2005 Idaho Code - 41-1626 — COMPENSATION REIMBURSEMENT OPTION

                                  TITLE  41
                                  INSURANCE
                                  CHAPTER 16
                         WORKMEN'S COMPENSATION RATES
    41-1626.  COMPENSATION REIMBURSEMENT OPTION. Notwithstanding any other
provision of this code, an insurer issuing a worker's compensation insurance
contract may include as part of the contract an option allowing a policyholder
at the policyholder's sole discretion, to reimburse the insurer for
compensation in amounts not to exceed one thousand dollars ($1,000) per claim,
subject to the following conditions:
    (1)  Claimant's rights shall be properly protected, and claimant's
benefits have been paid by the insurer.
    (2)  The insurer shall pay all benefits of a compensable claim to the
person or provider entitled to benefits regardless of the policyholder's
option to reimburse the insurer for the claim. Payment of benefits shall not
be delayed due to the decision of a policyholder to reimburse the insurer for
the claim.
    (3)  The making of such reimbursement does not constitute a waiver or
transfer of the insurer's duty to determine entitlement to benefits.
    (4)  In the event the insurer recovers any medical costs on a claim
reimbursed pursuant to this section, the insurer shall repay the policyholder
within thirty (30) days an amount equal to recovered medical costs.
    (5)  The claim to which a reimbursement by the policyholder applies may
not exceed one thousand dollars ($1,000) over the life of the claim. Should a
claim exceed the one thousand dollar ($1,000) limit after a portion has been
reimbursed by the policyholder, the insurer shall within thirty (30) days
notify the policyholder and return the reimbursement and adjust all reports
accordingly.
    (6)  The policyholder shall make all reports of accidents, injuries and
losses to the insurer as required under the provisions of title 72, Idaho
Code, regardless of the policyholder's intent to reimburse the insurer.
    (7)  The insurer shall record and report all losses for the purpose of
setting industry rates.
    (8)  Claims reimbursed pursuant to this section shall not be reported to a
rating organization for the purpose of determining the policyholder's
experience rating, nor shall the insurer otherwise increase a policyholder's
experience rating or otherwise make charges against the policyholder for any
compensation reimbursed by the policyholder pursuant to this section.
    (9)  No reduction in current premium may be granted as a result of a
reimbursed claim.
    (10) Nothing in this section shall apply to worker's compensation
insurance contracts offering the policyholder a deductible pursuant to the
provisions of title 72, Idaho Code.
    (11) If the insurer offers the reimbursement option and the policyholder
elects to exercise such option, the procedure for reimbursement shall be as
follows:
    (a)  Within thirty (30) days following each three (3) month period after
    policy inception or a period mutually agreed upon by the policyholder and
    the insurer, the insurer shall provide the policyholder with a list of all
    accepted nondisabling claims for which payments were made during that
    period and the respective cost of each claim.
    (b)  No later than thirty (30) days after receipt of the list, the
    policyholder shall identify the claims and the dollar amount the
    policyholder elects to reimburse for that period, and the policyholder
    shall reimburse the insurer accordingly.
    (c)  Failure by the policyholder to reimburse the insurer within the
    thirty (30) days allowed shall be deemed notice to the insurer that the
    policyholder has not elected to make any reimbursement for that period.