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What if the form has a field for both claims administrator and insurance carrier information, such as the application for adjudication or the compromise and release?

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What if the form has a field for both claims administrator and insurance carrier information, such as the application for adjudication or the compromise and release?

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Use the uniform assigned name of your organization in the claims administrator field and the formal name of the insurance carrier in the insurance carrier field. You must fill in the insurance carrier field on these forms, even if it is the same organization. For example, if the State Compensation Insurance Fund was submitting a C&R in a case, the filer would put the uniform assigned name, such as SCIF INSURED GLENDALE, in the field for claims administrator, and STATE COMPENSATION INSURANCE FUND in the field for insurance carrier.

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