Electronic Inspections of Accident Prevention Services
Texas Department of Insurance, Divsion of Workers Compensation (DWC) can conduct the periodic inspection of accident prevention services (Rule 166.5) via electronic means. Because of the extreme difference in electronic information systems, the following standards for providing information electronically to be reviewed during inspections should be followed. The Division should be notified as soon as possible after it has been determined that information will be provided electronically during the inspection.
Insurance companies wishing to provide policyholder information to be reviewed electronically during inspections will comply with the following requirements:
- Any insurance company desiring to electronically provide inspection information required by Rule 166.6(b) will notify the Accident Prevention Services section immediately after receipt of the Division's notification of inspection letter and no later than the date the policyholder list is due.
- Site of the inspection will be in accordance with Rule 166.5(b) with insurance company representatives or their designees being present.
- The insurance company will make a workstation available for each inspector conducting the inspection (typically two) that meets basic ergonomic standards. Dedicated printing capability will also be provided for the inspectors' use.
- Information presented electronically will be provided in a manner that does not impede or alter the inspection process and will be in accordance with the rules.
- All policyholder files presented electronically will be complete and each file will be located in a separate folder identified by the policyholder's business name.
- Loss control files will be presented in Microsoft Word. Any spreadsheets will be in Microsoft Excel. Database information will be presented in a report format for each individual policyholder and be included in the policyholder's electronic folder or will have a link to the information.
- A copy of the loss run for each selected account, pursuant to Rule 166.6(b)(1)(D), may or may not be submitted electronically. If submitted electronically, the loss run will be included in the policyholder's electronic file.
- Files will contain information that documents all requests for service pursuant to Rule 166.4(c)(2)(A), as well as all other services required by Rule 166.4(c)(2).
The Division reserves the right to make the final determination as to whether the inspection will be conducted electronically, based on the ability of the insurance company to comply with the above requirements. If you desire to configure your systems for electronic review capability, we encourage communication with us well in advance of the inspection so that coordination, review, and approval can occur in a timely manner and not impede the inspection process. Any questions regarding conducting inspections electronically should be directed to (512) 804-4618 or e-mailed to HealthSafety@tdi.texas.gov.
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Last updated: 12/28/2012