NAC616B.469. Submission of interim reports regarding occurrence of certain injuries and diseases.

Each self-insured employer must submit to the Division of Insurance of the Department of Business and Industry the following interim reports as a condition for the continuance of his or her certificate of authority to self-insure:

     1. Any injury or disease expected to result in the payment of at least $100,000 for medical costs or indemnity, or which will trigger excess insurance coverage, must be reported to the Commissioner within 30 days after the actual occurrence of the claim or the projection of the reserve. The report must contain:

     (a) The name of the claimant and the date and type of injury;

     (b) The amount paid to date for medical costs and indemnity;

     (c) The projected amount of reserves that have been established; and

     (d) The amount paid, or anticipated to be paid, by excess insurance.

     2. Any injury involving five or more employees for the same accident must be reported to the Commissioner within 30 days after the actual occurrence. The report must contain:

     (a) The names of the claimants and the dates and types of injuries;

     (b) The amount paid to date for medical costs and indemnity;

     (c) The projected amounts of reserves that have been established; and

     (d) The amount anticipated to be paid by excess insurance.

     (Added to NAC by Comm’r of Insurance, eff. 1-24-92; A by R112-04, 8-25-2004)