Section 54. The insurance contract  


Latest version.
  • 1. Right of recourse to the insurance
      carrier. Every  policy  of  insurance  covering  the  liability  of  the
      employer  for  compensation  shall  be  issued  by  one  or  more  stock
      companies, mutual corporations  or  reciprocal  insurers  authorized  to
      transact workers' compensation insurance in this state. In the case of a
      policy  with  multiple  insurers,  such insurers shall share one hundred
      percent of the liabilities by subscription,  and  one  of  the  insurers
      shall  serve  as  the lead insurer for notice and cancellation purposes.
      Such a policy shall contain a provision setting forth the right  of  the
      chair  to enforce in the name of the people of the state of New York for
      the benefit of the person entitled to the compensation  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
      compensation; provided, however, that payment in whole  or  in  part  of
      such  compensation 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.  Knowledge  and  jurisdiction of the employer extended to cover the
      insurance carrier. 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 on the part  of  the  employer
      shall  be deemed notice or knowledge, as the case may be, on the part of
      the insurance carrier, or if more than one insurer,  the  lead  carrier;
      that  jurisdiction  of  the  employer  shall,  for  the  purpose of this
      chapter, be jurisdiction of the lead insurance  carrier  and  that  such
      insurance  carrier  shall  in  all things be bound by and subject to the
      orders, findings, decisions or awards rendered against the employer  for
      the payment of compensation under the provisions of this chapter.
        3.  Insolvency  of  employer  does  not release the insurance carrier.
      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 compensation for injuries or death sustained
      by an employee during the life of such policy.
        4.  Limitation of indemnity agreements. Every contract or agreement of
      an employer the purpose of which is to indemnify him from loss or damage
      on account of the injury of an  employee  by  accidental  means,  or  on
      account  of  the  negligence  of  such employer or his officer, agent or
      servant, shall be absolutely void unless it shall also  cover  liability
      for the payment of the compensation and for the payment into the special
      funds  provided for by this chapter. Every such contract or agreement of
      insurance issued by an insurance carrier covering the  liability  of  an
      employer  for  the  payment of the compensation and for the payment into
      the special funds provided by this chapter shall be  deemed  to  include
      all  employees  of  the  employer  employed at or in connection with the
      business of the employer carried on,  maintained,  or  operated  at  the
      location  or  locations  set  forth  in  such  contract or agreement and
      employees for whose injuries a contractor may become  liable  under  the
      provisions  of  section  fifty-six  of  this  chapter.  Any  employee or
      employees or  class  of  employees  not  enumerated  in  section  three,
      subdivision  one,  group  one  to  seventeen inclusive, of this chapter,
      employed by a municipal corporation  or  political  subdivision  of  the
      state,  may  by  the  terms  of  the  contract or agreement be expressly
      excluded therefrom.
        5. Cancellation and termination of insurance contracts. No contract of
      insurance issued by an insurance carrier against liability arising under
      this chapter 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
      the  employer has secured insurance with another insurance carrier 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.  No  insurer shall refuse to renew any policy insuring against
      liability arising under this chapter unless at least thirty  days  prior
      to its expiration notice of intention not to renew has been filed in the
      office of the chair and also served on the employer.
        Such  notice  shall be served on the employer by delivering it to him,
      her or it or by sending it by mail, by certified or  registered  letter,
      return  receipt  requested, addressed to the employer at his, her or its
      last known place of business;  provided  that,  if  the  employer  be  a
      partnership,  then  such  notice  may  be  so given to any of 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; and further provided that an employer may designate any
      person or entity at any address to receive  such  notice  including  the
      designation  of  one  person  or  entity  to receive notice on behalf of
      multiple entities insured under one insurance policy and that service of
      notice at the address  so  designated  upon  the  person  or  entity  so
      designated  by  delivery  or by mail, by certified or registered letter,
      return receipt requested, shall satisfy the notice requirement  of  this
      section.  Provided,  however,  the  right to cancellation of a policy of
      insurance in the state fund shall be exercised only for  non-payment  of
      premiums or as provided in section ninety-four of this chapter.
        The  provisions  of  this  subdivision shall not apply with respect to
      policies containing coverage pursuant to subsection (j) of section three
      thousand four hundred twenty of the  insurance  law  relating  to  every
      policy  providing  comprehensive  personal liability insurance on a one,
      two, three or four family owner-occupied dwelling.
