The Public Information Act and Texas Law on Obtaining Government Records of Texas Department of Insurance

Texas Government Code, Chapter 552, gives Texas businesses and individuals the right to access government records; and an officer for public information and the officer’s agent may not ask why you want them. All government information is presumed to be available to the public. Certain exceptions may apply to the disclosure of the information. Governmental bodies shall promptly release requested information that is not confidential by law, either constitutional, statutory, or by judicial decision, or information for which an exception to disclosure has not been sought.

Request Information

To request information from TDI, please submit your request as follows:

By mail to:
Office of Agency Counsel
Texas Department of Insurance
P.O. Box 149104, Mail Code 110-1C
Austin, Texas 78714-9104

By e-mail to:
AgencyCounsel@tdi.texas.gov

By fax to:
(512) 490-1021

In person at:
333 Guadalupe
Austin, Texas 78701

For complaints regarding failure to release public information, please contact your local County or District Attorney at:

  • Office of the Attorney General, Open Records Hotline, at 512-478-6736 or toll-free at 1-877-673-6839.
  • Complaints Regarding Overcharges, please contact the Office of the Attorney General at (512) 475-2497.

If you need special accommodation pursuant to the Americans with Disabilities Act (ADA), please contact our ADA coordinator at (512) 676-6103.

Rights of Requestors


You have the right to:

  • Prompt access to information that is not confidential or otherwise protected;
  • Receive treatment equal to all other requestors, including accommodation in accordance with the Americans with Disabilities Act (ADA) requirements;
  • Receive certain kinds of information without exceptions, like the voting record of public officials, and other information;
  • Receive a written itemized statement of estimated charges, when charges will exceed $40, in advance of work being started and opportunity to modify the request in response to the itemized statement;
  • Choose whether to inspect the requested information (most often at no charge), receive copies of the information or both;
  • A waiver or reduction of charges if the governmental body determines that access to the information primarily benefits the general public;
  • Receive a copy of the communication from the governmental body asking the Office of the Attorney General for a ruling on whether the information can be withheld under one of the accepted exceptions, or if the communication discloses the requested information, a redacted copy;
  • Lodge a written complaint about overcharges for public information with the Office of the Attorney General. Complaints of other possible violations may be filed with the county or district attorney of the county where the governmental body, other than a state agency, is located. If the complaint is against the county or district attorney, the complaint must be filed with the Office of the Attorney General.

Responsibilities of Governmental Bodies

All governmental bodies responding to information requests have the responsibility to:

  • Establish reasonable procedures for inspecting or copying public information and inform requestors of these procedures;
  • Treat all requestors uniformly and shall give to the requestor all reasonable comfort and facility, including accommodation in accordance with ADA requirements;
  • Be informed about open records laws and educate employees on the requirements of those laws;
  • Inform requestors of the estimated charges greater than $40 and any changes in the estimates above 20 percent of the original estimate, and confirm that the requestor accepts the charges, or has amended the request, in writing before finalizing the request;
  • Inform the requestor if the information cannot be provided promptly and set a date and time to provide it within a reasonable time;
  • Request a ruling from the Office of the Attorney General regarding any information the governmental body wishes to withhold, and send a copy of the request for ruling, or a redacted copy, to the requestor;
  • Segregate public information from information that may be withheld and provide that public information promptly;
  • Make a good faith attempt to inform third parties when their proprietary information is being requested from the governmental body;
  • Respond in writing to all written communications from the Office of the Attorney General regarding charges for the information and complaints about violations of the Act.

Procedures to Request Information

  1. Submit a request by mail, fax, email or in person according to a governmental body’s reasonable procedures.
  2. Include enough description and detail about the information requested to enable the governmental body to accurately identify and locate the information requested.
  3. Cooperate with the governmental body’s reasonable efforts to clarify the type or amount of information requested.

A. Information to be released

  • You may review it promptly, and if it cannot be produced within 10 working days the public information officer will notify you in writing of the reasonable date and time when it will be available.
  • Keep all appointments to inspect records and to pick up copies. Failure to keep appointments may result in losing the opportunity to inspect the information at the time requested.

