(a) When an employee has died as the result of a compensable injury, a person claiming burial benefits shall file a request for payment of burial benefits and the bills showing the amount of burial and transportation costs incurred. The request and the documentation shall be filed with the insurance carrier within 12 months of the date of death of the employee.
(b) The person who incurred liability for the costs of burial is entitled to receive the lesser of:
(1) the actual costs incurred for reasonable burial expenses; or
(2) $2,500–if burial benefits are paid based on a compensable injury that occurs before September 1, 1999; or
(3) $6,000–if burial benefits are paid based on a compensable injury that occurs on or after September 1, 1999 and before September 1, 2015; or
(4) $10,000–if burial benefits are paid based on a compensable injury that occurs on or after September 1, 2015.
(c) The person who incurred liability for the costs of transporting the body of the employee is entitled to be reimbursed for the reasonable cost of transportation if the employee died away from the usual place of employment. The insurance carrier’s liability for transportation costs under this subsection shall not exceed the cost equivalent to transporting the body from the place the employee died to the employee’s usual place of employment.
(d) The insurance carrier shall review each claim for burial benefits. The insurance carrier must either pay or deny the claim within seven days of the date the claim was received by the carrier. If the claim is denied, the insurance carrier must notify the person claiming burial benefits and the division in writing of its denial and the facts supporting the denial.
The provisions of this §132.13 adopted to be effective January 1, 1991, 15 TexReg 7023; amended to be effective December 26, 1999, 24 TexReg 11452; amended to be effective March 20, 2016, 41 TexReg 1857.