Section 031-440-II-12 - Payment of Losses and Pool ExpensesA. Reporting and payment of losses. The servicing carrier shall pay all losses accruing on risks assigned to it as each loss becomes due and payable. On or before the 15th day of February, May, August, and November of each year, each servicing carrier shall report to the Plan manager all claims arising and losses paid to the end of the preceding quarter on account of risks assigned to it together with the then estimated value of all claims outstanding. For purposes of this rule, losses shall include assessments levied against servicing carriers by the Maine Insurance Guaranty Association with respect to the workers' compensation insurance account authorized by 24-A M.R.S.A. §4436, sub-§ 1. If losses paid exceed premiums written, less servicing fees and producer fees, then within thirty days after the receipt of such report or within the Plan shall reimburse each such servicing carrier for the losses paid by such servicing carrier.
B. Pool general expenses. Expenses incurred by the Pool in the administration of its affairs, and not allocable directly to any residual market risk, shall be paid from the general funds of the Pool. A record shall be kept of all such expenses and the Plan manager shall provide to the Board and to the Superintendent a written accounting of such expenditures at the end of each quarter. Except with respect to claims, the cost of the interpretation of physical and X-ray examinations of employees in assigned dust hazard risks, provided the employer pays for the making of such examinations, shall be a proper charge against, and shall be paid from, the general funds of the Pool. Payments by the Pool shall be limited to the following: 1) the Pool's administration expense;2) reimbursement for losses paid .under assigned risk policies;3) return premiums on such policies;4) payment of such refunds as way be allowed;5) reasonable expenses incurred by Board members while performing Board business; and6) reasonable and necessary amounts charged for the collection of any part of any premium on any assigned risks, provided that advance written approval to incur such collection costs is obtained in each case from the Pool manager. Such approval shall be given when it reasonably appears that diligent effort to collect the premium due has been made by the member in the regular course of business and has been ineffective. The Pool shall not assume for payment, and shall not be liable to pay, any expenses of any nature incurred by members except as provided herein.
C. Pool reimbursement. The servicing carrier shall reimburse the Pool for any monies recovered less expenses incurred in making that recovery by way of subrogation or otherwise on a claim for which the servicing carrier has already been reimbursed. If a servicing carrier's subrogation action is unsuccessful, the servicing carrier shall be reimbursed only for payments to any independent attorney representing the servicing carrier in the subrogation action and the court costs related thereto.02-031 C.M.R. ch. 440, § II-12