When an employer is self-insured for workers' compensation, who is responsible for claims adjustment?

When an employer is self-insured for workers' compensation, who is responsible for claims adjustment?

• A. The insurer's claims adjuster
• B. The employee
• C. The state’s workers' compensation board
• D. The employer (self-insured) or a designated administrator

Answer: (D)

In a self-insured workers’ compensation program, the employer takes on the financial risk and runs the claims process. The entity that adjusts claims is the employer itself or a designated administrator (often a third‑party administrator) hired to handle claims on the employer’s behalf. There is no insurer’s claims adjuster involved in a self‑insured arrangement. The state workers’ compensation board oversees licensing and compliance, not daily claim adjustments. The employee does not adjust claims.

In a self-insured workers’ compensation program, the employer takes on the financial risk and runs the claims process. The entity that adjusts claims is the employer itself or a designated administrator (often a third‑party administrator) hired to handle claims on the employer’s behalf. There is no insurer’s claims adjuster involved in a self‑insured arrangement. The state workers’ compensation board oversees licensing and compliance, not daily claim adjustments. The employee does not adjust claims.