Health And Safety Insurance Carriers Audit Worksheet {LIBC-226}

LIBC-226 - HEALTH & SAFETY INSURANCE CARRIER’S AUDIT WORKSHEET. This form issued by the Pennsylvania Department of Labor & Industry, Bureau of Workers’ Compensation, is used to audit insurance carriers that provide workers’ compensation coverage in Pennsylvania. The purpose of this form is to evaluate whether insurers are in compliance with state regulations concerning accident and illness prevention services offered to policyholders, as required under Pennsylvania workers’ compensation laws. Through this detailed form, the Bureau collects information on how insurers manage and deliver workplace safety programs, including the number and type of services provided (like on-site surveys, consultations, training, and industrial hygiene evaluations), how effectiveness is measured, and whether services are appropriately documented. It also assesses the qualifications of the safety service providers and verifies that insurers are notifying policyholders of available services, maintaining records, and submitting accurate annual reports. The form allows auditors to review specific policyholder cases to ensure that services requested were delivered, and that insurers made recommendations and documented their follow-through. www.FormsWorkflow.com