ch 7 - commercial Lines Regulation

What are the benefits provided under the Indiana Workers Comp Act?

1. Med pay (w/o dollar limites) till medical improves

2. Disability Income

   1. Temp total diability

      1. 66 2/3% wage & min/max total amt

   2. Perm total disability

      1. 66 2/3% of wage & min/max weekly and total amt

   3. Partial

      1. 66 2/3% of diff btwn pre & post wage

3. Death :small bury & surivivor pay

4. Vocational rehabilitation- return worker to status of employment

7 day period before temp benefits paid

21 day will pay retroactive start date

What are the classes that are not included in workers comp?

• railroad,

• real estate not employees,
  indep contractors,

• owner vehicle under k,

• unpaid worker under Fed school (minors limited)

• employees under municipal,

• employ casual domestic

• form/ag

What are positions that can have voluntary coverage?

executive, sole propiretors, parnterships

What is strictly required that is kept for employee coverage?

• employers keep all injury records

• 7 days of occurence death, out of work report sent to insured

• work comp insurance sends 7 days after or 14 after occurence

• minors excluded

What is Indianas exlusive remedy?

Indiana workers comp gives definite remedy

• employee remedy again employer is exclusive

• indemnify to worker is partial is limited to benefit established by worker comp

  • employee not sue unless employers gross negligence

What injuries are not covered by workers comp?

• intentional

• intoxication

• commiting offense

• employee fails safety

• employee doesn’t follow rules

claims must be filed 2 years from date of accident

if radiation 2 years of knowledge by employee

What about occupational disease and second injury?

occupational disease- disease must be from work not general public

second injury fund- pay difference between partial and total disabiality. paid by req contributions from company

Information about Workers Compensation Rating Bureau of Indiana

all insurance companies that write works needs to be apart of

• considered assigned risk plan

• idea cannot get through ordinary markets

• gather info to est fairand adeq rates

• minimum premium & rates

What groups of policies does cancelation and non renewel apply too?

Appllies: commercial & casualty

Except

• automobile

• medical mal practice

When can an insurer cancel policy if its over 90 days?

1. insured failed to pay premium

2. substantial change in scale of risk

3. insured commited fraud or material misrep

4. insured didnt comply with safety

5. reinsurance of risk cancelled

When does insurer need to provide written notice?

• 45 days before cancel

  • If: risk change, safety

• 20 days before cancel

  • IF: fraud or misrep

• 10 days before

  • IF: non payment of premium

When can an insurer cancel less than 90 days?

• 10 days - no payment

• 20 days - fraud & misrep

• 30 days - any other reason

policy < 1 yr - 45 days before expiration

policy > 1 yr - 45 days bef anniversary date

- notice notneeded when as result of transfer coverage

Information about the surplus line market

• surplus lines market carries more risk than purchasing insurance on the open market

• producer (resident or non) show covg is not already offered on mrkt (if it is higher not counted)

Collection dates for suprlus lines

Feb 1st

• collect 2.5% of all gross premium during 12 months

• dec page- taxes, frees, prem

20th day each month

• surplus line file w/ DOI

  transaction, policies, contracts

  • desc/location/risk and named

  • gross prem charged in K

  • name, address, kind insur

  • procurure insurer authroize to transact

March 31st

• submit financial statements of each unauthroized insured

  • commisioner can cancel

No remit due for surplus lines

• DOI / commisoner penalty 10% amt further and 1% each month/portion past

• penalities paid by insurers not insureds

• producer needs to keep seperate account for transaction