As a self-insured administrator, how long must you maintain the claims file?

• A. Five years from the date of injury and one year thereafter
• B. Five years from the date of injury and one year from the date of last payment of benefits
• C. Five years from the date of injury or the date of the last provision of benefits
• D. Two years from the date of the last payment of compensation

Answer: (C)

The correct choice is based on the requirement to keep claims files relevant to self-insured practices, including compliance with legal and regulatory obligations. Maintaining claims files for five years from the date of injury or the date of the last provision of benefits ensures that all relevant information is available for review should an audit, legal claim, or inquiry arise.

This timeframe allows sufficient documentation to support any potential disputes or questions regarding the claims. Retaining the file based on either the date of injury or the last benefit provision reflects the need to encompass all pertinent data, capturing the duration of claims processing and ensuring that any residual matters related to the claim can be effectively managed.

The other options may not sufficiently cover all necessary aspects of claims management, leading to potential gaps in documentation or compliance. Therefore, the specified five-year duration linked to either key date provides a comprehensive and prudent approach to record-keeping in the context of self-insured administrative practices.