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OhioBWC - Basics: (Policy library) - File

Policy Name:

Self-Insured Bankrupt Claims

Policy #:

CP-19-07

Code/Rule Reference:

R.C. 4123.351; R.C. 4123.75

Effective Date:

06/27/14

Approved:

Rick Percy, Chief of Operational Policy, Analytics & Compliance (Signature on file)

Origin:

Claims Policy

Supersedes:

All Injury Management policies, directives and memos regarding self-insured bankrupt claims that predate the effective date of this policy.

History:

New

 

 

I. POLICY PURPOSE

 

The purpose of this policy is to ensure that the management of workers’ compensation claims is properly transferred from a self-insuring employer that defaults to the BWC Self-Insured Bankrupt team.

 

II. APPLICABILITY

 

This policy applies to field staff, specifically members of the Self-Insured Bankrupt team.

 

III. DEFINITIONS

 

Self-insuring employer: An employer granted the privilege by BWC of administering its own workers’ compensation program and who pays compensation and benefits directly to the injured worker (IW).

 

Default: For purposes of this policy, when a self-insuring employer notifies BWC that it is no longer willing to administer a self-insured program or when it fails to pay compensation and/or benefits on an allowed workers’ compensation claim.  

 

Self-insuring employers guaranty fund: The fund established pursuant to R.C. 4123.351 through contributions from self-insuring employers, used to guarantee the payment of claims of a self-insuring employer in default.

 

Self-Insured Bankrupt Team: The BWC Field Operations team responsible for management of claims transferred to BWC from a self-insuring employer in default.  

Self-Insured Department: The BWC section that provides oversight and services to self-insuring employers, including underwriting of applications for self-insurance, self-insured claims audit, and consulting services.

 

Third-party administrator: An organization that processes workers’ compensation claims on an employer’s behalf.

 

IV. POLICY

 

A.    It is the policy of BWC to transfer management of workers’ compensation claims in a timely and efficient manner to BWC from a self-insuring employer in default.

 

B.    It is the policy of BWC to pay compensation and benefits from the guaranty fund on claims transferred to BWC when a self-insuring employer defaults.

 

BWC staff may refer to the corresponding procedure for this policy entitled “Self-insured Bankrupt Claims” for further guidance.


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