Appeals procedure

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20-367.01. Appeals procedure

A. Within a reasonable time after receiving a written request and on payment of a reasonable fee, every rating organization and insurer shall give to any insured affected by a rate that is made or applied by the organization or insurer, or to the insured's authorized representative, all pertinent information related to the rate.

B. If a person is aggrieved by the application of a rating system, the person may send a written request to the workers' compensation appeals board established by section 20-367 to review the manner in which the rating system has been applied to the insurance afforded the aggrieved person. The aggrieved person or that person's representative may present the grievance before the board. A representative of the rating organization whose rating system is the subject of the appeal shall attend any hearing before the board pursuant to this section to explain that application of the rating system to the aggrieved person.

C. If the board does not act on the aggrieved person's request for review within thirty days after receiving the request, the aggrieved person may proceed as if the board had rejected the request for review.

D. The appellant shall pay the cost to record the board's proceedings.

E. The board shall mail a written notice of its decision to the aggrieved person. Within thirty days after the date the board mails the written notice of its decision, the aggrieved person may appeal the action to the director. After a hearing held on at least ten days' written notice to the person and the rating organization or insurer, the director shall affirm, modify or reverse the board's decision. The person appealing the board's decision shall pay the costs of the transcript and record of the appeal to the director.


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