What to Consider When TPAs Are Involved

Image of a compassIt can be confusing for the Applicant and Respondent companies when there is a TPA involved. There are a few important guidelines to remember.

The Applicant company that is initiating a case can only name a Respondent member company. The Applicant cannot add the TPA code to the case. The Applicant can enter the TPA address and/or Rep information; however, the case needs to be filed against the Respondent member company. The TPA will add its code to the case when it responds, or the Respondent member may call or email AF’s Member Service Center to have the TPA code added to the case.

AF’s electronic notification will be sent to the Respondent member company unless the Respondent member company has provided a specific TPA’s email address to receive all of its AF notifications. Notifications cannot be case specific.

Finally, the Respondent should not raise an Affirmative Defense because the Applicant did not name the TPA. The subrogation is between the two member companies; therefore, the docket is properly filed by the Applicant when it names the correct Respondent company. The Respondent company has the responsibility to notify the TPA, if applicable.

Article published in: September 2017 E-Bulletin