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This entry was published on 2016-04-08
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SECTION 226
The insurance contract
Workers' Compensation (WKC) CHAPTER 67, ARTICLE 9
§ 226. The insurance contract. 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.