N.Y. Workers’ Compensation Law 226 – The insurance contract
§ 226. The insurance contract. 1. Every policy of insurance providing the benefits required to be paid under this article shall contain a provision setting forth the right of the chairman to enforce in the name of the people of the state of New York for the benefit of the person entitled to the benefits 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 benefits; provided, however, that payment in whole or in part of such benefits 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.
Terms Used In N.Y. Workers' Compensation Law 226
- Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
- Bankruptcy: Refers to statutes and judicial proceedings involving persons or businesses that cannot pay their debts and seek the assistance of the court in getting a fresh start. Under the protection of the bankruptcy court, debtors may discharge their debts, perhaps by paying a portion of each debt. Bankruptcy judges preside over these proceedings.
- Benefits: means the money allowances during disability payable to an employee who is eligible to receive such benefits, as provided in this article. See N.Y. Workers' Compensation Law 201
- Carrier: shall include : the state fund, stock corporations, mutual corporations and reciprocal insurers which insure the payment of benefits provided pursuant to this article; and employers and associations of employers or of employees and trustees authorized or permitted to pay benefits under the provisions of this article. See N.Y. Workers' Compensation Law 201
- Chairman: means the chairman of the workers' compensation board of the state of New York. See N.Y. Workers' Compensation Law 201
- Contract: A legal written agreement that becomes binding when signed.
- Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
- Employee: means a person engaged in the service of an employer in any employment defined in subdivision six of this section, except a minor child of the employer, except a duly ordained, commissioned, or licensed minister, priest or rabbi, a sexton, a christian science reader, or member of a religious order, or an executive officer of a 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 § 715 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 provided, however, that each officer must own at least one share of stock, except as provided in section two hundred twelve of this article, or an executive officer of an incorporated religious, charitable or educational institution, or persons engaged in a professional or teaching capacity in or for a religious, charitable or educational institution, or volunteers in or for a religious, charitable or educational institution, or persons participating in and receiving rehabilitative services in a sheltered workshop operated by a religious, charitable or educational institution under a certificate issued by the United States department of labor, or recipients of charitable aid from a religious or charitable institution who perform work in or for the institution which is incidental to or in return for the aid conferred, and not under an express contract of hire. See N.Y. Workers' Compensation Law 201
- Family leave: shall mean any leave taken by an employee from work: (a) to participate in providing care, including physical or psychological care, for a family member of the employee made necessary by a serious health condition of the family member; or (b) to bond with the employee's child during the first twelve months after the child's birth, or the first twelve months after the placement of the child for adoption or foster care with the employee; or (c) because of any qualifying exigency as interpreted under the family and medical leave act, 29 U. See N.Y. Workers' Compensation Law 201
- Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
- Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
- State fund: means the state insurance fund created under article six of this chapter. See N.Y. Workers' Compensation Law 201
2. 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 or sickness on the part of the employer shall be deemed notice or knowledge as the case may be, on the part of the insurance carrier; that jurisdiction of the employer shall, for the purpose of this chapter, be jurisdiction of the insurance carrier and that the insurance carrier shall in all things be bound by and subject to the orders, findings or decisions rendered in connection with the payment of benefits under the provisions of this article.
3. 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 benefits for disability suffered by an employee during the life of such policy.
4. Every policy of insurance issued to meet the requirements of section two hundred eleven shall contain a provision reciting in effect that notwithstanding any other provision of the policy, benefits shall be paid at least to the extent and in the manner and subject to the conditions required by the terms of the insured's provision of benefits under this article.
5. No contract of insurance issued by an insurance carrier providing the benefits to be paid under this article 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 insurance with another insurance carrier has been obtained 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. Such notice shall be served on the employer as prescribed by the chair, including delivering it to him or her by electronic means; provided that, if the employer be a partnership, then such notice may be given to any 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, provided, however, the right to cancellation of a policy of insurance in the state fund shall be exercised only for nonpayment of premiums or as provided in section ninety-four of this chapter.
6. (a) Any insurance carrier or the state insurance fund who issues, reinstates, amends or endorses any contract of insurance or rider thereto providing the benefits required to be paid under this article 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 or subdivision five of this section is not filed with the chair within the thirty-day time period, the chair may impose a penalty of up to one 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.
7. The chair may require by regulation that every policy of family leave insurance contain a provision requiring that all disputes be resolved by designated alternative dispute resolution process in accordance with such regulations.
8. Premiums for policies providing disability or family leave benefits in accordance with this Article of the insurance law, including subsection (n) of section four thousand two hundred thirty-five of such law.
9. Except as set forth in subdivision eight of section two hundred eleven of this article, every policy of insurance issued pursuant to this article must offer coverage for both disability and family leave benefits.