B. Cost of Records

  • You must respond to any written estimate of charges within 10 days of the date the governmental body sent it or the request is considered automatically withdrawn.
  • If estimated costs exceed $100.00 (or $50.00 if a governmental body has fewer than 16 full time employees) the governmental body may require a bond, prepayment or deposit.
  • You may ask the governmental body to determine whether providing the information primarily benefits the general public, resulting in a waiver or reduction of charges.
  • Make a timely payment for all mutually agreed charges. A governmental body can demand payment of overdue balances exceeding $100.00, or obtain a security deposit, before processing additional requests from you.

C. Information that may be withheld due to an exception

  • By the 10th business day after a governmental body receives your written request, a governmental body must:
    1. Request an Attorney General opinion and state which exceptions apply;
    2. Notify the requestor of the referral to the Attorney General; and
    3. Notify third parties if the request involves their proprietary information.
  • Failure to request an Attorney General opinion and notify the requestor within 10 business days will result in a presumption that the information is open unless there is a compelling reason to withhold it.
  • Requestors may send a letter to the Attorney General arguing for release, and may review arguments made by the governmental body. If the arguments disclose the requested information, the requestor may obtain a redacted copy.
  • The Attorney General must issue a decision no later than the 45th working day from the day after the attorney general received the request for a decision. The attorney general may request an additional 10 working day extension.
  • Governmental bodies may not ask the Attorney General to “reconsider” an opinion.

 

For more information contact: AgencyCounsel@tdi.texas.gov

 

Williams, McClure & Parmelee is dedicated to high quality legal representation of businesses and insurance companies in a variety of matters. We are experienced Texas civil litigation attorneys based in Fort Worth who know Texas courts and Texas law. For more information, please contact the law firm at 817-335-8800. The firm’s new office location is 5601 Bridge Street, Suite 300, Fort Worth, Texas 76112.

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The Statutory Basis for Declaratory Judgment Actions in Texas Lawsuits

 

  1. State: Uniform Declaratory Judgment Act, Tex. Civ. Prac. & Rem. Code Ch. 37
  • 37.004 provides:

(A) A person interested under a deed, will, written contract, or other writings constituting a contract or whose rights, status, or other legal relations are affected by statute, municipal ordinance, contract, or franchise may have determined any question of construction or validity arising under the instrument, statute, ordinance, contract or franchise and obtain a declaration of rights, status, or other legal relations there under.

(B) A contract may be construed either before or after there has been a breach.

  • 37.002 provides that the chapter is remedial: “It’s purpose is to settle and to afford relief from uncertainty and in security with respect to rights, status, and other legal relations; and it is to be legally construed and administered.” The Act does not create or enlarge jurisdiction. E.g., Chenault v. Phillips, 914 S.W.2d 140, 141 (Tex. 1996). Pursuant to §37.003, a declaration may be either affirmative or negative in form and effect. Thus, an insured can seek an affirmative finding of coverage, or an insurer can seek a negative determination that coverage does not exist. However, each party must still plead for relief and carry its own burden of proof. See, e.g., City of Galveston v. Giles, 902 S.W.2d 167 (Tex. App.–Houston [1st Dist.] 1995, no writ); Employers Cas. Co. v. Tilley, 484 S.W.2d 802, 806 (Tex. Civ. App.–Beaumont 1972), aff’d other grounds, 496 S.W.2d 552 (Tex. 1973) (court had no authority to order declaration against insurer in response to insured’s motion for summary judgment on insurer’s claims); Indigo Oil, Inc. v. Wiser Oil Co., 1998 TEX. APP. LEXIS 7550 (Tex. App.–Dallas 1998, pet. denied) (failure to satisfy burden is not finding of proof of opposite).
  • 37.008 provides that the court may refuse to render a declaratory judgment if the judgment would not terminate the uncertainty or controversy giving rise to the proceeding.
  1. Federal: Declaratory Judgment Act, 28 U.S.C. §§2201-2202
  • 2201. Creation of remedy

(a) In a case of actual controversy within its jurisdiction, except with respect to Federal taxes . . . any court of the United States, upon the filing of an appropriate pleading, may declare the rights and other legal relations of any interested party seeking such declaration, whether or not further relief is or could be sought. Any such declaration shall have the force and effect of a final judgment or decree and shall be reviewable as such.

* * *

  • 2202. Further relief

Further necessary or proper relief based on a declaratory judgment or decree may be granted, after reasonable notice and hearing, against any adverse party whose rights have been determined by such judgment.

