1. The Laws of New York
  2. Consolidated Laws
  3. Workers' Compensation
  4. Article 9: Disability Benefits


Section 226 The insurance contract

Workers' Compensation (WKC)

1. Every policy of insurance providing the benefits required to be paid under this article shall contain a provision setting forth the right of the chairman to enforce in the name of the people of the state of New York for the benefit of the person entitled to the benefits insured by the policy, either by filing a separate application or by making the insurance carrier a party to the original application, the liability of the insurance carrier in whole or in part for the payment of such benefits; provided, however, that payment in whole or in part of such benefits by either the employer or the insurance carrier shall to the extent thereof be a bar to the recovery against the other of the amount so paid.

  2. Every such policy shall contain a provision that, as between the employee and the insurance carrier, the notice to or knowledge of the occurrence of the injury or sickness on the part of the employer shall be deemed notice or knowledge as the case may be, on the part of the insurance carrier; that jurisdiction of the employer shall, for the purpose of this chapter, be jurisdiction of the insurance carrier and that the insurance carrier shall in all things be bound by and subject to the orders, findings or decisions rendered in connection with the payment of benefits under the provisions of this article.

  3. Every such policy shall contain a provision to the effect that the insolvency or bankruptcy of the employer shall not relieve the insurance carrier from the payment of benefits for disability suffered by an employee during the life of such policy.

  4. Every policy of insurance issued to meet the requirements of section two hundred eleven shall contain a provision reciting in effect that notwithstanding any other provision of the policy, benefits shall be paid at least to the extent and in the manner and subject to the conditions required by the terms of the insured's provision of benefits under this article.

  5. No contract of insurance issued by an insurance carrier providing the benefits to be paid under this article shall be cancelled within the time limited in such contract for its expiration unless notice is given as required by this section. When cancellation is due to non-payment of premiums such cancellation shall not be effective until at least ten days after a notice of cancellation of such contract, on a date specified in such notice, shall be filed in the office of the chair and also served on the employer. When cancellation is due to any reason other than non-payment of premiums such cancellation shall not be effective until at least thirty days after a notice of cancellation of such contract, on a date specified in such notice, shall be filed in the office of the chair and also served on the employer; provided, however, in either case that if insurance with another insurance carrier has been obtained which becomes effective prior to the expiration of the time stated in such notice, the cancellation shall be effective as of the date of such other coverage. Such notice shall be served on the employer as prescribed by the chair, including delivering it to him or her by electronic means; provided that, if the employer be a partnership, then such notice may be given to any one of the partners, and if the employer be a corporation then the notice may be given to any agent or officer of the corporation upon whom legal process may be served, provided, however, the right to cancellation of a policy of insurance in the state fund shall be exercised only for nonpayment of premiums or as provided in section ninety-four of this chapter.

  6. (a) Any insurance carrier or the state insurance fund who issues, reinstates, amends or endorses any contract of insurance or rider thereto providing the benefits required to be paid under this article shall file notification in the office of the chair within thirty days after such issuance, reinstatement, amendment or endorsement of the contract. Such notice shall be filed in the manner and form prescribed by the chair.

  (b) In the event notice required under this subdivision or subdivision five of this section is not filed with the chair within the thirty-day time period, the chair may impose a penalty of up to one hundred dollars for each ten-day period the insurance carrier or state insurance fund failed to file the notification. All penalties collected pursuant to this subdivision shall be deposited in the uninsured employers' fund.

  7. The chair may require by regulation that every policy of family leave insurance contain a provision requiring that all disputes be resolved by designated alternative dispute resolution process in accordance with such regulations.

  8. Premiums for policies providing disability or family leave benefits in accordance with this article shall be calculated in accordance with applicable provisions of the insurance law, including subsection (n) of section four thousand two hundred thirty-five of such law.

  9. Except as set forth in subdivision eight of section two hundred eleven of this article, every policy of insurance issued pursuant to this article must offer coverage for both disability and family leave benefits.