Claims Kit

Penalties for Late Reporting W. Va. Code St. R. 85-2-6

Failure of an insurer or self-insured employer to timely report data to the Commissioner as required may subject the private carrier or self-insured employer to a fine not to exceed $500 per occurrence of untimely reporting.

Reporting of Claim by Employer W. Va. Code 23-4-1b

The employer must report every injury sustained by their employee to the commission,  The report must be on forms recommended  by the commission or the Insurance Commissioner, whichever is applicable, and shall be made within five days of the employer's receipt of the employee's notice of injury, or within 5 days after the employer has been notified by the commission or the Insurance Commissioner, that a claim for benefits has been filed. The 5 day period may not be extended by the commission the successor to the commission, or another private carrier, but the employer has the right to file a supplemental report at a later date.

Posting Requirements

West Virginia Code 23-2C-15(c) requires, in part, that:

"Every employer shall post a notice upon its premises in a conspicuous place identifying its workers' compensation insurer. The notice must include the name, business address and telephone number of the insurer and of the person to contact with questions about a claim. The employer shall at all times maintain the notice provided for the information of his or her employees."

First, the statute simply requires that the notice include the name, business address and telephone number of the employer's workers' compensation insurer. This requirement is straightforward and self-explanatory.

Second, the statute requires that the notice should contain information regarding the "person" an injured worker may contact with any questions he or she may have regarding a claim. OIC interprets this requirement broadly. The "person" identified in the notice may be 1) an employee of the injured worker's employer - for example, a manager, human resources director or employee benefits coordinator; 2) an adjuster for the insurer; or 3) the insurer's third-party claims administrator. However, the "person" identified: 1) should be readily available to the injured worker to personally assist the injured worker with the injured worker's claim; and 2) should possess sufficient knowledge about the workers' compensation claims process to adequately do so.

With regard to the physical composition of the notice, the statute provides no requirements with regard to the composition or size of the notice, or typeface used in the notice, and these determinations are left to the discretion of the insurer. It should be noted that the statute requires the notice to be posted in a conspicuous place upon the employer's premises. Consistent with spirit of this directive, notices should be composed in a fashion that will provide workers with the required information in a legible format that can be easily seen and understood