Where must the claims file be maintained for an out-of-state self-insurer?

• A. In California
• B. In the state where the self-insured is located
• C. In California unless the Manager approves administration from outside of CA
• D. In the state where the third party administrator is located

Answer: (C)

The correct choice is that the claims file must be maintained in California unless the Manager approves administration from outside of California. This requirement is in place to ensure that all self-insurance claims comply with California regulations and can be easily accessed for audits, investigations, or any regulatory oversight that may be necessary. Keeping the claims file within California provides a centralized location for oversight by the state's workers’ compensation authority, thus enhancing accountability and compliance with local laws.

This approach also facilitates communication and coordination between the self-insured entity and the regulatory bodies, which is essential for efficient claims processing and management. Additionally, while the self-insured may operate in other states or have third-party administrators in those states, California law mandates that claims files be readily available within the jurisdiction of California unless specifically allowed otherwise through managerial approval. This exception might be granted in cases where the administration methods align with California regulations while being located elsewhere.