(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.
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Source Note: 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 |