Cal. Code Regs. tit. 10 § 2592.10
CLAIMS ADJUSTER or MEDICAL-ONLY CLAIMS ADJUSTER DESIGNATION
This Designation is awarded to
______________________________
(Adjuster's Name)
for: [] Claims Adjuster [] Medical-Only Claims Adjuster |
(Check Only One) |
as a result of successfully completing the required hours for workers' compensation training pursuant to California Insurance Code Section 11761 and California Code of Regulations, Title 10, Sections 2592.02 and 2592.03
Total Hours of Training Completed: __________
Designation Given By:
______________________________
(Name of Insurance Company, Self-Insured Employer, or Third-Party Administrator)
| ___________________________ | ___________________________ | |
| (Date) | (Signature) |
Name of person awarding designation (print or type):
Title of person awarding designation:
Business address:
Cal. Code Regs. Tit. 10, § 2592.10
Note: Authority cited: Section 11761, Insurance Code. Reference: Section 11761, Insurance Code.