Texas Workers' Compensation

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§ 114.11. Audit Program

(a) The division shall audit certified self-insurers as frequently as necessary to assure compliance with the Texas Workers’ Compensation Act and division rules, but shall audit each certified self-insurer at least once every three years.

(b) An audit may include, but not be limited to:

(1) any representation made on an application or in an annual report required by §114.15(b) of this title (relating to Revocation of Certificate of Authority to Self-Insure);

(2) payroll and classification;

(3) loss history;

(4) claims administration;

(5) loss reserves;

(6) interviews of the certified self-insurer, its agents, or employees regarding any matter within their knowledge and pertaining to the obligations of the certified self-insurer under the Act or division rules; and

(7) any other issue deemed appropriate by the division.

(c) A written report shall be provided to the certified self-insurer within 30 days after the audit is completed.

(d) A certified self-insurer’s unreasonable refusal to make the required information available constitutes:

(1) grounds for revocation of the certificate; and

(2) a Class A administrative violation, with each day of noncompliance constituting a separate violation.

The provisions of this §114.11 adopted to be effective January 1, 1993, 17 TexReg 7896; amended to be effective May 9, 2004, 29 TexReg 4186; amended to be effective January 6, 2019, 44 TexReg 99.

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At a Glance:

Title:

§ 114.11. Audit Program

Title:

Title 28. Insurance

Status:

Current

Usage:

New Law Rule

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