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Industrial Council and the WV Workers’ Compensation

Industrial Council and the WV Workers’ Compensation
Claims Index

The WV Workers’ Compensation Claims Index was created pursuant to West Virginia Code § 23-2C-5(c). It was established by the WV Industrial Council and is maintained by the WV Insurance Commission. The purpose of the Claims Index is to provide basic historical claims information for West Virginia injured workers to authorized workers’ compensation carriers, third party administrators (TPAs) and self-insured employers who adjust and administer workers’ compensation claims (hereafter, “administrators”).

The Claims index receives information that is reported by West Virginia insurers and private carriers. Every workers’ compensation insurer and self-insured employer operating in West Virginia is required to provide information on West Virginia workers’ compensation claims filed with it or its administrator to the OIC through EDI reporting. For more information, see W. Va. Code St. R. §85-2-1 et seq. and the WV EDI Implementation Guide, both of which can also be found on this web site.

The claims index can be searched by claimant Social Security number, and contains basic demographic data of a particular claimant which can be used to assist insurers and/or administrators in obtaining contact information of other insurers or administrators who possess detailed information on the specific claimant being referenced. Each insurer or administrator may have different processes established for the release of the information about prior or existing claims.

In order to access the Claims Index, an administrator must apply through the OIC’s Claims Services Division. Applications are available on the Insurance Commission’s website at www.wvinsurance.gov. If the application is without a signature it cannot be processed and will be returned. The completed application should be sent to the Insurance Commission Claims Services Division at the following address:

WV Offices of the Insurance Commissioner
Attn: Claims Services
PO Box 50541
Charleston, WV 25305

You may also fax the completed application to (304) 558-8948, Attn: Claims Services, or call (304) 558-5838.

Parties other than administrators, such as attorneys who are representing parties in claims pending before the Office of Judges, may also obtain claims index information, but only on a case-by-case basis. If you are an attorney and wish to obtain information about a particular claimant, please fill out Claims Index Request for Information and submit it to the Insurance Commissioner’s Claims Service Division as described above.

Please note that the Claims Index is only as accurate as the information provided by the claims administrators. The administrator is responsible for the accuracy and timeliness of the information filed. If you discover a problem please contact the carrier or administrator.

Finally, please note that information in the claims index is for the limited purpose of use in claims administration only, and the information cannot be used for inappropriate purposes, nor should the access ability be shared with other parties who are not authorized to have access, including claims defense attorneys. Please carefully read the terms and conditions of the Application form for more information.

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