Senate Bill No. 38–Committee on Commerce and Labor

Prefiled January 27, 1999

(On Behalf of Legislative Committee on Workers’ Compensation)

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Referred to Committee on Commerce and Labor

 

SUMMARY—Makes various changes concerning duties and powers of insurers who provide industrial insurance. (BDR 53-379)

FISCAL NOTE: Effect on Local Government: Yes.

Effect on the State or on Industrial Insurance: No.

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EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted. Green numbers along left margin indicate location on the printed bill (e.g., 5-15 indicates page 5, line 15).

 

AN ACT relating to industrial insurance; requiring certain records of an employer who is insured by a private carrier to be open to inspection by that private carrier; expanding the types of organizations or associations of employers to which private carriers may provide industrial insurance; changing the period within which an insurer must provide notice that an employer has changed insurers or allowed his industrial insurance to lapse; requiring an insurer to notify certain claimants of circumstances under which a claim for workers’ compensation may be closed automatically; providing a penalty; and providing other matters properly relating thereto.

 

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

1-1 Section 1. NRS 616A.485 is hereby amended to read as follows:

1-2 616A.485 1. The books, records and payrolls of an employer insured

1-3 by the system must be open to inspection by the administrator, the system or

1-4 its auditor or agent or by auditors of the department of taxation to

1-5 determine:

1-6 (a) The accuracy of the payroll;

1-7 (b) The number of persons employed; and

1-8 (c) Any other information necessary for the administration of chapters

1-9 616A to 617, inclusive, of NRS.

1-10 2. The books, records and payroll of an employer who is self-insured, a

1-11 member of an association of self-insured public or private employers or

2-1 insured by a private carrier must be open to inspection by the administrator

2-2 or his auditor or agent in the manner prescribed in subsection 1.

2-3 3. The books, records and payroll of an employer who is insured by a

2-4 private carrier must be open to inspection by that private carrier or its

2-5 auditor or agent in the manner prescribed in subsection 1.

2-6 Sec. 2. NRS 616B.026 is hereby amended to read as follows:

2-7 616B.026 1. An insurer, other than a self-insured employer or an

2-8 association of self-insured public or private employers, shall provide to each

2-9 employer to whom the insurer provides industrial insurance , whether or not

2-10 the employer is a member of a group that is provided with industrial

2-11 insurance pursuant to NRS 616B.036, a certificate of insurance which

2-12 indicates that the employer has obtained a policy of industrial insurance.

2-13 2. A certificate of insurance provided by an insurer pursuant to

2-14 subsection 1 must include, without limitation:

2-15 (a) The name of the insurer;

2-16 (b) The name of the insured;

2-17 (c) The number of the policy; and

2-18 (d) The period for which the policy is effective.

2-19 Sec. 3. NRS 616B.036 is hereby amended to read as follows:

2-20 616B.036 1. The system and private carriers may provide industrial

2-21 insurance for an organization or association of employers as a group if:

2-22 (a) The members of the [group or] organization or association are

2-23 engaged in a common trade or business; and

2-24 (b) The formation and operation of a program of industrial insurance for

2-25 the organization or association will substantially assist in the handling of

2-26 claims and the prevention of accidents for the employers as a group.

2-27 2. Notwithstanding the provisions of subsection 1, a private carrier

2-28 may provide industrial insurance for an organization or association of

2-29 employers as a group whose members are not engaged in a common trade

2-30 or business if:

2-31 (a) The organization or association of employers is formed and

2-32 maintained for purposes other than obtaining industrial insurance; and

2-33 (b) The contract or other agreement pursuant to which the private

2-34 carrier will provide industrial insurance for the organization or

2-35 association provides that:

2-36 (1) A separate policy will be issued to each member of the

2-37 organization or association; and

2-38 (2) The organization or association and each of its members are not

2-39 liable for the cost of the administration of claims or the compensation

2-40 payable pursuant to the provisions of chapters 616A to 616D, inclusive, or

2-41 chapter 617 of NRS.

2-42 3. The commissioner must approve each [group or] organization or

2-43 association before a policy of industrial insurance may be issued to it [.

3-1 3.] as a group pursuant to subsection 1 or 2.

