Notice Pursuant To Certificate Of Insurer Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Notice Pursuant To Certificate Of Insurer Form. This is a Tennessee form and can be use in Workers Compensation.
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Tags: Notice Pursuant To Certificate Of Insurer, I-1, Tennessee Workers Compensation,
NOTICE
Beginning April 1, 2001, all insurance carriers issuing workers' compensation insurance policies
in Tennessee must submit proof of coverage (POC) information required by Tennessee Code
Annotated, Section 50-6-406(a) electronically to a vendor that is IAIABC certified and approved
by the Tennessee Workers' Compensation Division.
The National Council on Compensation Insurance and Claimport are IAIABC certified and
authorized to submit POC data on each carriers' behalf.
The Workers’ Compensation Division will accept filings from The National Council on
Compensation Insurance beginning April 1, 2001. Then, other vendors such as Claimport will be
added as testing with the Division is completed.
The Tennessee Workers' Compensation Division will no longer accept the following paper
coverage forms:
Form I-1, Certificate of Insurer
Form I-2, Notice of Cancellation, Reinstatement or Endorsement
Carriers will still be held responsible by the Tennessee Workers' Compensation Division for the
timely and accurate submission of all POC data as required by Tennessee law and administrative
rule. Any questions with regard to this announcement may be directed to Bonnie Hudgens,
Workers' Compensation Division at (615) 532-2731 or email bhudgens@mail.state.tn.us.
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