Form LA-3263 Notification of Primary Liaison and Adjusters Processing or Supervising Tennessee Workers' Compensation Claims - Tennessee

What Is Form LA-3263?

This is a legal form that was released by the Tennessee Department of Labor and Workforce Development - a government authority operating within Tennessee. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form LA-3263?
A: Form LA-3263 is a notification form used to inform the Tennessee Workers' Compensation Division about the primary liaison and adjusters processing or supervising workers' compensation claims in Tennessee.

Q: Who needs to submit Form LA-3263?
A: Insurance carriers and self-insured employers who are handling workers' compensation claims in Tennessee need to submit Form LA-3263.

Q: What information is required on Form LA-3263?
A: Form LA-3263 requires information such as the name, address, and contact details of the primary liaison and adjusters, as well as the list of claims they will be processing or supervising.

Q: Is there a deadline for submitting Form LA-3263?
A: Yes, Form LA-3263 should be submitted within 30 days of the date the primary liaison or adjuster begins processing or supervising workers' compensation claims in Tennessee.

Q: What happens if I fail to submit Form LA-3263?
A: Failure to submit Form LA-3263 can result in penalties and may affect the processing of workers' compensation claims in Tennessee.

Q: Can I make changes to the information on Form LA-3263?
A: Yes, if there are any changes to the information provided on Form LA-3263, you are required to notify the Tennessee Workers' Compensation Division within 10 days of the change.

Q: Are there any fees associated with submitting Form LA-3263?
A: No, there are no fees associated with submitting Form LA-3263.

Q: Who can I contact for more information about Form LA-3263?
A: For more information about Form LA-3263, you can contact the Tennessee Workers' Compensation Division directly.