Oklahoma Administrative Code
Title 810 - Oklahoma Workers' Compensation Commission
Chapter 25 - Workers' Compensation Insurance and Self Insurance
Subchapter 13 - Third-party Administrator Permit for Workers' Compensation Purposes
Section 810:25-13-4 - Operating requirements
Current through Vol. 42, No. 1, September 16, 2024
The TPA must:
(1) Have adequate personnel on staff to handle the volume and type of work. The TPA may subcontract for services not provided by the TPA, but requested from the self-insurer;
(2) Be financially solvent, and must report its financial statements on an annual basis to the Commission in an approved form and manner;
(3) Maintain an adequate Errors and Omissions policy;
(4) Maintain an adequate Fidelity Bond;
(5) Establish claims reserves at the most likely outcome. Best case reserving is not allowed.
(6) Retain its independence when setting claim reserves. The TPA shall not let the self-insurer influence the amount of the reserve or the closing of a claim;
(7) Maintain an Oklahoma office, if handling a group self-insurance association program; and
(8) Maintain adequate computerized records and paper claims files on each claim. A copy of this information must be made available for the Commission's review at all times upon request.
