Section 29. Remedies of employees; subrogation  


Latest version.
  • 1. If an employee entitled
      to  compensation  under  this  chapter  be  injured  or  killed  by  the
      negligence  or  wrong  of  another  not in the same employ, such injured
      employee, or in case of death, his dependents, need not elect whether to
      take compensation and medical benefits under this chapter or  to  pursue
      his remedy against such other but may take such compensation and medical
      benefits and at any time either prior thereto or within six months after
      the  awarding  of compensation or within nine months after the enactment
      of a law or laws creating, establishing or affording a new or additional
      remedy or remedies, pursue his remedy against such other subject to  the
      provisions  of  this  chapter.  If  such injured employee, or in case of
      death, his dependents, take or intend to take compensation, and  medical
      benefits  in  the  case of an employee, under this chapter and desire to
      bring action against such other, such action must be commenced not later
      than six months after the awarding of compensation  or  not  later  than
      nine   months  after  the  enactment  of  such  law  or  laws  creating,
      establishing or affording a new or additional remedy or remedies and  in
      any  event  before  the expiration of one year from the date such action
      accrues. In such case, the state  insurance  fund,  if  compensation  be
      payable therefrom, and otherwise the person, association, corporation or
      insurance  carrier  liable  for the payment of such compensation, as the
      case may be, shall have a lien on the proceeds of any recovery from such
      other, whether by judgment, settlement or otherwise, after the deduction
      of the reasonable and necessary expenditures, including attorney's fees,
      incurred in effecting such recovery, to the extent of the  total  amount
      of  compensation  awarded under or provided or estimated by this chapter
      for such case and the expenses for medical treatment paid or to be  paid
      by  it  and to such extent such recovery shall be deemed for the benefit
      of such fund, person, association, corporation or  carrier.  Should  the
      employee or his dependents secure a recovery from such other, whether by
      judgment, settlement or otherwise, such employee or dependents may apply
      on  notice  to  such lienor to the court in which the third party action
      was instituted, or to a court of competent jurisdiction if no action was
      instituted, for an  order  apportioning  the  reasonable  and  necessary
      expenditures,  including  attorneys'  fees,  incurred  in effecting such
      recovery. Such expenditures shall be equitably apportioned by the  court
      between  the  employee  or  his dependents and the lienor. Notice of the
      commencement of such action shall be given within thirty days thereafter
      to the chairman, the employer and the  insurance  carrier  upon  a  form
      prescribed   by   the  chairman.  Any  of  the  foregoing  providers  of
      compensation and/or medical benefits which has recovered a lien pursuant
      to the provisions hereof against the recovery of a person injured on  or
      after  February  first,  nineteen  hundred  seventy-four and before July
      first, nineteen hundred seventy-eight, through the use or operation of a
      motor vehicle in this state, shall notify such person by certified  mail
      in  a  manner  to  be approved by the chairman and the superintendent of
      insurance  of  the  responsibility  of  an  "insurer"  (as  defined   in
      subsection (g) of section five thousand one hundred two of the insurance
      law),  to  reimburse  such person under such circumstances to the extent
      that the recovered lien represent first party  benefits  as  defined  in
      article fifty-one of the insurance law.
        1-a.  Notwithstanding  any  other provision of this chapter, the state
      insurance fund, if  compensation  and/or  medical  benefits  be  payable
      therefrom,  or otherwise the person, association, corporation, insurance
      carrier or statutory fund liable for the payment  of  such  compensation
      and/or  medical  benefits  shall  not have a lien on the proceeds of any
      recovery received pursuant to subsection (a) of  section  five  thousand
      one  hundred  four of the insurance law, whether by judgment, settlement
    
      or otherwise for compensation and/or medical benefits paid which were in
      lieu of first party benefits which another insurer would have  otherwise
      been  obligated to pay under article fifty-one of the insurance law. The
      sole  remedy  of  any of the foregoing providers to recover the payments
      specified in the preceding sentence shall be pursuant to the  settlement
      procedures  contained  in  section five thousand one hundred five of the
      insurance law.
