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Introduced Version House Bill 3024 History

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Key: Green = existing Code. Red = new code to be enacted
H. B. 3024


(By Delegate Walters)
[Introduced January 9, 2008; referred to the
Committee on Banking and Insurance then the Judiciary.]




A BILL to amend and reenact §23-5-1 of the Code of West Virginia, 1931, as amended, relating to improving claimants' access to worker's compensation adjusters by requiring that all worker's compensation adjusters employed by a private insurance carrier shall be located within the geographic borders of West Virginia.

Be it enacted by the Legislature of West Virginia:
That §23-5-1 of the Code of West Virginia, 1931, as amended, be amended and reenacted to read as follows:
ARTICLE 5. REVIEW.

§23-5-1. Notice by commission or self-insured employer of decision; procedures on claims; objections and hearing.

(a) The Workers' Compensation Commission, the successor to the commission, other private insurance carriers and self-insured employers may hear and determine all questions within their jurisdiction. All adjusters employed by a private insurance carrier shall be located within the geographic borders of West Virginia. In matters arising under articles three and four of this chapter, the commission, the successor to the commission, other private insurance carriers and self-insured employers shall promptly review and investigate all claims. The parties to a claim shall file the information in support of their respective positions as they consider proper. In addition, the commission, the successor to the commission, other private insurance carriers and self-insured employers may develop additional information that it considers to be necessary in the interests of fairness to the parties and in keeping with their fiduciary obligations. With regard to any issue which is ready for a decision, the commission, the successor to the commission, other private insurance carriers and self-insured employers shall explain the basis of its decisions.
(b) Except with regard to interlocutory matters and those matters set forth in subsection (d) of this section, upon making any decision, upon making or refusing to make any award or upon making any modification or change with respect to former findings or orders, as provided by section sixteen, article four of this chapter, the commission, the successor to the commission, other private insurance carriers and self-insured employers shall give notice, in writing, to the employer, employee, claimant or dependant as the case may be, of its action. The notice shall state the time allowed for filing an objection to the finding. The action of the commission, the successor to the commission, other private insurance carriers and self-insured employers is final unless the employer, employee, claimant or dependant shall, within thirty days after the receipt of the notice, object in writing, to the finding. Unless an objection is filed within the thirty-day period, the finding or action is final. This time limitation is a condition of the right to litigate the finding or action and hence jurisdictional. Any objection shall be filed with the office of judges with a copy served upon the commission, the successor to the commission, other private insurance carriers and self-insured employers, whichever is applicable, and other parties in accordance with the procedures set forth in sections eight and nine of this article. In all instances where a private carrier, self-insured employer or a third-party administrator has made claims decisions as authorized in this chapter, they shall provide claimants notice of all claims decisions as provided by rules for self-administration promulgated by the board of managers and shall be bound by each requirement imposed upon the commission by this article.
(c) Where a finding or determination of the commission, the successor to the commission, other private insurance carriers and self-insured employers, whichever is applicable, is protested only by the employer, and the employer does not prevail in its protest, and in the event the claimant is required to attend a hearing by subpoena or agreement of counsel or at the express direction of the commission or office of judges, then the claimant in addition to reasonable traveling and other expenses shall be reimbursed for loss of wages incurred by the claimant in attending the hearing.
(d) The commission, the successor to the commission, other private insurance carriers and self-insured employers, whichever is applicable may amend, correct or set aside any order or decision on any issue entered by it which, at the time of issuance or any time thereafter, is discovered to be defective or clearly erroneous or the result of mistake, clerical error or fraud, or otherwise not supported by the evidence. Jurisdiction to take this action continues until the expiration of two years from the date of entry of an order unless the order is sooner affected by appellate action: Provided, That corrective actions in the case of fraud may be taken at any time.
(e) All objections to orders of the commission, the successor to the commission, other private insurance carriers and self-insured employers, whichever is applicable shall be styled in the name of the issuing entity. All appeals prosecuted from the office of judges shall be in the name of the issuing party. In all actions under this article, the Workers' Compensation Commission shall be the party in interest unless the parties to the appeal are limited to a claimant and a self-insured employer.



NOTE: The purpose of this bill is to improve claimants' access to worker's compensation adjusters by requiring that all worker's compensation adjusters employed by a private insurance carrier be located within the geographic borders of West Virginia.


Strike-throughs indicate language that would be stricken from the present law, and underscoring indicates new language that would be added.
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