616B.018 - Index of claims: Establishment; contents; format; use; fee; administrative fine for failure by insurer to provide information.
616B.018 Index of claims: Establishment; contents; format; use; fee; administrative fine for failure by insurer to provide information.
1. The Administrator shall establish a method of indexing claims for compensation that will make information concerning the claimants of an insurer available to other insurers and the Fraud Control Unit for Industrial Insurance established pursuant to NRS 228.420.
2. Every insurer shall provide the following information if required by the Administrator for establishing and maintaining the index of claims:
(a) The first name, last name, middle initial, if any, date of birth and social security number of the injured employee;
(b) The name and tax identification number of the employer of the injured employee;
(c) If the employer of the injured employee is a member of an association of self-insured public or private employers, the name and tax identification number of that association;
(d) The name and tax identification number of the insurer, unless the employer of the injured employee is self-insured and this requirement would duplicate the information required pursuant to paragraph (b);
(e) The date upon which the employer’s policy of industrial insurance that covers the claim became effective and the date upon which it will expire or must be renewed;
(f) The number assigned to the claim by the insurer;
(g) The date of the injury or of the sustaining of the occupational disease;
(h) The part of the body that was injured or the occupational disease that was sustained by the injured employee;
(i) The percentage of disability as determined by the rating physician or chiropractor;
(j) Which part of the body was permanently impaired, if any;
(k) What type of accident or occupational disease that is the subject of the claim;
(l) The date, if any, that the claim was closed; and
(m) If the claim has been closed, whether the closure was pursuant to the provisions of:
(1) Subsection 2 of NRS 616C.235; or
(2) Subsection 1 of NRS 616C.235,
Ê and what type of compensation was provided for the claim.
3. The Administrator shall require information provided pursuant to subsection 2 to be submitted:
(a) In a format that is consistent with nationally recognized standards for the reporting of data regarding industrial insurance; and
(b) Electronically or in another medium approved by the Administrator.
4. The Administrator shall ensure that the requirement for an insurer to provide information pursuant to subsection 2 is administered in a fair and equal manner so that an insurer is not required to provide more or a different type of information than another insurer similarly situated.
5. The provisions of this section do not prevent the Administrator from:
(a) Conducting audits pursuant to the provisions of NRS 616B.003 and collecting information from such audits;
(b) Receiving and collecting information from the reports that insurers must submit to the Administrator pursuant to the provisions of NRS 616B.009;
(c) Investigating alleged violations of the provisions of chapters 616A to 617, inclusive, of NRS; or
(d) Enforcing the provisions of chapters 616A to 617, inclusive, of NRS.
6. If an employee files a claim with an insurer, the insurer is entitled to receive from the Administrator a list of the prior claims of the employee. If the insurer desires to inspect the files related to the prior claims, the insurer must obtain the written consent of the employee.
7. Any information obtained from the index of claims may be admitted into evidence in any hearing before an appeals officer, a hearing officer or the Administrator.
8. The Division may assess and collect a reasonable fee for its services provided pursuant to this section. The fee must be payable monthly or at such other intervals as determined by the Administrator.
9. If the Administrator determines that an insurer has intentionally failed to provide the information required by subsection 2, the Administrator shall impose an administrative fine of $1,000 for the initial violation, and a fine of $2,000 for a second or subsequent violation.
10. As used in this section, “tax identification number” means the number assigned by the Internal Revenue Service of the United States Department of the Treasury for identification.
(Added to NRS by 1991, 352; A 1993, 702, 1859; 1995, 531, 539; 1997, 3216; 1999, 1038; 2001, 115, 123)