Florida Regulations 69L-5.113

From Wcc
Jump to: navigation, search

Florida > Regulations

§ 69L-5.113 Application to Provide Servicing.(repealed)

Repealed. (03-09-10)

(1) Applications by businesses for approval to provide underwriting, claims adjusting, loss control, safety engineering services, and any other services for which the applicant has or intends to contract to provide to self-insurers pursuant to Section 440.38(2)(a), Florida Statutes, shall be made on Form |^SI-22|. Form |^SI-22|, Service Company Application, is hereby incorporated by reference into Rule Chapter 4L-5, F.A.C. The form required by this rule shall bear the date September 1996 (9/96). A copy of Form |^SI-22| is available from the Division of Workers' Compensation, Bureau of Monitoring and Audit, Self-Insurance Section, 200 East Gaines Street, Tallahassee, FL 32399-4224. Applications shall be approved pursuant to Section 120.60, Florida Statutes, and the model rules of procedure. (2) Any business desiring to become qualified as a service company for individual self-insurers must be approved before any contract for servicing shall be recognized. (3) To satisfy application requirements, insurance companies licensed to write workers' compensation insurance by the Florida Department of Insurance to operate within the State of Florida must submit a completed Form |^SI-22| (or a copy thereof), proof of the Certificate of Insurance, and a copy of the Division of Safety letter of approval for their safety program. (4) Any business making application to qualify as a service company shall provide proof that it meets the following conditions before approval is to be granted: (a) The ownership, control, and management is competent and trustworthy and possesses managerial experience that would make the proposed service company operation beneficial to the workers covered. Some examples as proof of competency shall be a history void of questionable claims handling techniques, questionable patterns of claims, repeated unreasonably controverted claims or poor payment practices. The division shall not grant or continue authority to transact the business of a service company in this state at any time during which the division has good reason to believe that the ownership, control, or management of the service company includes any person whose business practice or conduct is detrimental to the public, stockholders, or creditors. Each person listed above shall file a biographical statement, Form |^SI-27|, and provide the division with an independent background investigation report. Form |^SI-27|, Biographical Statement, is hereby incorporated by reference into Rule Chapter 4L-5, F.A.C. The form required by this rule shall bear the date September 1996 (9/96). A copy of Form SI-27 is available from the Division of Workers' Compensation, Bureau of Monitoring and Audit, Self-Insurance Section, 200 East Gaines Street, Tallahassee, FL 32399-4224. (b) A number of experienced and qualified claims personnel, licensed Florida worker' compensation claims adjusters, loss control and safety engineering personnel, as required in Section 626.897(3)(b) and (c), Florida Statutes, employed on a full-time basis to meet the needs of all self-insurers with which it intends to contract. (c) Experienced and qualified personnel, as required in Section 626.897(3)(c), Florida Statutes, employed on a full-time basis in the area of underwriting to meet the needs of all self-insurers with which it intends to contract. In this context, underwriting includes coordinating of a self-insurance program, the ability to procure bonds and excess insurance, provide summary data regarding the self-insurer's cost of accidents, including the frequency and distribution, by type and cause, and the skill to make recommendations to self-insurers regarding the correction of any deficiencies that arise in the self-insurance program. (d) Has, within the State of Florida, a person experienced and qualified in the field of workers' compensation authorized to act in all matters concerning the service company. (e) That any rehabilitation services offered by, or under contract, to the service company shall be from the approved list of providers of such services maintained by the division pursuant to Section 440.49(7), Florida Statutes. (5) In support of its application, the business shall submit summary information concerning its organization, and detailed resumes of all staff with administrative or professional capacity in sufficient numbers to establish its ability to provide services to all self-insurers with which it intends to contract. (6) Any service company which seeks authorization shall certify that they have sufficient record keeping capabilities. Specific Authority 440.38(1)(b), (2), (4)(b), 440.56(4) FS. Law Implemented 440.38(1)(b), (2), (4)(b), 440.56(4) FS. History-New 10-1-82, Amended 12-25-84, Formerly 38F-5.40, Amended 12-19-93, Formerly 38F-5.040, Amended 5-19-97, Formerly 38F-5.113.