        In the event such cancellation or termination notice is not filed with
      the chair within the required time period,  the  chair  shall  impose  a
      penalty  in  the  amount  of up to five 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.
        5-a.  Issuance,  amendment,  endorsement or reinstatement of insurance
      contracts. a. Any insurance carrier or  the  state  insurance  fund  who
      issues,  reinstates,  amends  or  endorses  any contract of insurance or
      rider thereto covering the liability of  an  employer  for  compensation
      under  this  chapter  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  is  not  filed
      with  the  chair  within  the  thirty-day  time period, or notice is not
      provided  by  a  group  self-insured  trust   pursuant   to   regulation
      promulgated   by   the  board  regarding  notification  of  the  trust's
      commencement or termination of coverage for any employer, the chair  may
      impose  a  penalty of up to five hundred dollars for each ten-day period
    
      the insurance carrier or state insurance fund  or  group  self-insurance
      trust  failed to file the notification. All penalties collected pursuant
      to this subdivision shall be deposited in the uninsured employers' fund.
        c.  The provisions of this subdivision shall not apply with respect to
      insurance policies containing coverage pursuant  to  subsection  (j)  of
      section three thousand four hundred twenty of the insurance law relating
      to  every policy providing comprehensive personal liability insurance on
      a one, two, three or four family owner-occupied dwelling.
        6. a. Insurance of officers of corporations. Every  executive  officer
      of  a  corporation  shall  be  deemed to be included in the compensation
      insurance contract or covered  under  a  certificate  of  self-insurance
      unless   that   person   is   an   unsalaried  executive  officer  of  a
      not-for-profit  corporation  or  unincorporated  association  and   such
      corporation  or  association  elects  to  exclude  that  person from the
      coverage of this chapter. Such election to exclude such person shall  be
      made  in  writing  on  a form prescribed by the chair and filed with the
      insurance carrier. Such election shall be effective with respect to  all
      of  the  policies  issued  to  the  corporation  or  association by such
      insurance  carrier  as  long  as  it  shall  continuously   insure   the
      corporation   or  association,  provided  that  written  notice  of  the
      continuation of the election to exclude any or all executive officers is
      given to the corporation or association with each renewal notice of  the
      policy.  If  such  election is revoked, it shall be in writing on a form
      prescribed by the chair, and shall be  filed  with  the  chair  and  the
      insurance  carrier.  Such revocation shall not be effective until thirty
      days after such filing.  Any  executive  officer  whose  corporation  or
      association  files  an  election  not  to be included under this chapter
      shall be deemed not to be an employee within the intent of this chapter;
      however, if not excluded, such officers and their  dependents  shall  be
      entitled to compensation as provided by this chapter.
        b. An executive officer of any corporation who at all times during the
      period  involved  owns  all  of  the issued and outstanding stock of the
      corporation and holds all of the offices pursuant to  paragraph  (e)  of
      section seven hundred fifteen of the business corporation law and who is
      the  executive  officer  of  a  corporation having other persons who are
      employees required to be covered under this chapter shall be  deemed  to
      be  included  in  the compensation insurance contract or covered under a
      certificate of self-insurance unless the officer elects to  be  excluded
      from  the  coverage  of this chapter. Such election shall be made by the
      corporation filing a notice that the corporation elects to  exclude  the
      executive  officer of such corporation named in the notice from coverage
      of this chapter. Such election shall be filed with the insurance carrier
      or the chair in the case of self-insurance upon a form prescribed by the
      chair of  the  workers'  compensation  board.  Such  election  shall  be
      effective  with  respect  to  all policies issued to such corporation by
      such insurance carrier as long  as  it  shall  continuously  insure  the
      corporation  and  shall  be final and binding upon the executive officer
      named in the notice until revoked by the corporation in accordance  with
      paragraph a of this subdivision.
