Section 3443. Workers' compensation and employers' liability insurance; optional policyholder deductibles  


Latest version.
  • An  insurer  issuing  a   workers'  compensation  and  employers'  liability  insurance  policy, and a group
      self-insurer  for  municipal  corporations  as  defined  in  subdivision
      three-a of section fifty of the workers' compensation law, 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.