TPA will administer workers' compensation claims of insolvent SIEs and SIAs, including, but not limited to claim management and administration; case management; bill review; excess insurance recovery; subrogation; payment; and settlement in consultation with Division staff and in accordance with applicable Nevada laws. TPA will assume the complete handling of all open and reopened claims as well as new claims, accepted by the Division and assigned to the contracted TPA, of insolvent SIEs or SIAs, whether currently insolvent or determined in the future to be insolvent, from the effective date of this contract. Division approval is required before a new or reopened claim may be paid by either Fund. TPA will ensure that requests for all outside case management services utilized, including, but not limited to, nurse case management and special investigation services, must be discussed with and approved by the Division in advance. TPA will ensure that prior to reopening any previously closed claims, the adjuster must provide and discuss the rationale with Division staff...