        (c)  An  executive  officer of any corporation who at all times during
      the period involved owns all of the issued and outstanding stock of  the
      corporation  and  holds  all of the offices pursuant to paragraph (e) of
      section seven hundred fifteen of the business corporation law and who is
      the executive officer of a corporation that has no other persons who are
      employees required to be covered under this chapter shall be  deemed  to
      be  excluded from coverage under this chapter unless such officer elects
      to be covered. Such coverage may be effected by obtaining  an  insurance
      policy  or in the case of self-insurance by the corporation submitting a
    
      form prescribed by the chair of the workers' compensation board,  giving
      notice  that  the  corporation  elects to bring the executive officer of
      such corporation named  in  the  notice  within  the  coverage  of  this
      chapter.
        d. Any two executive officers of a corporation who at all times during
      the  period  involved between them own all of the issued and outstanding
      stock of the corporation and hold all such  offices,  provided,  however
      that  each  officer  must  own  at least one share of stock, who are the
      executive officers of such corporation  having  other  persons  who  are
      employees  required  to be covered under this chapter shall be deemed to
      be included in the compensation insurance contract or  covered  under  a
      certificate  of  self-insurance unless one or both the officers elect to
      be excluded from the coverage of this chapter. Such  election  shall  be
      made  by  any  such corporation filing a form prescribed by the chair of
      the workers' compensation board with the insurance carrier or the  chair
      in  the case of self-insurance giving notice that the corporation elects
      to exclude one or both of the executive  officers  of  such  corporation
      named  in  the  notice  from the coverage of this chapter. Such election
      shall  be  effective  with  respect  to  all  policies  issued  to  such
      corporation  by  such insurance carrier as long as it shall continuously
      insure the corporation and shall be final and binding upon the executive
      officers as named in the notice until revoked  by  the  corporation.  If
      such election is revoked, it shall be in writing on a form prescribed by
      the  chair  and shall be filed with the chair and the insurance carrier.
      Such revocation shall not be effective  until  thirty  days  after  such
      filing.
        e. Any two executive officers of a corporation who at all times during
      the  period  involved between them own all of the issued and outstanding
      stock of such corporation and hold all such offices,  provided,  however
      that  each  officer  must  own  at least one share of stock, who are the
      executive officers of such corporation that has no other persons who are
      employees required to be covered under this chapter shall be  deemed  to
      be excluded from coverage under this chapter unless one or both officers
      elect  to  be  covered.  Such  coverage  may be effected by obtaining an
      insurance policy or, in the case of self-insurance, by  the  corporation
      submitting  a  form prescribed by the chair of the workers' compensation
      board, giving notice that the corporation elects to bring  one  or  both
      executive  officers  of  such  corporation  named  in  the notice within
      coverage of this chapter.
        f. Notwithstanding the provisions of paragraph a of  this  subdivision
      or  any  other  provision  of  this  chapter, any executive officer of a
      religious, charitable or educational corporation and the officers  of  a
      municipal   corporation,   and  officers  of  any  post  or  chapter  of
      organizations of veterans of any war of the United States may be brought
      within the coverage of the insurance contract as if they were  employees
      by  any  such corporation filing with the insurance carrier, upon a form
      prescribed by the chair of the workers'  compensation  board,  a  notice
      that  the  corporation elects to bring one or more executive officers of
      such corporation named  in  the  notice  within  the  coverage  of  this
      chapter.  Such  election shall be effective with respect to all policies
      issued to such corporation by such insurance carrier as long as it shall
      continuously insure the corporation. If such  election  is  revoked,  it
      shall be in writing on a form prescribed by the chair and filed with the
      chair  and  with  the  insurance carrier and a copy thereof furnished to
      each officer as to whom such  revocation  is  applicable,  upon  a  form
      prescribed  by  the  chair. Such revocation shall not be effective until
      thirty days after such filing. The estimation  of  the  wage  values  of
      executive  officers  within the coverage of the insurance contract shall
    
      be reasonable and separately stated and added to the  valuation  of  the
      payrolls upon which the premium is computed.
        g. The executive officers brought within the coverage of the insurance
      contract,  and  the dependents of any such executive officers, including
      executive officers of religious, charitable or educational  corporations
      and  officers  of  municipal  corporations,  and officers of any post or
      chapter of organizations of veterans of any war  of  the  United  States
      that  have  elected  to  bring their officers within the coverage of the
      policy, shall have the same rights and  remedies  as  any  employee  and
      shall  be  entitled to compensation and medical care as provided by this
      chapter, and the insurance carrier shall  be  liable  therefor  and  for
      payments  into the special funds provided in this chapter as in the case
      of an employee. The executive officers who may  be  brought  within  the
      coverage  of  an  insurance  contract  shall  include  an  officer  of a
      corporation who at all times during the  period  involved  between  them
      owns  all  of  the  issued  and outstanding stock of the corporation and
      holds all of the offices pursuant to  paragraph  (e)  of  section  seven
      hundred  fifteen  of  the  business  corporation  law  or  two executive
      officers of a corporation who at all times during  the  period  involved
      between  them  own  all  of  the  issued  and  outstanding stock of such
      corporation and hold all such offices and who is the  executive  officer
      or  who  are  the  executive officers of a corporation that has no other
      persons who are employees required to be covered under this chapter.
        h. Any officer or officers, elective or  appointive,  of  a  municipal
      corporation  or  other political subdivision of the state complying with
      the provisions of group nineteen of subdivision one of section three  of
      this   chapter  shall  be  deemed  executive  officers  subject  to  the
      provisions of this subdivision.