        1-b. Notwithstanding any  other  provision  of  this  chapter  to  the
      contrary,  the  state  insurance  fund,  if  compensation and/or medical
      benefits be payable therefrom, or  otherwise  the  person,  association,
      corporation,  insurance carrier or statutory fund liable for the payment
      of such compensation and/or medical benefits: (a) shall not have a  lien
      on  the  proceeds  of  any  award  from  the  September  eleventh victim
      compensation fund of two thousand one established pursuant to  title  IV
      of  the  federal air transportation safety and system stabilization act,
      public law 107-42, as amended; and (b) shall  not  terminate  or  reduce
      such compensation and/or medical benefits based upon the submission of a
      claim  for  an  award  from  such  federal  fund,  and/or  the waiver or
      compromise of any cause of action resulting from such submission.
        2. If such injured employee, or in case of death, his dependents,  has
      taken  compensation under this chapter but has failed to commence action
      against such other within the time limited therefor by subdivision  one,
      such  failure  shall  operate  as  an  assignment of the cause of action
      against such other to the state for the benefit of the  state  insurance
      fund, if compensation be payable therefrom, and otherwise to the person,
      association, corporation, or insurance carrier liable for the payment of
      such  compensation.  Except  as hereinafter provided, the failure of the
      injured employee or his dependents to commence an action pursuant to the
      provisions of subdivision one of this section, shall not operate  as  an
      assignment  of  the  cause  of  action  as  provided  herein, unless the
      insurance carrier  shall  have  notified  the  claimant  in  writing  by
      personal  service  or  by  certified  or registered mail, return receipt
      requested, at least thirty days prior to  the  expiration  of  the  time
      limited  for the commencement of an action by subdivision one, that such
      failure to commence such  action  shall  operate  as  an  assignment  of
      whatever  cause  of  action  may exist to such insurance carrier. If the
      insurance carrier shall fail to give such notice, the time  limited  for
      the commencement of an action by subdivision one shall be extended until
      thirty days after the insurance carrier shall have notified the claimant
      in  writing  that failure to commence an action within thirty days after
      the mailing of such notice shall operate as an assignment of  the  cause
      of  action  to  such  carrier,  and  in  the event the claimant fails to
      commence such action within  thirty  days  after  the  mailing  of  such
      notice,  such  failure  shall  operate as an assignment of such cause of
      action to such carrier. If such fund, person,  association,  corporation
      or  carrier,  as  such  an  assignee, recover from such other, either by
      judgment, settlement or otherwise, a sum in excess of the  total  amount
      of  compensation  awarded to such injured employee or his dependents and
      the expenses for  medical  treatment  paid  by  it,  together  with  the
      reasonable   and  necessary  expenditures  incurred  in  effecting  such
      recovery, it shall  forthwith  pay  to  such  injured  employee  or  his
      dependents,  as  the  case may be, two-thirds of such excess, and to the
      extent of two-thirds of any such excess such recovery  shall  be  deemed
      for   the   benefit  of  such  employee  or  his  dependents.  When  the
      compensation awarded requires periodical payments the  number  of  which
      cannot  be  determined  at the time of such award, the board shall, when
      the injury or death was caused by the negligence or wrong of another not
      in the same employ, estimate the probable total amount thereof upon  the
    
      basis  of the survivorship annuitants table of mortality, the remarriage
      tables of the Dutch Royal Insurance Institution and such facts as it may
      deem pertinent, and such estimate shall be  deemed  the  amount  of  the
      compensation  awarded  in  such  case,  for the purpose of computing the
      amount of such excess recovery, subject to the modification  thereof  as
      hereinafter  provided.  If  any  of the foregoing providers, having paid
      benefits under this chapter to  an  injured  employee,  who  is  also  a
      "covered  person" (as defined in subsection (j) of section five thousand
      one hundred two of the insurance law), and who was injured  in  a  motor
      vehicle  accident  in  this  state on and after February first, nineteen
      hundred  seventy-four  and   before   July   first,   nineteen   hundred
      seventy-eight,  maintains  an  action,  as  assignee, against such third
      party, who  is  also  a  "covered  person",  and  recovers,  whether  by
      judgment, settlement or otherwise, it shall advise the injured employee,
      by  certified  mail,  in a manner to be approved by the chairman and the
      superintendent of insurance, of the responsibility of an  "insurer"  (as
      defined  in  subsection  (g) of section five thousand one hundred two of
      the insurance law) to further compensate such injured employee.