 

Williams, McClure & Parmelee is dedicated to high quality legal representation of businesses and insurance companies in a variety of matters. We are experienced Texas civil litigation attorneys based in Fort Worth who know Texas courts and Texas law. For more information, please contact the law firm at 817-335-8800. The firm’s new office location is 5601 Bridge Street, Suite 300, Fort Worth, Texas 76112.

Martindale AVtexas[2]

Collections and Foreign Judgments, Construction Law, Contracts and Commercial Litigation, Employment Law Defense, Insurance Defense Litigation, Nonsubscriber Law

TDI Prosecutor Named for Tarrant County, Texas Insurance Fraud Claims

Specialized Expertise with Investigating, Prosecuting Insurance Fraud

AUSTIN – The Texas Department of Insurance (TDI) announced William “Doug” Wallace as a fraud prosecutor who will work exclusively with criminal prosecutors in the Tarrant County District Attorney’s Office to combat insurance fraud.

Wallace has two decades of insurance industry experience and has focused much of his professional career on special investigations and fraud as well as insurance defense, coverage and subrogation. He spent four years at Nationwide Insurance Trial Division and also served as general counsel of US Lloyds Insurance Company. He is a 2005 graduate of the University of Oklahoma College of Law. Before attending law school, Wallace spent 12 years in the insurance industry as a claims adjuster, supervisor, manager, and litigation manager.

TDI partners with district attorneys in Dallas, Harris, Tarrant and Bexar counties to provide expertise in the investigation and prosecution of insurance fraud.

 

For more information contact: MediaRelations@tdi.texas.gov

 

 

Williams, McClure & Parmelee is dedicated to high quality legal representation of businesses and insurance companies in a variety of matters. We are experienced Texas civil litigation attorneys based in Fort Worth who know Texas courts and Texas law. For more information, please contact the law firm at 817-335-8800. The firm’s new office location is 5601 Bridge Street, Suite 300, Fort Worth, Texas 76112.

Martindale AVtexas[2]

Employment Law Defense, Insurance Defense Litigation, Nonsubscriber Law, Workers' Compensation Defense

Travis County Court Approves $84.4 Million Settlement in Farmers Insurance Case–Texas Insurance Defense Law

AUSTIN – A Travis County district court has granted preliminary approval of a settlement with Farmers Insurance Group that will return $84.4 million to policyholders stemming from a 2002 rate case.

“I’m pleased with the court’s decision,” said Texas Insurance Commissioner David Mattax. “It’s time to return this money to policyholders, who have been waiting for more than a decade. These refunds, combined with the rate reductions Farmers agreed to in 2002, are excellent news for consumers.”

Mattax noted that the court’s original approval of the settlement in 2003 described the agreement as “an extraordinarily high percentage of recovery on the claims that were asserted.” The amended version adds an additional $10 million for consumers to account for the delays while the settlement was challenged in court.

Notices about the settlement will be mailed within 60 days to people who may be eligible for a refund.

Mattax also thanked the Texas Attorney General’s Office for its work representing the state in the long, complex case.

 

For more information contact: MediaRelations@tdi.texas.gov

 

Williams, McClure & Parmelee is dedicated to high quality legal representation of businesses and insurance companies in a variety of matters. We are experienced Texas civil litigation attorneys based in Fort Worth who know Texas courts and Texas law. For more information, please contact the law firm at 817-335-8800. The firm’s new office location is 5601 Bridge Street, Suite 300, Fort Worth, Texas 76112.

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Insurance Defense Litigation

Regional Workplace Safety Summit August 12 in Austin, Texas–for Texas Employers

July 14, 2015

AUSTIN, TX — The Division of Workers’ Compensation is hosting a regional workplace safety workshop August 12 in Austin to help employers learn how to avoid common workplace injuries and comply with federal safety requirements.

The workshop will be 8 a.m. to 4 p.m. at the Holiday Inn Austin-Town Lake, 20 North IH-35. The cost is $50 per person, which includes coffee and snacks. Presentations will cover:

  • Components of an effective accident prevention program.
  • Guidance on complying with Occupational Safety and Health Administration (OSHA) programs and training.
  • The latest information on safe work areas, construction requirements for exit routes, and how to develop effective emergency action plans and fire prevention plans.

Participants can find full course descriptions and register online on the Texas Department of Insurance website at www.tdi.texas.gov/wc/safety/regional.html. For more information, call (512) 804-4610 or emailsafetytraining@tdi.texas.gov.