3-2 4. The commissioner shall adopt regulations for the qualification of

3-3 [groups for industrial insurance.] organizations or associations of

3-4 employers described in subsections 1 and 2.

3-5 Sec. 4. NRS 616B.460 is hereby amended to read as follows:

3-6 616B.460 1. An employer may elect to purchase industrial insurance

3-7 from a private carrier for his employees pursuant to chapters 616A to 617,

3-8 inclusive, of NRS.

3-9 2. An employer may elect to purchase insurance from an insurer other

3-10 than his present insurer if the employer has:

3-11 (a) Given at least 10 days’ notice to the administrator of the change of

3-12 insurer; and

3-13 (b) Furnished evidence satisfactory to the administrator that the payment

3-14 of compensation has otherwise been secured.

3-15 3. Each private carrier and the system shall notify the administrator if

3-16 an employer has changed his insurer or has allowed his insurance to lapse,

3-17 within [24 hours or by the end of the next working day] 15 days after the

3-18 insurer has notice of the change or lapse.

3-19 Sec. 5. NRS 616C.235 is hereby amended to read as follows:

3-20 616C.235 1. Except as otherwise provided in subsection 2:

3-21 (a) When the insurer determines that a claim should be closed before all

3-22 benefits to which the claimant may be entitled have been paid, the insurer

3-23 shall send a written notice of its intention to close the claim to the claimant

3-24 by first-class mail addressed to the last known address of the claimant. The

3-25 notice must include a statement that if the claimant does not agree with the

3-26 determination, he has a right to request a resolution of the dispute pursuant

3-27 to NRS 616C.305 and 616C.315 to 616C.385, inclusive. A suitable form for

3-28 requesting a resolution of the dispute must be enclosed with the notice. The

3-29 closure of a claim pursuant to this subsection is not effective unless notice

3-30 is given as required by this subsection.

3-31 (b) If the insurer does not receive a request for the resolution of the

3-32 dispute, it may close the claim.

3-33 (c) Notwithstanding the provisions of NRS 233B.125, if a hearing is

3-34 conducted to resolve the dispute, the decision of the hearing officer may be

3-35 served by first-class mail.

3-36 2. If the medical benefits required to be paid for a claim are less than

3-37 $500, the claim closes automatically if the claimant does not receive

3-38 additional medical treatment for the injury for at least 12 months [.] after

3-39 the claim is opened. The claimant may not appeal the closing of such a

3-40 claim. The insurer shall send to each claimant who receives less than

3-41 $500 in medical benefits within 6 months after the claim is opened a

3-42 written notice that explains the circumstances under which a claim may

4-1 be closed automatically pursuant to this subsection. The written notice

4-2 must be:

4-3 (a) Sent by first-class mail addressed to the last known address of the

4-4 claimant; and

4-5 (b) A document that is separate from any other document or form that

4-6 is used by the insurer.

4-7 The closure of a claim pursuant to this subsection is not effective unless

4-8 notice is given as required by this subsection.

4-9 Sec. 6. NRS 616D.250 is hereby amended to read as follows:

4-10 616D.250 1. Any employer insured by the system who refuses to

4-11 submit his books, records and payroll for inspection, as provided by NRS

4-12 616A.485, to a representative of the system or the administrator, or to an

4-13 auditor from the department of taxation [,] presenting written authority for

4-14 the inspection, is subject to a penalty of $1,000 for each offense, to be

4-15 collected by a civil action in the name of the system or the administrator.

4-16 2. A self-insured employer, a member of an association of self-insured

4-17 public or private employers or an employer insured by a private carrier who

4-18 refuses to submit his books, records and payroll to the administrator or the

4-19 private carrier for inspection as provided by NRS 616A.485 [,] is subject to

4-20 a penalty of $1,000 for each offense, to be collected by a civil action in the

4-21 name of the administrator [.] or the private carrier, as applicable.

4-22 3. The person who gives such refusal is guilty of a misdemeanor.

4-23 Sec. 7. 1. This section and section 5 of this act become effective on

4-24 July 1, 1999.

4-25 2. Sections 1 to 4, inclusive, and 6 become effective at 12:01 a.m. on

4-26 July 1, 1999.

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