Privacy Statement

Article 5, Part 5

5-5-1.  PROOF OF PAYMENT

(1)  Because only costs that the applicant has already paid are eligible for reimbursement, proof of payment pursuant to the regulations is required for all costs submitted on a third-party liability claim.  For any costs paid directly by the third party and reimbursed to the third party by the applicant, proof of payment may be required from both the third party and the applicant.

5-5-2.  PROOF OF DAMAGES

(1)  All third-party costs must be sufficiently documented to demonstrate the amount of the damages and the basis for the damages.  If the third-party claim is based upon a settlement agreement, jury verdict, or court order that does not itemize damages and costs, the applicant must provide supporting documentation to show that allowable costs were incurred whose total reached the amount paid to the third party.  If the applicant cannot provide this documentation, only allowable costs which the applicant can adequately document will be reimbursed.

(2)  With respect to third-party reimbursement claims submitted to the Division of Oil and Public Safety before the Committee adopts this Article 5, the Committee may, at its sole discretion, approve full or partial reimbursement solely on the basis of a settlement agreement, jury verdict or final court order, and with no further documentation of actual damages and costs.

5-5-3.  OTHER REQUIRED DOCUMENTATION

(1)  Any settlement agreement, jury verdict, or final court order must be provided with a third-party liability claim. These may be used as baselines from which the OPS will conduct eligibility, reasonableness and necessity reviews. 

(2)  Any other documentation as requested by the OPS or the Committee, including, but not limited to:

(a)    Waiver and/or release agreements
(b)    Subrogation agreements
(c)    Tax forms
(d)    Real and personal property appraisals
(e)    Personal property repair bills
(f)     Medical bills
(g)    Financial statements
(h)    Lease agreements
(i)     Utility bills
(j)     Pleadings and other documents of legal effect
(k)    Insurance policies  

5-5-4.  INDEPENDENT EXAMINATION

(1)  Either the OPS or the Committee may require physical examination by a property appraiser of the damaged property which is the subject of the reimbursement claim.  Fund monies may be used to pay fees and expenses associated with the appraisal, and any such payment will not count against the $1 million per-occurrence reimbursement limit.