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    « Health Care Reform Primer: Exchanges -- Certifying Plans, Territories, and Rewards for Quality | Main | A Tail of One City »

    March 24, 2011

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    tina poirier

    if i am on workmens comp and the dr has not released me yet and my claim is about to expire can i renew my claim

    Tim Dodge

    Tina,
    Workers' Compensation claims do not "expire." They close when all the bills are paid and the injured worker is back on the job (or the period for her to receive disability benefits runs out; for example, someone with a serious permanent partial disability can receive disability benefits for no more than 525 weeks in New York.) Therefore, it is unnecessary for you to "renew" your claim. If you're nearing the end of the disability period written into your state's laws, you probably cannot get that extended.

    Joann

    We received a certificate on 8/04/10 showing coverage for a Subcontractor until 4/30/11. Our recent Audit came back to us that this policy cancelled on 6/24/10 and we have to pay for the Sub since they did not have coverage during part of the sudit period. Our Safety Group said this Insurance company should not have sent this certificate that it was sent in error. We never received a cancellation notice. Why do we have to pay for this?

    Tim Dodge

    Joann,
    First, I'm sorry that your subcontractor deceived you like that. From your insurance company's standpoint, the sub did not have Workers' Compensation insurance. Had he gotten injured while working on your project, and he had sought Workers' Comp benefits from you, it's very possible that he would have been successful and your company would have had to pay. Therefore, they're including his compensation in your payroll when they calculate your WC insurance premium.

    What was done to you, of course, was unfair. First, you were given a fraudulent certificate of insurance -- it indicated that coverage was in force when it had actually terminated more than a month earlier. Second, if your contract with the sub required him to carry WC insurance, then he violated the contract. Giving someone a false insurance document is an act of insurance fraud. The New York Insurance Department has a fraud hotline you can call -- 1-888-FRAUD-NY. You might also want to consider contacting law enforcement authorities. At the very least, the sub may owe you restitution for the additional insurance premium you had to pay. You may want to discuss with your attorney whether you should seek recovery.

    JOE

    IF THE INSURED REQUEST TO CANCEL THEIR POLICY WHY SHOULD THE COMPANY ISSUED A 30 DAY NOTICE TO THE INSURED. I REQUESTED CANCELLATION OF SAID POLICY AND THEY SEND ME A 3O DAY NOTICE ADVISING ME THAT THEY ARE TO CANCEL MY POLICY ON A LATER DATE INSTEAD OF MY REQUESTED DATE?

    Tim Dodge

    Joe,
    It sounds like your policy was with the New York State Insurance Fund. If so, New York State Workers' Compensation Law states that an employer may not withdraw from the Fund until 30 days after it has given notice of its intent to do so. The law does not require 30 days' advance notice to private carriers, but it does for the State Fund.

    Injury Compensation Ireland

    Good advice! Must make a note of it.

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