Texas Administrative Code
Title 28 - INSURANCE
Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION
Chapter 114 - SELF-INSURANCE
Section 114.11 - Audit Program
Universal Citation: 28 TX Admin Code ยง 114.11
Current through Reg. 49, No. 38; September 20, 2024
(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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