        2-a. Notwithstanding any other provisions of this chapter, the failure
      of a "covered person" (as defined in  subsection  (j)  of  section  five
      thousand   one  hundred  two  of  the  insurance  law),  who  has  taken
      compensation and/or medical benefits under  this  chapter  for  injuries
      arising out of the use or operation of a motor vehicle in this state, to
      commence  an  action against such other within the time limited therefor
      by subdivision one of this section shall not operate as an assignment of
      the cause of action to the provider thereof for their recovery when such
      benefits were paid in lieu of first party benefits which another insurer
      would have otherwise been obligated to pay under  article  fifty-one  of
      the insurance law, unless such other is not a "covered person". The sole
      remedy  of  any  of  the  foregoing  providers  to  recover the payments
      specified in the preceding sentence when the other party is  a  "covered
      person"  shall  be  pursuant  to  the settlement procedures contained in
      section five thousand one hundred five of the insurance law.
        3. In  the  event  of  a  modification  of  an  award  increasing  the
      compensation previously awarded or in the event that the total amount of
      periodical  payments made pursuant to an award under which the number of
      such payments could not be determined at the time of  the  award,  shall
      exceed the total thereof as estimated by the board, the principal of any
      of such excess recovery theretofore paid to such injured employee or his
      dependents  shall  be  credited against such increase or such excess. In
      the event of a modification  of  an  award  ending  or  diminishing  the
      compensation previously awarded or in the event that the total amount of
      periodical  payments made pursuant to an award under which the number of
      such payments could not be determined at the time of the award, shall be
      less than the total thereof  as  estimated  by  the  board,  such  fund,
      person,  association, corporation or carrier shall forthwith pay to such
      injured employee or his dependents, as the case may be,  any  additional
      amount  of  such  excess  recovery to which such injured employee or his
      dependents may be entitled  by  reason  of  such  modification  or  such
      deficiency, determined as hereinbefore provided.
        4.  If  such  injured  employee,  or in case of death, his dependents,
      proceed  against  such  other,  the  state   insurance   fund,   person,
      association,  corporation,  or  insurance  carrier,  as the case may be,
      shall contribute only the deficiency, if any, between the amount of  the
      recovery   against   such  other  person  actually  collected,  and  the
      compensation provided or estimated by this chapter for such case.
        5. In case of the payment of an award to the commissioner of  taxation
      and  finance  in  accordance with subdivisions eight and nine of section
    
      fifteen and in accordance with section twenty-five-a such payment  shall
      operate  to  give  to  the  employer or insurance carrier liable for the
      award a cause of action for the amount of such payment together with the
      reasonable  funeral  expenses and the expense of medical treatment which
      shall be in addition to any cause of action by the legal representatives
      of the deceased. Such a cause of action assigned to  the  state  may  be
      prosecuted or compromised in the name of the state insurance fund by the
      commissioners  of  the  state  insurance  fund. A compromise of any such
      cause of action by the employee or his dependents at an amount less than
      the compensation provided for by this chapter shall be  made  only  with
      the written approval of the commissioners of the state insurance fund or
      such   officer   thereof  designated  by  them,  if  the  deficiency  of
      compensation would  be  payable  from  the  state  insurance  fund,  and
      otherwise   with  the  written  approval  of  the  person,  association,
      corporation, or insurance carrier  liable  to  pay  the  same.  However,
      written  approval  of  the  commissioners of the state insurance fund or
      such officer thereof designated by  them  or  written  approval  of  the
      person,  association,  corporation, or the insurance carrier need not be
      obtained if the employee or his dependents  obtain  a  compromise  order
      from a justice of the court in which the third-party action was pending.
      The  papers  upon  an  application to compromise and settle such a claim
      shall consist of the petition, the affidavit of the  attorney,  and  the
      affidavit of one or more physicians.