 

For more information contact: MediaRelations@tdi.texas.gov

 

 

 

Williams, McClure & Parmelee is dedicated to high quality legal representation of businesses and insurance companies in a variety of matters. We are experienced Texas civil litigation attorneys based in Fort Worth who know Texas courts and Texas law. For more information, please contact the law firm at 817-335-8800. The firm’s new office location is 5601 Bridge Street, Suite 300, Fort Worth, Texas 76112.

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Construction Law, Employment Law Defense, Insurance Defense Litigation, Nonsubscriber Law, Workers' Compensation Defense

Small Employer Health Insurance Under Texas Law–Texas Department of Insurance

(January 2015)

Small employers don’t have to offer health insurance to their employees, but employers that do must make it equally available to all employees working 30 hours or more per week (not on a temporary or seasonal basis) and their dependents.

Texas insurance law definefs a small employer as a business with two to 50 employees, regardless of how much they work.

In general, insurance companies require at least 75 percent of a small employer’s eligible employees to participate in the health plan. (An eligible employee is a full-time employee who usually works at least 30 hours a week.) Companies must always round down to the nearest whole number when calculating the number of participating eligible employees. For example, a business with five employees would achieve 75 percent participation if three eligible employees participate. Seventy-five percent of five is 3.75, and 3.75 rounded down is three.

Insurance companies that offer small-employer coverage must make it available to any employer who applies year round. However, if the employer doesn’t meet the minimum participation requirements, availability may be limited to the federal open enrollment period running from November 15 through December 15 of each year.

Types of Plans

The Affordable Care Act requires all individual and small-employer group plans to cover a standardized package of services. These services are known as essential health benefits.
The essential health benefits include the following items and services:
ambulatory patient services (outpatient care you get without being admitted to a hospital)

  • emergency services
  • hospitalization (including surgery)
  • maternity and newborn care
  • mental health and substance use disorder services, including behavioral health treatment (including counseling and psychotherapy)
  • prescription drugs
  • rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
  • laboratory services
  • preventive and wellness services and chronic disease management pediatric services, including oral and vision care.

The essential health benefits are based on a typical plan bought by small employers in Texas. This means that all of the benefits requirements for small-employer plans under Texas law were adopted as part of the federal essential health benefits standard. Learn more about what Texas law requires atwww.tdi.texas.gov/hmo/hmmanben.html.

Grandfathered plans (those that an employer bought before March 23, 2010) aren’t required to contain the essential health benefits, but they do need to comply with Texas laws. Also, some types of insurance, such as indemnity policies, aren’t subject to the ACA and don’t count as minimum essential coverage for tax purposes.

Providing Coverage

Employers must give new employees at least 31 days from their start date to enroll in a health plan. After this time, employees may be required to wait up to one year for the next open enrollment period to join. Insurance companies must offer a 31-day open enrollment period annually.

Employers may require newly eligible employees to wait up to 90 days before being eligible for benefits. However, the insurance company may not charge a premium during this period.

Beginning in January 2014, insurance companies won’t be able to impose coverage limits, exclusions, or waiting periods for employees with preexisting conditions who had a gap in coverage.

Continuing Coverage

State regulations and a federal law called COBRA (Consolidated Omnibus Budget Reconciliation Act) allow employees to maintain benefits for a time after leaving a job. COBRA doesn’t apply to all small employers, but state continuation requirements do. Employers are required to tell employees about their rights to continue coverage. Former employees who choose to continue their coverage through COBRA or state continuation must pay the full cost of the plan. Employers aren’t required to contribute toward their premiums for former employees, even if they previously paid a share. Ask your carrier about your responsibilities regarding continuation notices.

Paying for Coverage

The law doesn’t require employers to contribute toward health benefit plan premiums. Many insurance companies, however, require employers to pay at least 50 percent of their employees’ plan premiums. Employers may choose to pay a higher percentage than the company requires.

Employers are usually not required to contribute toward the cost of dependent coverage.
Premiums may increase at each renewal term because of rising health care costs. However, Texas law caps small-employer rate increases due to health factors – such as the amount of employee claims experience – at 15 percent per year. State law also protects businesses who buy small-employer health insurance by prohibiting insurance companies from discontinuing coverage without a reason.

