Texas Workers' Compensation

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§ 124.5. Mode of Payment Made by Insurance Carriers

(a) The insurance carrier shall make all medical benefit and burial payments by:

(1) check or other readily negotiable instrument; or

(2) electronic transfer by mutual agreement to an account designated in writing by the payee.

(b) Except as provided by §126.2 of this title (relating to Payment of Benefits to Minors), insurance carriers shall make all payments of income or death benefits by:

(1) check or other readily negotiable instrument to the order of the claimant; or

(2) electronic transfer if required to under subsection (f) of this section or by mutual agreement between the insurance carrier and the claimant including an access card under §124.6 of this title (relating to Electronic Transfer Payments Made Through an Access Card).

(c) An insurance carrier that routinely pays benefits by check or other negotiable instrument to the claimant drawn on an out-of-state financial institution shall accompany each instrument with written information about the insurance carrier’s office location and telephone number where the claimant may call, at the insurance carrier’s expense, to obtain help with cashing the instrument, if necessary.

(d) A claimant may request that the insurance carrier make benefit payments by electronic transfer to a personal bank account by providing the insurance carrier in writing: the name and routing transit number of the financial institution and the account number and type of account that the claimant wants the benefits electronically transferred to. The insurance carrier shall provide the claimant with a form to fill out the information required by this subsection within seven days of receiving a request for such a form from the claimant.

(e) Subsections (f)-(i) of this section apply to income or death benefit payments due on or after September 1, 2000.

(f) Unless relieved by subsection (g) of this section, the insurance carrier shall make income or death benefit payments by electronic transfer if the claimant:

(1) requests in writing that payment be made by electronic transfer;

(2) provides the information required by subsection (d) of this section; and

(3) is reasonably expected to be entitled to receive income or death benefits for a period of eight weeks or more from the point that paragraphs (1) and (2) of this subsection are satisfied.

(4) This subsection does not apply to electronic transfer payments made through an access card under §124.6 of this title.

(g) An insurance carrier is relieved of the responsibility to make payment of temporary income benefits, impairment income benefits, and supplemental income benefits by electronic transfer if the mode of payment has been switched at the request of the claimant three times after initially changing to electronic payments.

(h) The insurance carrier shall initiate payment by electronic transfer starting with the first income or death benefit payment due on or after the 21st day after the requirements of subsection (f) of this section are met but shall continue to timely make payments by check until the insurance carrier initiates benefit delivery by electronic transfer.

(i) If the claimant has previously been receiving income or death benefit payments by electronic transfer and wants to receive benefits by check, the insurance carrier shall initiate income or death benefit delivery by check starting with the first benefit payment due to the claimant on or after the 7th day after receiving a written request.

(j) Effective date. Unless otherwise specified, this section is effective for income or death benefit payments due on or after June 1, 2015.

The provisions of this §124.5 adopted to be effective January 11, 1991, 16 TexReg 116; amended to be effective November 28, 1999, 24 TexReg 10333; amended to be effective June 1, 2015, 40 TexReg 332.

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At a Glance:

Title:

§ 124.5. Mode of Payment Made by Insurance Carriers

Title:

Title 28. Insurance

Status:

Current

Usage:

New Law Rule

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