        6-a.  Insurance  contracts   with   fire   or   ambulance   districts.
      Notwithstanding  any other provision of this section or of this chapter,
      any insurance contract to secure workers' compensation  for  a  fire  or
      ambulance  district  pursuant  to  subdivision one or subdivision two of
      section fifty of this chapter issued to take effect  on  or  after  July
      first,  nineteen  hundred  sixty,  in  relation  to  a fire district and
      January first, in the year  next  succeeding  the  year  in  which  this
      subdivision  as  hereby  amended  becomes  effective,  in relation to an
      ambulance district or any such contract renewed to continue in effect on
      or after such dates, shall provide workers'  compensation  coverage  for
      all fire or ambulance district officers, whether elective or appointive,
      and  all  fire  or ambulance district employees, whether or not they are
      compensated for their services, unless the board of  fire  or  ambulance
      commissioners  of  the fire district or ambulance district by resolution
      elects not to provide such coverage for any one or more of such officers
      or employees, or class  thereof.  Such  election  not  to  provide  such
      coverage shall be effective with respect to all such insurance contracts
      thereafter  issued  to  such fire or ambulance district by any insurance
      carrier until revoked in whole or in part by resolution of the board  of
      fire  or ambulance commissioners of the fire or ambulance district. Such
      election not to provide such coverage shall not become  effective  until
      thirty  days  after  a  copy  of such resolution has been filed with the
      chairman of the workers'  compensation  board  and  with  the  insurance
      carrier  and a copy thereof is furnished to each officer and employee as
      to whom such revocation is applicable.  The  chairman  of  the  workers'
      compensation  board  shall  prescribe  the  form of such resolution. The
      provisions of this subdivision shall not be applicable  in  cases  where
      the  injury  arises  out  of  and  in  the course of duty as a volunteer
      firefighter or a volunteer  ambulance  worker  or  as  a  civil  defense
      volunteer  and where the computation of benefits would be made under the
    
      provisions of the volunteer firefighters' benefit law or  the  volunteer
      ambulance workers' benefit law or under article ten of this chapter.
        7.  Limitation  of  the  issuance  of  policies by a foreign insurance
      company. No policy or contract of insurance issued by  a  foreign  stock
      corporation or mutual association authorized to transact the business of
      workers'  compensation  insurance  in  this  state, except a corporation
      organized under the laws of a state or country  outside  of  the  United
      States  and  domiciled  in this state, covering or intended to cover the
      liability of an employer to his employees under this chapter,  shall  be
      accepted  as  a compliance with subdivision two of section fifty of this
      chapter, unless such foreign stock  corporation  or  mutual  association
      shall  have  filed  with  the  superintendent  of  insurance  a  bond or
      undertaking with good and sufficient sureties to the people of the state
      of New York, and conditioned upon the payment in full  of  any  and  all
      compensation  and  benefits  as  provided in this chapter to any and all
      persons entitled thereto under any such policy or contract of insurance.
      Such bond shall be approved as to form by the attorney-general and as to
      sufficiency by the superintendent of insurance. The amount of such  bond
      shall  be such sum as may reasonably represent twenty-five per centum of
      the outstanding reserves for compensation losses on policies  issued  by
      such  foreign stock corporation or mutual association upon risks located
      in the state of New York as determined by law or by the requirements  of
      the  superintendent  of insurance, provided, however, that the amount of
      such bond shall in no case be less than twenty-five thousand dollars nor
      more than one million dollars. Such  bond  shall  be  renewed  annually.