Businesses with 25 or fewer full-time equivalent employees that pay at least 50 percent of premiums and pay average annual wages below $50,000 may be eligible for a tax credit of up to 50 percent (35 percent for nonprofits) of the premiums the business pays if it buys coverage through the federal small-business health options program, called the Small Business Health Options Program (SHOP). For more information, visit www.healthcare.gov/small-businesses/provide-shop-coverage/.

How Insurers Calculate Small-Employer Plan Premiums

Insurance companies base the amount employers pay for insurance on the specific benefits package and cost-sharing levels chosen by the employer. The health status of employees won’t impact rates. Insurance companies will consider the following factors:

  • Age of employees. Older people usually have more expensive and more frequent health-related claims. Generally, the older your workforce, the more your plan will cost. However, federal law prevents insurers from charging more than three times more for older employees than they charge for younger employees.
  • Tobacco use. Federal law allows health plans to charge tobacco users up to 50 percent more. Texas law requires that rating factors related to health status be spread across the employer group. A group with more tobacco users will pay higher rates than a group with fewer tobacco users.
  • Geographic area. Health care costs vary by region because of differences in the cost of living and the number of providers in the area. Most plans use either the county or ZIP code of the employer’s business address to base rates.

Affordable Care Act Requirements

Small businesses with fewer than 50 full-time plus full-time equivalent employees won’t face a penalty if they don’t provide health insurance to their employees.

Federal law defines a full-time employee as one who works at least 30 hours during a typical week. The law counts each 120 hours worked by part-time employees in a month as one full-time equivalent employee.

Consider a company that employs 30 full-time employees who work at least 120 hours each per month and 24 part-time workers who average 80 hours each per month.

To convert the part-time employees’ hours to full-time equivalent employees, multiply the number of part-time workers by the average number of hours they work each month: 24 x 80 = 1,920. Then divide the total number of hours worked by 120: 1,920/120 = 16. To get the total number of full-time equivalent employees, add this number to the number of full-time employees: 30 + 16 = 46. Thus, the employer in this example has 46 full-time equivalent employees and qualifies as a small employer under the law.

For more information, visit HealthCare.gov or call 1-800-318-2596.

Buying Coverage Through the Insurance Marketplace

The federal government will operate the insurance marketplace in Texas.

Businesses with 50 or fewer full-time plus full-time equivalent employees may buy coverage through the SHOP. In 2016, employers with up to 100 full-time and full-time equivalent employees will be able to buy SHOP coverage. An employer that has SHOP coverage and hires more employees than the threshold will be able to continue coverage through SHOP.

For more information about the insurance marketplace, visit HealthCare.gov or call 1-800-706-7893

Shopping for Coverage

Because premiums, deductibles, copayments, and coinsurance levels can vary from plan to plan, it pays to shop around. The following tips can help you find the best value for your money:

  • Understand coverages when comparing plans and rates. Plans with higher deductibles, copayments, and employee share of coinsurance generally will have lower premiums. Keep in mind that your employees will also have to pay more out of pocket when they access services or benefits.
  • Consider factors other than cost, such as a company’s financial strength and complaint record. You can learn a company’s financial rating, as determined by an independent rating organization, and complaint record by calling the Texas Department of Insurance Consumer Help Line at 1-800-252-3439 or by visiting our website at www.tdi.texas.gov.
  • Buy only from licensed insurance companies and HMOs. Selling unlicensed coverage is illegal in Texas. If you buy from an unlicensed company, your employees’ claims could go unpaid and you could be held liable for the full amount of your employees’ claims and losses. You can learn whether a company is licensed by calling the Consumer Help Line or by viewing the company profiles on our website.
  • Understand that employee health coverage is different from workers’ compensation insurance, which covers only job-related injuries and illnesses. Although workers’ compensation insurance is not required in Texas, it protects an employer from high damage awards in the case of workplace accidents. Providing regular health coverage to employees isn’t a legal alternative to providing workers’ compensation insurance. Read TDI’s Workers’ Compensation Insurance publication for more information.

For More Information or Assistance

For answers to general insurance questions, for information about filing an insurance-related complaint, or to report suspected insurance fraud, call the Consumer Help Line at 1-800-252-3439 between 8 a.m. and 5 p.m., Central time, Monday-Friday, or visit our website at www.tdi.texas.gov.

You can also visit HelpInsure.com to help you shop for automobile, homeowners, condo, and renters insurance, and TexasHealthOptions.com to learn more about health care coverage and your options.

