(a) No person, firm, or corporation, other than an insurer admitted to transact workers’ compensation insurance in this state, shall contract to administer claims of self-insured employers as a third-party administrator unless in possession of a certificate of consent to administer self-insured employers’ workers’ compensation claims.
(b) As a condition of receiving a certificate of consent, all persons given discretion by a third-party administrator to deny, accept, or negotiate a workers’ compensation claim shall demonstrate their competency to the director by written examination, or other methods approved by the director.
(c) A separate certificate shall be required for each adjusting location operated by a third-party administrator. A third-party administrator holding a certificate of consent shall be subject to regulation only under this division with respect to the adjustment, administration, and management of workers’ compensation claims for any self-insured employer.
(d) A third-party administrator retained by a self-insured employer to administer the employer’s workers’ compensation claims shall estimate the total accrued liability of the employer for the payment of compensation for the employer’s annual report to the director and shall make the estimate both in good faith and with the exercise of a reasonable degree of care. The use of a third-party administrator shall not, however, discharge or alter the employer’s responsibilities with respect to the report.
(Amended by Stats. 2009, Ch. 140, Sec. 137. (AB 1164) Effective January 1, 2010.)
Last modified: October 25, 2018