Current through Reg. 49, No. 38; September 20, 2024
(a) Under Labor
Code §§
411.061,
411.063, and
411.068(a)(1),
an insurance company writing workers' compensation insurance in Texas must
maintain or provide accident prevention facilities that are adequate to provide
accident prevention services required by the nature of its policyholders'
operations, and must include:
(1)
surveys;
(2)
recommendations;
(3) training
programs;
(4)
consultations;
(5) analyses of
accident causes;
(6) industrial
hygiene;
(7) industrial health
services;
(8) qualified accident
prevention personnel. To provide qualified accident prevention personnel and
services, an insurance company may:
(A) employ
qualified personnel;
(B) retain
qualified independent contractors;
(C) contract with the policyholder to provide
personnel and services; or
(D) use
a combination of the methods provided in this paragraph; and
(9) written records, reports, and
evidence of all accident prevention services provided to each
policyholder.
(b) Under
Labor Code §
411.068(a)(2),
an insurance company must use accident prevention services to prevent injuries
to employees of its policyholders in a reasonable manner, which at a minimum,
include:
(1) Notice of availability of
accident prevention services and return-to-work coordination services. Under
Labor Code §
411.066, an insurance
company must include a notice on the information page or on the front of the
policy containing text identical to the following in at least 10-point bold
type for each workers' compensation insurance policy delivered or issued for
delivery in Texas: Pursuant to Texas Labor Code §
411.066, (name of company)
is required to notify its policyholders that accident prevention services are
available from (name of company) at no additional charge. These services may
include surveys, recommendations, training programs, consultations, analyses of
accident causes, industrial hygiene, and industrial health services. (Name of
company) is also required to provide return-to-work coordination services as
required by Texas Labor Code §
413.021 and to notify you
of the availability of the return-to-work reimbursement program for employers
under Texas Labor Code §
413.022. If you would like
more information, contact (name of company) at (telephone number) and (email
address) for accident prevention services or (telephone number) and (email
address) for return-to-work coordination services. For information about these
requirements, call the Texas Department of Insurance, Division of Workers'
Compensation (TDI-DWC) at 1-800-687-7080 or for information about the
return-to-work reimbursement program for employers, call the TDI-DWC at (512)
804-5000. If (name of company) fails to respond to your request for accident
prevention services or return-to-work coordination services, you may file a
complaint with the TDI-DWC in writing at
http://www.tdi.texas.gov or by mail to
Texas Department of Insurance, Division of Workers' Compensation, P.O. Box
12050, HS-WS, Austin, Texas 78711-2050;
(2) Contact and surveys following fatalities.
An insurance company must contact the policyholder within seven working days of
knowledge of a work-related fatality and offer a survey. Survey offers accepted
by the policyholder must be initiated by the insurance company within 60 days
of policyholder acceptance of the survey offer. No offer of a survey is
required if the fatality occurred outside of Texas or was the result of an
accident on a common carrier, unless the fatality involves an employee of the
common carrier during the course and scope of normal job duties; and
(3) Services requested by a policyholder. An
insurance company must provide to each policyholder accident prevention
services required by the nature of their policyholders' operations within 15
days from the date of a policyholder request for services, if appropriate
services can be provided without conducting a survey; and within 60 days from
the date of a policyholder request, if a survey is required regardless of any
provision of this section. Services can be provided at a later date if
circumstances require, and the policyholder agrees to the later date.
(c) The division may determine
adequacy of an insurance company's accident prevention services in accordance
with the requirements of this chapter and generally accepted tools and
guidelines of loss control provision and through:
(1) review of reports of annual information,
as required by §
166.3 of this title; and
(2) inspections, as specified in §
166.5 of this title (relating to
Inspections of Adequacy of Accident Prevention Facilities and
Services).
(d) Accident
prevention services must be provided to policyholders at no additional
charge.
(e) An insurance company
must not solicit or obtain from its policyholders a prospective waiver
declining all accident prevention services. Under Labor Code §
411.063(a)(3),
if an insurance company contracts with a policyholder to provide accident
prevention personnel or services, this contract does not limit in any way the
insurance company's authority or responsibility to comply with any statutory or
regulatory requirement contained in this chapter. Insurance companies are
responsible for maintaining or providing all services, including contracted
services, in accordance with this chapter.
(f) This section is effective July 1,
2024.
