Section 2592.06 - Maintenance of Records(a) An insurer shall maintain copies of the Designation forms pertaining to trained and experienced claims adjusters, medical-only claims adjusters and medical bill reviewers in its employ or acting on its behalf, notwithstanding whether or not that person was designated by it or was employed or trained by or on behalf of another insurer or a medical billing entity, as long as the claims adjuster, medical-only claims adjuster, or medical bill reviewer is in its employ or acting on its behalf and thereafter for five (5) years.(b) An insurer shall maintain copies of the Post-Designation Training Forms as long as the claims adjuster, medical-only claims adjuster, or medical bill reviewer is in its employ or acting on its behalf, notwithstanding whether or not that person received post-designation training by that insurer or was employed or trained by or on behalf of another insurer or medical billing entity, and thereafter for five (5) years.(c) If a trained or experienced claims adjuster, medical-only claims adjuster, or medical bill reviewer is employed by or works on behalf of an insurer that did not designate him or her, the insurer that did designate the claims adjuster, medical-only claims adjuster, or medical bill reviewer shall send copies of the Designation Forms to the current insurer within 20 working days after a request for the Designation Forms has been received.(d) All insurers shall maintain a record of all courses given or taken by claims adjusters, medical-only claims adjusters, or medical bill reviewers to comply with this article. The record shall include:(1) The name and business address of all students, along with the beginning and ending date of the training of the student and a statement of whether or not the student has completed the training in all topic areas required to be covered.(2) A complete description of the curriculum, including all topics covered with a detailed statement of how much time was spent training students in each topic, the name of the entity providing the instruction, and the name of the instructor or instructors and any persons who instructed under the direction of the instructor.(e) All insurers shall maintain a record of all post-designation courses, seminars, workshops, or other training taken by claims adjusters, medical-only claims adjusters, and medical bill reviewers employed by or acting on their behalf. The record shall also include the dates of such training, the time spent in the training, and the topics covered.(f) All records maintained pursuant to this article shall be made available to the Insurance Commissioner and to the Administrative Director of the Division of Workers' Compensation. Copies of all Designation Forms maintained pursuant to the article and issued to a claims adjuster, medical-only claims adjuster, or medical bill reviewer shall be provided by the insurer that issued the forms to that person within 20 working days of a request for copies of the forms from the claims adjuster, medical-only claims adjuster, or medical bill reviewer.(g) Upon the request of a policyholder or an injured worker whose claim is being adjusted, the insurer shall provide to the requesting policyholder or injured worker a copy of the Designation Form of the claims adjuster, medical-only claims adjuster, or medical bill reviewer handling the claim demonstrating that person's qualifications in adjusting that claim.Cal. Code Regs. Tit. 10, § 2592.06
1. New section filed 1-23-2006; operative 2-22-2006 (Register 2006, No. 4). Note: Authority cited: Section 11761, Insurance Code. Reference: Section 11761, Insurance Code.
1. New section filed 1-23-2006; operative 2-22-2006 (Register 2006, No. 4).