By:  Fraser                                                       S.B. No. 819
	(In the Senate - Filed March 3, 2003; March 10, 2003, read 
first time and referred to Committee on State Affairs; May 2, 2003, 
reported favorably by the following vote:  Yeas 6, Nays 1; 
May 2, 2003, sent to printer.)


A BILL TO BE ENTITLED

AN ACT


relating to the right of an insurance carrier to contest the 
compensability of an injury in a workers' compensation case; 
providing an administrative violation.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:                        
	SECTION 1.  Section 409.021, Labor Code, is amended to read 
as follows:      
	Sec. 409.021.  INITIATION OF BENEFITS; INSURANCE CARRIER'S 
REFUSAL; ADMINISTRATIVE VIOLATION.  (a)  An insurance carrier 
shall initiate compensation under this subtitle promptly.  Not 
later than the seventh day after the date on which an insurance 
carrier receives written notice of an injury, the insurance carrier 
shall:
		(1)  begin the payment of benefits as required by this 
subtitle; or         
		(2)  notify the commission and the employee in writing 
of its refusal to pay and advise the employee of:
			(A)  the right to request a benefit review 
conference; and                 
			(B)  the means to obtain additional information 
from the commission.       
	(b)  An insurance carrier who fails to begin the payment of 
benefits or file a notice of refusal on or before the seventh day 
after the date on which the insurance carrier is notified of the 
injury does not waive the carrier's right to contest the 
compensability of the injury but commits an administrative 
violation subject to Subsection (f).
	(c)  An insurance carrier shall notify the commission in 
writing of the initiation of income or death benefit payments in the 
manner prescribed by commission rules.
	(d) [(c)]  If an insurance carrier does not contest the 
compensability of an injury on or before the 60th day after the date 
on which the insurance carrier is notified of the injury, the 
insurance carrier waives its right to contest compensability.  The 
initiation of payments by an insurance carrier does not affect the 
right of the insurance carrier to continue to investigate or deny 
the compensability of an injury during the 60-day period.
	(e) [(d)]  An insurance carrier may reopen the issue of the 
compensability of an injury if there is a finding of evidence that 
could not reasonably have been discovered earlier.
	(f) [(e)]  An insurance carrier commits a violation if the 
insurance carrier does not initiate payments or file a notice of 
refusal as required by this section.  A violation under this 
subsection is a Class B administrative violation.  Each day of 
noncompliance constitutes a separate violation.
	SECTION 2.  This Act takes effect September 1, 2003, and 
applies only to a claim for workers' compensation benefits based on 
a compensable injury that occurs on or after that date.  A claim 
based on a compensable injury that occurs before the effective date 
of this Act is governed by the law in effect on the date the 
compensable injury occurred, and the former law is continued in 
effect for that purpose.



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