1292-S AMH CONW H2120

1292-S AMH CONW H2120.1

SHB 1292 - H AMD 061 FAILED 2-28-97

By Representative Conway

On page 3, beginning on line 18, strike all material through "claim." on page 4, line 21, and insert the following:

"(5)(a) If the department determines that a retrospective rating employer or group, or an authorized claims administrator, may have violated the authority granted in this section, the department shall notify the employer, group, or authorized claims administrator in writing outlining the violation and the corrective action required. The notice must specify a reasonable period of time for corrective action. The employer, group, or authorized claims administrator is subject to penalties under this subsection for the violation or for failing to take the required corrective action within the specified period, or both.

(b) If the department finds a pattern of improper claims closure or other violations of the authority granted in subsection (2) or (3) of this section, the director, or his or her designee, shall suspend the retrospective rating employer's or group's, or authorized claims administrator's, authority to assist the department in the processing of claims under this section for a period of up to two years. The department shall issue an order and notice under RCW 51.52.050 which states the grounds for the suspension. As provided in chapter 51.52 RCW, the order becomes final within sixty days from the date the order is communicated to the employer, group, or authorized claims administrator unless a written request for reconsideration is filed with the department or an appeal is filed with the board of industrial insurance appeals.

(6)(a) The director shall adopt under chapter 34.05 RCW all necessary rules governing the administration of this section. The rules should encourage broad participation in retrospective rating plans by employers and groups of employers consistent with insurance principles. The retrospective rating plan employer's or group's, or authorized claims administrator's, exercise of authority under this section may require prior notification to the department, but the rules must minimize the department's need to respond and must ensure that a failure to respond or a delay in response by the department does not impede the timely administration of the claim."

SHB 1292 - H AMD

On page 4, after line 30, insert the following:

"(7)(a) Retrospective rating employers and groups, and authorized claims administrators, have a duty of good faith and fair dealing towards claimants. Violations of these good faith duties shall include, but not be limited to: (i) Attempting to close a valid claim under this section that the employer, or his or her representative, knew or should have known was closed inappropriately; (ii) interfering with a worker's right to file a claim under this title; or (iii) having a history or pattern of repeated unfair claims practices. The department shall adopt rules on unfair claims practices.

(b) A worker of a retrospective rating employer or beneficiary of such worker who is injured or damaged because of a violation of this section or violation of a rule adopted by the director under this section may bring a civil action against a retrospective rating employer or group, or authorized claims administrator, in superior court to enjoin further violations and to recover reasonable damages sustained by him or her, together with the cost of the suit including reasonable attorneys' fees to be set by the court."

Renumber the subsections consecutively and correct internal references accordingly.