      Every   such   bond   shall   contain   a   provision   authorizing  the
      attorney-general upon the certificate of the superintendent of insurance
      that there has been default in the payment of  compensation  for  thirty
      days  or  that  the  bonded company has become insolvent to enforce such
      bond in the name of the people of the state of New York for the  benefit
      of  any  and  all  persons  entitled  to the compensation assured by any
      policy issued by such foreign stock corporation or mutual association or
      otherwise entitled to any benefits under such policy.  In  lieu  of  the
      bond  required  to be given hereunder any such foreign stock corporation
      or mutual association may deposit with the superintendent  of  insurance
      securities  of the kind prescribed in section one thousand three hundred
      eighteen of the insurance law in an  amount  equal  to  twenty-five  per
      centum  of  the outstanding reserves for compensation losses on policies
      issued by such foreign stock  corporation  or  mutual  association  upon
      risks  located  in  the state of New York, but not less than twenty-five
      thousand dollars nor more than one million  dollars.  In  computing  the
      amount  of  such  securities  they  shall be valued as determined by the
      superintendent  of  insurance  in  valuing  the  assets   of   insurance
      companies.  Such  securities  shall  be  held  by  the superintendent of
      insurance as a special deposit and as express security for  the  payment
      of   such  compensation  or  benefits  and  may  be  sold  by  the  said
      superintendent without notice in the event that there has  been  default
      in  the  payment  of compensation for thirty days or that the depositing
      company has become insolvent. The income thereon shall be  collected  by
      the superintendent of insurance and, prior to any default in the payment
      of such compensation or benefits, shall be paid over by him to the stock
      corporation or mutual association depositing the same.
        However,  no  such  bond  or undertaking shall be required to be filed
      after July first, nineteen hundred thirty-eight, by any  carrier  making
      payment  to  the  stock  or  mutual  funds  respectively  established by
      sections one hundred seven and one hundred nine-d of this chapter.
        8. A self-employed person, a partner of a partnership  as  defined  in
      section  ten of the partnership law but not including a limited partner,
    
      a partner of a registered limited liability partnership  as  defined  in
      section  two  of  the  partnership  law, a member of a limited liability
      company as defined in subdivision (m) of section one hundred two of  the
      limited  liability  company  law  or  a member of a professional service
      limited liability company as defined in subdivision (f) of  section  one
      thousand  two  hundred  one of the limited liability company law, having
      other persons who are  employees  required  to  be  covered  under  this
      chapter  may  be  included  in  the  compensation  insurance contract or
      covered under a certificate of self-insurance. Such  election  shall  be
      made  by  any  such partnership, sole proprietorship, registered limited
      liability partnership, limited liability company or professional service
      limited liability company filing with the insurance carrier or the chair
      in the case of self-insurance upon a form prescribed  by  the  chair,  a
      notice  that  the  partnership,  sole proprietorship, registered limited
      liability partnership, limited liability company or professional service
      limited liability company elects to include the partner,  partners,  the
      self-employed  person  or  member named in the notice in the coverage of
      this chapter. Such election shall  be  effective  with  respect  to  all
      policies  issued  to  such  partnership, sole proprietorship, registered
      limited liability partnership, limited liability company or professional
      service limited liability company by such insurance carrier as  long  as
      it  shall  continuously  insure  the  employees of the partnership, sole
      proprietorship,  registered  limited  liability   partnership,   limited
      liability  company  or  professional  service limited liability company.
      Such election shall be final and binding upon the partner, self-employed
      person or member named in the notice until revoked by  the  partnership,
      sole  proprietorship,  registered limited liability partnership, limited
      liability company or professional service limited liability  company.  A
      self-employed  person,  a  partner  of  a  partnership,  a  partner of a
      registered  limited  liability  partnership,  a  member  of  a   limited
      liability  company  or  a  member  of  a  professional  service  limited
      liability company having no other persons who are employees required  to
      be  covered  under  this  chapter  shall  be  deemed to be excluded from
      coverage under this chapter unless he or she elects to be covered.  Such
      coverage may be effected by obtaining an insurance policy.
        The  self-employed  persons,  partners of a partnership, partners of a
      registered limited liability partnership, members of a limited liability
      company or members of a professional service limited  liability  company
      brought   within  the  coverage  of  the  insurance  contract,  and  the
      dependents of any such self-employed persons, partners of a partnership,
      partners of a registered limited liability  partnership,  members  of  a
      limited  liability  company or members of a professional service limited
      liability company shall  have  the  same  rights  and  remedies  as  any
      employee  or his or her dependents and shall be entitled to compensation
      and medical care as provided by this chapter, and the insurance  carrier
      shall  be  liable  therefor  and  for  payments  into  the special funds
      provided in this chapter as in the case of an employee.