Texas Labor Code 408.147 – Contest of Supplemental Income Benefits by Insurance Carrier; Attorney’s Fees
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(a) An insurance carrier may request a benefit review conference to contest an employee’s entitlement to supplemental income benefits or the amount of supplemental income benefits.
(b) If an insurance carrier fails to make a request for a benefit review conference within 10 days after the date of the expiration of the impairment income benefit period or within 10 days after receipt of the employee’s statement, the insurance carrier waives the right to contest entitlement to supplemental income benefits and the amount of supplemental income benefits for that period of supplemental income benefits.
Terms Used In Texas Labor Code 408.147
- Entitlement: A Federal program or provision of law that requires payments to any person or unit of government that meets the eligibility criteria established by law. Entitlements constitute a binding obligation on the part of the Federal Government, and eligible recipients have legal recourse if the obligation is not fulfilled. Social Security and veterans' compensation and pensions are examples of entitlement programs.
(c) If an insurance carrier disputes the commissioner’s determination that an employee is entitled to supplemental income benefits or the amount of supplemental income benefits due and the employee prevails on any disputed issue, the insurance carrier is liable for reasonable and necessary attorney’s fees incurred by the employee as a result of the insurance carrier’s dispute and for supplemental income benefits accrued but not paid and interest on that amount, according to § 408.064. Attorney’s fees awarded under this subsection are not subject to Sections 408.221(b), (f), and (i).