        The petition shall contain the following:
        a.  The  name  and  residence  of  the  petitioner if the employee, or
      petitioner's relationship to the deceased;
        b. The date of accident and a general description thereof;
        c. The nature and extent of the damages sustained, including the  name
      of  the physician or physicians attending or consulting in the treatment
      and the medical expenses incurred, the period  of  disability  resulting
      from  the  accident,  the  total  amount  of wages lost thereby, and the
      present physical condition;
        d. The terms of the attorney's retainer and of the proposed settlement
      and petitioner's approval thereof; and
        e. Whether any previous application for the settlement  of  the  claim
      has  been made, and if so, the time and the court or justice thereof and
      the disposition made of same.
        The affidavit of the attorney shall set forth by whom,  on  what  date
      and  under what terms he was retained, the services rendered by him, his
      fee if the settlement is approved, the acts complained of, the terms  of
      the proposed settlement with a statement of his reasons for recommending
      the  same,  and  shall  state  that  he  has not become concerned in the
      application or its subject matter at  the  instance  of  such  defendant
      directly  or  indirectly  and  that  he  has  not received and is not to
      receive any compensation from such defendant directly or indirectly.
        The affidavit of the physician in a claim arising from personal injury
      to the employee, shall set forth  his  connection  with  the  case;  the
      period  covered  by the treatment and the nature, duration and extent of
      the injuries; the date of his last examination and the condition of  the
      employee  at  that  time; whether or not the employee is still suffering
      any disability or inconvenience as the result of the injury, giving  the
      details  thereof; whether or not the accident has left the employee with
      any permanent disability, defect, scar or impairment; the  cost  of  the
      treatment  and  whether or not he expects to be paid or has been paid by
      the defendant or by anyone acting on the defendant's behalf.  Where  the
      affidavit  as  to  the  present  condition  is not made by the attending
      physician, the latter's affidavit setting forth  the  character  of  the
      injuries and treatment should also be attached, or the failure to obtain
    
      it  explained.  Where the employee was confined to a hospital, the court
      may require the production of hospital records.
        A  copy  of the papers to be used on the application to compromise and
      settle the claim must be served as directed by the court or in the  same
      manner  as  provided in the civil practice law and rules for a notice of
      motion upon the commissioners  of  the  state  insurance  fund  or  such
      officer  thereof  designated  by  them  or upon the person, association,
      corporation, or insurance carrier, whose  written  approval  would  have
      been  required to compromise such cause of action by the employee or his
      dependents. This notice shall afford  them  the  opportunity  to  submit
      affidavits and to be heard by the court on the application.
        If  the  third-party  action  is  on  trial  at  the time the offer of
      settlement which is acceptable to the plaintiff, is made and either such
      written approval or order as provided in this subdivision  is  required,
      the action may be marked settled subject to the securing of such written
      approval  or  such  order. If such written approval or such order is not
      subsequently secured within three months the action shall be restored to
      the head of the trial day calendar.
        6. The right to compensation or benefits under this chapter, shall  be
      the  exclusive  remedy  to  an  employee, or in case of death his or her
      dependents, when such employee is injured or killed by the negligence or
      wrong of another in the same  employ,  the  employer's  insurer  or  any
      collective bargaining agent of the employer's employees or any employee,
      of such insurer or such collective bargaining agent (while acting within
      the  scope  of his or her employment). The limitation of liability of an
      employer set forth in section eleven of this article for the  injury  or
      death  of an employee shall be applicable to another in the same employ,
      the  employer's  insurer,  any  collective  bargaining  agent   of   the
      employer's  employees  or any employee of the employer's insurer or such
      collective bargaining agent (while acting within the scope of his or her
      employment). The option to maintain an action in the courts for  damages
      based  on  the  employer's  failure  to  secure compensation for injured
      employees and their dependents as set forth in section  eleven  of  this
      article  shall  not  be  construed  to  include the right to maintain an
      action against another in the same employ, the employer's  insurer,  any
      collective  bargaining agent of the employer's employees or any employee
      of the employer's insurer or such  collective  bargaining  agent  (while
      acting within the scope of his or her employment).