For printed copies of consumer publications, call the Consumer Help Line.

To report suspected arson or suspicious activity involving fires, call the State Fire Marshal’s 24-hourArson Hotline at 1-877-4FIRE45 (434-7345).

The information in this publication is current as of the revision date. Changes in laws and agency administrative rules made after the revision date may affect the content. View current information on our website. TDI distributes this publication for educational purposes only. This publication is not an endorsement by TDI of any service, product, or company.

 

For more information contact: ConsumerProtection@tdi.texas.gov or 1-800-252-3439

 

 

Williams, McClure & Parmelee is dedicated to high quality legal representation of businesses and insurance companies in a variety of matters. We are experienced Texas civil litigation attorneys based in Fort Worth who know Texas courts and Texas law. For more information, please contact the law firm at 817-335-8800. The firm’s new office location is 5601 Bridge Street, Suite 300, Fort Worth, Texas 76112.

Martindale AVtexas[2]

Contracts and Commercial Litigation, Insurance Defense Litigation

Colleyville, Texas Insurance Fraud and Murder Case Update

A housekeeper who was found dead in September of last year was killed as part of a seven-figure life insurance scam. Anita Fox, 72, was found murdered in the entryway of a home she was cleaning in Colleyville, Texas. Colleyville police said that Gerard Gorman, 48, and his son Bernard, 27, were named suspects in the “complex” scam. Police believe someone took out a fraudulent seven-figure life insurance policy on her, which she was not aware of. They believe the Gormans killed her because of it, trying to cash in on the money. Gerard Gorman was found dead of natural causes near Houston last month. Bernard Gorman was arrested by police in Florida and has been charged with Fox’s murder. It is unknown whether the insurance agent who sold the policy will be implicated. The FBI and the Fraud Unit are investigating whether more people are involved and if there is a larger insurance fraud scheme. Read the Star-Telegram story about the fraud scheme.

 

Williams, McClure & Parmelee is dedicated to high quality legal representation of businesses and insurance companies in a variety of matters. We are experienced Texas civil litigation attorneys based in Fort Worth who know Texas courts and Texas law. For more information, please contact the law firm at 817-335-8800. The firm’s new office location is 5601 Bridge Street, Suite 300, Fort Worth, Texas 76112.

Martindale AVtexas[2]

Contracts and Commercial Litigation, Insurance Defense Litigation

Owner of Fictitious Title Company Gets 55 Years in Texas Insurance Fraud Case

The Texas Department of Insurance (TDI) Fraud Unit, along with the Harris County District Attorney’s office, investigated Telly J. Smith and his fictitious online title company named “Exodus Title Company,” which was not associated in any way with the legitimate, TDI licensed title company Exodus Title, LLC of Houston.  Smith forged property deeds to steal the ownership of four properties and then stole money from lending institutions by securing over $3 million in mortgages on the stolen properties.

The 14-month investigation required the review of detailed financial records, real property and title records.  The thoroughness of the investigation resulted in the suspect pleading guilty in the 230th District Court of Harris County.  After pleading guilty, the suspect, Telly J. Smith, requested a hearing before the judge for sentencing.   After reviewing the evidence of the investigation, the Honorable Judge Brad Hart sentenced Smith to 55 years confinement in the Institutional Division of the Texas Department of Criminal Justice, assessed a fine of $10,000, and ordered Smith to pay $1.7 million in restitution.

 

Williams, McClure & Parmelee is dedicated to high quality legal representation of businesses and insurance companies in a variety of matters. We are experienced Texas civil litigation attorneys based in Fort Worth who know Texas courts and Texas law. For more information, please contact the law firm at 817-335-8800. The firm’s new office location is 5601 Bridge Street, Suite 300, Fort Worth, Texas 76112.

Martindale AVtexas[2]

Contracts and Commercial Litigation, Insurance Defense Litigation

Changes to OSHA’s Recordkeeping Rules–for Texas Employers

The Occupational Safety and Health Administration (OSHA) has expanded its requirement for reporting fatalities and severe injuries, and updated the list of industries exempt from recordkeeping requirements.  The final rule announced September 11, 2014 requires all employers to notify OSHA when an employee is killed on the job or suffers a work-related hospitalization, amputation or loss of an eye. The rule, which also updates the list of employers partially exempt from OSHA record-keeping requirements, will go into effect on January 1, 2015 for workplaces under federal OSHA jurisdiction.

