Cal. Code Regs. Tit. 10, § 2592.10 - Designation-Claims Adjuster and Medical-Only Claims Adjuster

CLAIMS ADJUSTER or MEDICAL-ONLY CLAIMS ADJUSTER DESIGNATION

This Designation is awarded to

______________________________

(Adjuster's Name)

for: [] Claims Adjuster [] Medical-Only Claims Adjuster

(Check Only One)

as a result of successfully completing the required hours for workers' compensation training pursuant to California Insurance Code Section 11761 and California Code of Regulations, Title 10, Sections 2592.02 and 2592.03

Total Hours of Training Completed: __________

Designation Given By:

______________________________

(Name of Insurance Company, Self-Insured Employer, or Third-Party Administrator)

___________________________		___________________________
(Date)		(Signature)

Name of person awarding designation (print or type):

Title of person awarding designation:

Business address:

Notes

Cal. Code Regs. Tit. 10, § 2592.10

1. New section filed 1-23-2006; operative 2-22-2006 (Register 2006, No. 4).

Note: Authority cited: Section 11761, Insurance Code. Reference: Section 11761, Insurance Code.

1. New section filed 1-23-2006; operative 2-22-2006 (Register 2006, No. 4).