Illinois Administrative Code
Title 35 - ENVIRONMENTAL PROTECTION
Part 1501 - DRYCLEANER ENVIRONMENTAL RESPONSE TRUST FUND PROGRAM
Subpart D - INSURANCE CLAIMS
Section 1501.450 - Claim Procedures

A) On and after the effective date of this Part, an owner or operator of an insured drycleaning facility, under Section 1501.410, may submit an insurance coverage claim to the Agency.

B) The insurance coverage claim must be on forms prescribed and provided by the Agency and must include, at a minimum, the following:

C) The insurance coverage claim in paper form, one original and one copy, must be mailed to the address designated by the Agency on the forms.

D) The Agency must review the insurance coverage claim to determine whether it is complete, in compliance with the limitations, conditions, and procedures of this Subpart, and eligible for further claim processing under this Section.

E) Upon completion of the review, the Agency must issue a determination of eligibility, or ineligibility, for further claim processing under this Section. The following rules apply regarding an Agency determination of ineligibility:

F) If the Agency's determination of ineligibility is based on the incompleteness of the insurance coverage claim, the claimant may correct any deficiencies and resubmit the claim to the Agency.

A) Identification of the claimant, the remediation site, including:

B) Line-item estimates of the costs that the claimant anticipates and for which the claimant will seek insurance coverage, including the following:

A) To be eligible for eventual reimbursement from the Fund, costs must be within the range of usual and customary rates for similar or equivalent goods or services, incurred in performance of remediation work approved by the Agency, and necessary to respond to the release for which the claimant is seeking reimbursement from the Fund. [415 ILCS 135/45(f)(8)]

B) The Agency's budget review must consist of a detailed review of the costs associated with each element necessary to accomplish the goals of the SRP plan as required under the EPAct and 35 Ill. Adm. Code 740. Items to be reviewed must include costs associated with any materials, activities, or services that are included in the budget. The overall goal of the review must be to assure that costs associated with materials, activities, and services are reasonable, consistent with the associated SRP plan, incurred in the performance of remedial action activities, and not used for remedial action activities in excess of those necessary to meet the associated SRP plan.

A) The Agency's budget determination must be provided in writing.

B) The Agency may combine the notification of its budget determination with the notification of its final determination on the corresponding SRP plan.

C) If a budget is denied or approved with modification of estimated remedial action costs, the written notification must contain, at a minimum, the following information as applicable:

D) If the Agency denies an SRP plan or approves an SRP plan with conditions, in accordance with Part 740, the Agency may return the corresponding budget to the claimant without review. If the SRP plan is amended in response to Agency action, the claimant may submit a revised budget for review.

E) The burden of proof is on the claimant in any review.

A) The Agency-approved budget.

B) The SRP determination that an applicable phase of remedial action was completed under 35 Ill. Adm. Code 740.

C) Line-item costs that the claimant incurred for the development and implementation of the SRP plan, including:

D) All invoices, bills, and payment documentation related to the incurred line-item costs, above.

E) An IRS Form W-9 completed by the claimant.

F) A designation of the claimant's address to which payment, if approved, and notice of final action on the request are to be sent.

A) To be eligible for reimbursement from the Fund, costs must be within the range of usual and customary rates for similar or equivalent goods or services, incurred in performance of remediation work approved by the Agency, and necessary to respond to the release for which the claimant is seeking reimbursement from the Fund. [415 ILCS 135/40(f)(8)]

B) The Agency's review may include a review of any or all elements and supporting documentation relied upon by the claimant in developing the reimbursement request, including a review of invoices or receipts supporting all claims. The review also may include the review of any plans, budgets, or reports previously submitted for the site to ensure that the request is consistent with work proposed and performed in conjunction with the site.

C) Line-item costs must be less than or equal to their corresponding estimates in the Agency-approved budget. If an actual cost exceeds the amount approved in the budget, the claimant will not be reimbursed for the difference.

D) Work crossing multiple line-items, as well as transferring funds between line-items, is prohibited.

A) The Agency's reimbursement request determination must be provided in writing.

B) If a reimbursement request is denied or approved with modification of remedial action costs, the written notification must contain the following information:

C) The burden of proof is on the claimant in the proceeding.

A) Any deductible, under Section 1501.420, must be subtracted from any amount approved for payment by the Agency.

B) The Agency must instruct the Illinois Office of the Comptroller to issue payment to the claimant at the address designated in accordance with Section 1501.450(c)(2)(G). The Agency must not authorize the Illinois Office of the State Comptroller to issue payment to an agent, designee, or entity that has conducted remedial action activities for the claimant.