What Incidents Must be Reported to OSHA?

Under the revised rule, employers will be required to notify OSHA of:

  • work-related fatalities within eight hours of knowledge;
  • work-related in-patient hospitalizations within 24 hours of knowledge;
  • amputations within 24 hours of knowledge; and
  • losses of an eye within 24 hours of knowledge.

Previously, OSHA’s regulations required an employer to report only work-related fatalities and in-patient hospitalizations of three or more employees. Reporting single hospitalizations, amputations or loss of an eye was not required under the previous rule.

All employers covered by the Occupational Safety and Health Act, even those who are exempt from maintaining injury and illness records as described below, are required to comply with OSHA’s new severe injury and illness reporting requirements.

How to Report Incidents to OSHA

Employers can report these events by telephone to the nearest OSHA Area Office during normal business hours or the 24-hour OSHA hotline 1-800-321-OSHA [6742], or electronically through a new tool which will be released soon and accessible at the link below.

Updated List of Industries Exempt from OSHA Recordkeeping Requirements

The new rule maintains the exemption for any employer with 10 or fewer employees, regardless of their industry classification, from the requirement to routinely keep records of employee injuries and illnesses.

In the new rule, OSHA has updated the list of industries that, due to relatively low occupational injury and illness rates, are exempt from the requirement to routinely keep injury and illness records. The rule will go into effect January 1, 2015 for workplaces under federal OSHA jurisdiction.

The previous list of exempt industries was based on the old Standard Industrial Classification (SIC) system and the new rule uses the North American Industry Classification System (NAICS) to classify establishments by industry. The new list is based on updated injury and illness data from the Bureau of Labor Statistics.

For more information on the industries now exempt from keeping records or new industries now covered, please visit OSHA’s website.

Williams, McClure & Parmelee is dedicated to high quality legal representation of businesses and insurance companies in a variety of matters. We are experienced Texas civil litigation attorneys based in Fort Worth who know Texas courts and Texas law. For more information, please contact the law firm at 817-335-8800. The firm’s new office location is 5601 Bridge Street, Suite 300, Fort Worth, Texas 76112.

Martindale AVtexas[2]

Construction Law, Employment Law Defense, Insurance Defense Litigation, Nonsubscriber Law, Workers' Compensation Defense

Sample Form of Affidavit For Texas Law–Reasonableness and Necessity of Services

AFFIDAVIT

 

Before me, the undersigned authority, personally appeared ______(NAME OF AFFIANT)______, who, being by me duly sworn, deposed as follows:

My name is __________(NAME OF AFFIANT)__________. I am of sound mind and capable of making this affidavit.

I am the person in charge of records of __________(PERSON WHO PROVIDED THE SERVICE)__________.  Attached to this affidavit are records that provide an itemized statement of the service and the charge for the service that __________(PERSON WHO PROVIDED THE SERVICE)__________ provided to __________ (PERSON WHO RECEIVED THE SERVICE)__________ on __________(DATE)__________.  The attached records are a part of this affidavit.

The attached records are kept by me in the regular course of business.  The information contained in the records was transmitted to me in the regular course of business by __________(PERSON WHO PROVIDED THE SERVICE)__________ or an employee or representative of __________(PERSON WHO PROVIDED THE SERVICE)__________ who had personal knowledge of the information.  The records were made at or near the time or reasonably soon after the time that the service was provided.  The records are the original or an exact duplicate of the original.

The service provided was necessary and the amount charged for the service was reasonable at the time and place that the service was provided.

________________________________

Affiant

SWORN TO AND SUBSCRIBED before me on the __________ day of __________, 19___.

My commission expires:

______________________

 

________________________________

Notary Public, State of Texas

Notary’s printed name:

 

 

Williams, McClure & Parmelee is dedicated to high quality legal representation of businesses and insurance companies in a variety of matters. We are experienced Texas civil litigation attorneys based in Fort Worth who know Texas courts and Texas law. For more information, please contact the law firm at 817-335-8800. The firm’s new office location is 5601 Bridge Street, Suite 300, Fort Worth, Texas 76112.

Martindale AVtexas[2]

 

Collections and Foreign Judgments, Construction Law, Contracts and Commercial Litigation, Employment Law Defense, Insurance Defense Litigation