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Overage requests made in connection with a pending workers compensation claim. Use of Form The WCIRB can provide coverage information to an insurance company, employer, injured worker, licensed health care provider, Third Party Entity (TPE) acting on behalf of a member insurer who has a TPE agreement with the WCIRB or an attorney involved in a pending workers compensation claim. Authorization Before the coverage request will be processed, the requesting party must certify that he/she is en.

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