NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A11372
SPONSOR: Rules (Paulin) TITLE OF BILL:
An act to amend the workers' compensation law, in relation to notifica-
tion in the case of a change to a workers' compensation claims represen-
tative
PURPOSE:
To require insurance carriers to provide notice when a claims represen-
tative changes or when it is determined that the assignment of a claims
representative is no longer necessary.
SUMMARY OF PROVISIONS:
Section one of the bill adds a new section 138 to the workers' compen-
sation law which would require insurance carriers to provide notice when
a claim is assigned to a new claims representative, or when it is deter-
mined that the assignment of a claims representative is no longer neces-
sary. This section also sets out notice requirements and would require
insurance carriers to provide notice to claimants either electronically
or by certified or registered mail.
JUSTIFICATION:
This legislation would require workers' compensation insurance carriers
to provide notice to a claimant when their claim is assigned to a new
representative.
When an employee is injured on the job, he or she relies on workers'
compensation insurance benefits to cover medical expenses related to
their injury. Most insurance carriers assign a claims representative to
specific claimants and such representative is the claimant's point of
contact at the insurance company to help with facilitating coverage.
It is not uncommon for insurance carriers to reassign a claims represen-
tative when necessary. This can lead to a delay in resolution of claims
and obtaining coverage for needed medical services when the claimant is
unaware that their representative has changed. This situation can be
especially problematic for those who are left out of work long term or
even permanently and experience regular turnover of their claims repre-
sentatives. Individuals receiving workers' compensation should be given
notice when they are assigned to a new claims representative to ensure
prompt resolution of their claims.
LEGISLATIVE HISTORY:
New bill.
FISCAL IMPLICATIONS:
None.
EFFECTIVE DATE:
This act shall take effect on the ninetieth day after it shall have
become a law.
STATE OF NEW YORK
________________________________________________________________________
11372
IN ASSEMBLY
October 19, 2018
___________
Introduced by COMMITTEE ON RULES -- (at request of M. of A. Paulin) --
read once and referred to the Committee on Labor
AN ACT to amend the workers' compensation law, in relation to notifica-
tion in the case of a change to a workers' compensation claims repre-
sentative
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. The workers' compensation law is amended by adding a new
2 section 138 to read as follows:
3 § 138. Workers' compensation claims representative replacement. 1.
4 Where an injured employee is entitled to workers' compensation benefits
5 under this chapter and a claims representative has been assigned to his
6 or her workers' compensation claim by an insurance carrier or self-in-
7 sured employer, such insurance carrier or self-insured employer shall be
8 required to notify such injured employee or such employee's personal
9 representative in the event that such claim is assigned to a new claims
10 representative, or it is determined that the assignment of a claims
11 representative is no longer necessary. For the purposes of this section,
12 "claims representative" shall mean any employee, agent, or other repre-
13 sentative of an insurance carrier or self-insured employer that is
14 responsible for processing, adjudicating, or in any way effecting the
15 settlement of a workers' compensation claim.
16 2. An insurance carrier or self-insured employer shall provide such
17 notice by electronic means or by certified or registered mail, return
18 receipt requested, to the last known address of the injured employee or
19 such employee's personal representative within fourteen business days of
20 the replacement of any claims representative or the determination that
21 the assignment of a claims representative is no longer necessary. Such
22 notice must include the name and contact information of the new claims
23 representative when a new assignment has been made.
24 § 2. This act shall take effect on the ninetieth day after it shall
25 have become a law.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD16532-01-8
