2006 New York Code - Workers\' Compensation And Employers\' Liability Insurance; Optional Policyholder Deductibles.



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

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