Nevada Administrative Code › Chapter 616B - Industrial Insurance: Insurers; Liability for Provision of Coverage › GENERAL PROVISIONS › Section 616B.014 - Transfer of file of claim; duties of insurer or third-party administrator who transfers or receives file

Current through June 11, 2024
1. If an insurer or
			 third-party administrator transfers the file of a claim to another insurer or
			 third-party administrator, the insurer or third-party administrator who
			 transfers the file shall:
(a) Provide in a
			 usable format to the insurer or third-party administrator who receives the file
			 the information necessary to administer the claim.
(b) Provide in a usable format to the insurer
			 or third-party administrator who receives the file the information necessary to
			 comply with all reporting requirements and requests imposed by law.
(c) Continue to pay all compensation due the
			 claimant until the insurer or third-party administrator who receives the file
			 provides notice in writing to the insurer or third-party administrator who
			 transferred the file that an account to pay such compensation has been
			 established and funded.
(d) Provide
			 to the insurer or third-party administrator who receives the file a printed
			 report of all claims which are open on the date on which the file is
			 transferred. The insurer or thirdparty administrator who transfers the file and
			 the insurer or third-party administrator who receives the file shall retain a
			 copy of the report for as long as necessary to assign responsibility for any
			 failure to pay compensation, but in no event for a period of less than 2 years
			 after the date on which the file is transferred. The report must be delivered
			 to the insurer or third-party administrator who receives the file on or before
			 the date on which the file is transferred and must include for each claim:
(1) The current status of the
			 claim;
(2) For any compensation due
			 within 90 days after the date on which the file is transferred, the dates on
			 which the compensation is due and the anticipated period for which the
			 compensation is due;
(3) Any pending
			 issues and determinations;
(4) A
			 brief summary of the history and projected outcome of the claim; and
(5) Information sufficient to enable the
			 insurer or third-party administrator who receives the file to make timely
			 payment of compensation and to continue administering the
			 claims.
(e) Provide
			 notice of the transfer by mail to:
(1) The
			 injured employee whose claim is being transferred;
(2) The attorney or other authorized
			 representative of the injured employee;
(3) Any person who is a provider of health
			 care for the injured employee;
(4)
			 Any person who is performing a rating evaluation of the injured
			 employee;
(5) Any person who is
			 administering the claim which is being transferred; and
(6) The Administrator and the
			 Commissioner.
(f) Not
			 later than 3 days after receiving a notice or other legal documentation
			 relating to a contested claim that is before a hearing officer, appeals officer
			 or court of competent jurisdiction:
(1)
			 Notify, in writing, the sender of the notice or other legal documentation of
			 the name, address and telephone number of the insurer or third-party
			 administrator who receives the file; and
(2) Forward the notice or other legal
			 documentation to the insurer or third-party administrator who receives the
			 file.