AdjusterAcademy is pleased to present varying views from noted authors and experts on the subject of insurance claims and issues relating to the need for expert training of claims personnel. The following is the text from Assembly Bill 1262, authored by Assembly Member Matthews and is being sponsored by the Insurance Commissioner, John Garamendi. This bill, if passed, would require all workers' compensation adjusters to be trained and for insurers to certify to the Commissioner that adjusters meet minimum standards established by the Commissioner. 

AB 1262 has already passed in the Assembly is now being considered by the Senate.

Watch this site for the latest update on this important bill as well as other pending legislation relating to workers' compensation reform.

AMENDED IN ASSEMBLY APRIL 28, 2003   CALIFORNIA LEGISLATURE—2003–04 REGULAR SESSION   ASSEMBLY BILL No. 1262   Introduced by Assembly Member Matthews   February 21, 2003   An act to add Article 5 (commencing with Section 11761) to Chapter 3 of Part 3 of Division 2 of the Insurance Code, relating to workers’ compensation insurance.   LEGISLATIVE COUNSEL’S DIGEST AB 1262, as amended, Matthews. Workers’ Compensation Insurance: study claims adjusters. Existing law generally regulates insurers offering workers’ compensation insurance and other specified entities involved in administering this type of insurance. This bill would require the Insurance Commissioner to adopt regulations setting forth the minimum standards of training, experience, and skill that workers’ compensation claims adjusters must possess. The bill would require every workers’ compensation insurer, as defined, to certify to the commissioner that the personnel employed by the insurer to adjust workers’ compensation claims, or employed for that purposes by a medical billing entity, as defined, meet those minimum standards.   Existing law generally regulates the issuance of workers’ compensation insurance. This bill would require the Insurance Commissioner to conduct a study examining the competitiveness of the workers’ compensation insurance system, as specified, and to submit a report to the Legislature and the Governor.   Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.   The people of the State of California do enact as follows:   SECTION 1. The Insurance Commissioner shall conduct SECTION 1. Article 5 (commencing with Section 11761) is added to Chapter 3 of Part 3 of Division 2 of the Insurance Code, to read: Article 5. Standards Applicable to Claims Adjusters   11761. (a) The commissioner shall adopt regulations setting forth the minimum standards of training, experience, and skill that workers’ compensation claims adjusters must possess to perform their duties with regard to workers’ compensation claims. (b) Every insurer shall certify to the commissioner that the personnel employed by the insurer to adjust workers’ compensation claims, or employed for that purpose by any medical billing entity with which the insurer contracts, meet the minimum standards adopted by the commissioner pursuant to subdivision (a). (c) For the purposes of this section, ‘‘medical billing entity’’ means a third party that reviews or adjusts workers’ compensation medical bills for insurers. (d) For the purposes of this section, ‘‘insurer’’ means an insurer admitted to transact workers’ compensation insurance in this state, the State Compensation Insurance Fund, an employer that has secured a certificate of consent to self-insure pursuant to subdivision (b) or (c) of Section 3700 of the Labor Code, or a third-party administrator that has secured a certificate of consent pursuant to Section 3702.1 of the Labor Code. a study of the workers’ compensation insurance system that examines the state of competitiveness in the market, determines factors affecting that state of competitiveness, and identifies ways to improve market functioning. The commissioner shall submit a   report containing findings and recommendations to the Legislature and the Governor.