| (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.
|
| Source Note: 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 |
