Legislation

Search OpenLegislation Statutes

This entry was published on 2023-09-22
The selection dates indicate all change milestones for the entire volume, not just the location being viewed. Specifying a milestone date will retrieve the most recent version of the location before that date.
SECTION 3443
Workers' compensation and employers' liability insurance; optional policyholder deductibles
Insurance (ISC) CHAPTER 28, ARTICLE 34
§ 3443. Workers' compensation and employers' liability insurance;
optional policyholder deductibles. An insurer issuing a workers'
compensation and employers' liability insurance policy, may offer, as
part of the policy or by endorsement, deductibles optional to the
policyholder for benefits payable under the policy, subject to approval
by the superintendent and subject to underwriting by the insurer,
consistent with the following standards or factors:

(a) claimants' rights are properly protected and claimants' benefits
are paid without regard to any such deductible;

(b) appropriate premium reductions reflect the type and level of any
deductible approved by the superintendent and selected by the
policyholder;

(c) premium reductions for deductibles are determined before
application of any experience modification, premium surcharge, or
premium discount;

(d) recognition is given to policyholder characteristics, including
size, financial capabilities, nature of activities, and number of
employees;

(e) if the policyholder selects a deductible, the policyholder is
liable to the insurer for the deductible amount in regard to benefits
paid for compensable claims;

(f) the insurer pays all of the deductible amount, applicable to a
compensable claim, to the person or provider entitled to benefits and
then seeks reimbursement from the policyholder for the applicable
deductible amount; and

(g) failure to reimburse deductible amounts by the policyholder to the
insurer is treated under the policy in the same manner as nonpayment of
premiums.