical Agent.
				The statistical data shall be presented in a legible and understandable format.
				Technical terms shall be avoided wherever possible. It shall be permissible for
				the insurer to provide the unit statistical report, by whatever name called, in
				lieu of an independently created form, provided the unit statistical report is
				accompanied by a legible and understandable explanation of its
				format.
(b) The disclosure
				statement contained in Form GID-63 attached hereto and incorporated herein, or
				one substantially the same, shall be attached to the statistical data provided
				to the Insured.
1. The disclosure shall
				provide a statement in bold face type, to be signed by an authorized
				representative of the Insured, that the statistical data has been reviewed and
				is accurate, and a representative of the Insurer has explained to the Insured's
				representative that the statistical data may affect the Insured's premium for
				Georgia Workers' Compensation insurance.
2. The disclosure shall indicate that the
				statistical data will be deemed accurate if the disclosure is not returned to
				the address provided by the Insurer within 30 days from the date mailed.
(i) The Insurer shall deliver the statistical
				data and disclosure in person or by depositing the information in the United
				States mail to be dispatched by at least first-class mail to the last address
				of record of the Insured, and receiving the receipt provided by the United
				States Postal Service or such other evidence of mailing as prescribed or
				accepted by the United States Postal Service.
(ii) Statistical data that is deemed to be
				accurate will not in any way affect the right of the Insured to appeal to the
				Georgia Worker's Compensation Appeals Board.
3. The disclosure shall also provide a
				statement for an authorized representative of the Insured to dispute the
				accuracy of the data. The statement shall direct the Insured to clearly
				identify any discrepancies. The disputed data shall be furnished to the Insurer
				by the return date indicated on the disclosure statement.
(i) If the Insurer confirms the accuracy of
				the information provided by the Insured, the Insurer shall correct their
				records and proceed to furnish the amended data to the Statistical
				Agent.
(ii) If the Insurer does not
				agree with the data provided by the Insured, the Insurer shall submit the
				Insurer's data to the Statistical Agent.
(I)
				The Insurer shall notify the risk within 60 days of the original mail date that
				the experience modification factor will be promulgated from the information
				provided by the Insurer.
(II) The
				Insured shall be instructed, in detail, of their right to appeal to the Georgia
				Workers' Compensation Appeals Board.
(III) The Insurer's failure to respond to the
				Insured in the time prescribed shall be deemed an acknowledgement that the
				insured's records are accurate, and amendments are to be made before reporting
				the statistical data to the Statistical Agent.
(c) Verification of data shall not
				be mandatory for insured who are not eligible for experience rating, however,
				the data and explanation shall be furnished to insureds upon request.