GQ Corner

Q: I need clarification on rule 124.5 regarding mode of payment. We don’t have electronic transfer at this time so we pay claimants with a check each week when they are owed indemnity. We are located in Ohio.  Part (c) of 124.5 sounds as though I should be sending a note with my contact information with each check I send to the claimant because we are out of state and use an out of state bank. I do send a PLN 2 with the first check and prior to that, I send a letter with a medical authorization form, which gives my contact information. Should I be sending my contact information with every check when paying the claimant?

A: You must include that information with each check. You also need to implement the option for electronic transfer ASAP as this is a mandatory requirement. The DWC does not recognize an exception for cases that are adjusted out of the state of Texas since Texas Labor Code Section  406.010 provides: “An insurance carrier shall provide claims service: (1)  through offices of the insurance carrier located in this state;  or (2)  by other resident representatives with full power to act for the insurance carrier.”

Q: This was a death claim from 2014. We found no beneficiaries at that time and sent the required check to the SIF. We have found recently discovered that the claimant had a daughter. If we have proof she is the claimant’s daughter, can we reclaim our money and how do we do so? Is there a particular form I need to use?

A: Rule 116.11 (a) (2) allows you to file a request for reimbursement from SIF for death benefits paid to SIF before a legal beneficiary was determined to be entitled. A form has not been created for SIF reimbursement requests. Instead, you simply address a letter to SIF requesting reimbursement and provide the information needed pursuant to 116.11(a)(2).