Fla. Admin. Code Ann. R. 69L-56.307 - Electronic Cancellation of Claim
(FROI MTC 01 as found in the IAIABC Implementation Guide for Claims: First, Subsequent, Header, Trailer and Acknowledgement Detail Records, Release 3, January 1, 2009 Edition.)
(1) The claim administrator shall send FROI
MTC 01 (Cancel) immediately upon the claim administrator's knowledge of the
need to cancel if any of the following occur:
(a) An Electronic First Report of Injury or
Illness was accepted by the Division and the claim administrator subsequently
determined the claim was filed in error because it was actually a Medical Only
Case. The FROI MTC 01 shall reflect the Claim Type as "B" (Became Medical
Only).
(b) An Electronic First
Report of Injury or Illness was accepted by the Division and the claim
administrator subsequently determined the claim was filed with inaccurate
identifying information and was a duplicate of another accepted
claim.
(2) If a claim has
been cancelled via FROI MTC 01 (Cancel) after an Electronic First Report of
Injury or Illness was previously filed with the Division and the claim
administrator determines the claim should not be cancelled after all, the claim
administrator shall re-file a subsequent Electronic First Report of Injury or
Illness using the applicable MTC(s) specified in this rule for reporting an
Electronic First Report of Injury or Illness. The original Electronic First
Report of Injury or Illness sent to the Division shall be disregarded and
considered not filed with the Division. The due date for filing the subsequent
Electronic First Report of Injury or Illness shall correspond to the filing
timeframes specified in this rule for the applicable MTC(s) required for an
Electronic First Report of Injury. If un-canceling a claim to file a full or
partial denial of indemnity benefits, the claim administrator shall provide to
the employee and employer, Form DFS-F2-DWC-12 adopted in Rules
69L-56.4012 and
69L-3.025,
F.A.C.
Notes
Rulemaking Authority 440.591, 440.593(5) FS. Law Implemented 440.593 FS.
New 1-7-07, Amended 5-17-09.
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