11 N.C. Admin. Code 23A.0301

Current through Register Vol. 39, No. 11, December 2, 2024

Section 23A .0301 - PROOF OF INSURANCE COVERAGE

(a) Every employer, either personally or through its carrier or third party administrator, subject to the provisions of the Workers' Compensation Act shall file with the Commission proof that it has obtained workers' compensation insurance, and shall post notice of proof of insurance to employees consistent with Rule .0201 of this Subchapter.

(b) Upon actual notice of a workers' compensation claim or upon reporting a workers' compensation claim to a carrier, third party administrator, servicing agent, professional employer organization as defined in G.S. 58-89A-5(14), or the Commission, all employers shall provide the injured worker with the name of their insurance carrier and policy number or shall inform the injured worker of their self-insured status, membership in a self-insurance group or relationship with a professional employer organization that provides the insurance coverage.

(c) Every carrier, third party administrator, servicing agent, or other entity filing a Form 19 Employer's Report of Employee's Injury or Occupational Disease to the Industrial Commission shall identify by name and address any professional employer organization and the name of the client company employing the employee who is the subject of the Form 19 Employer's Report of Employee's Injury or Occupational Disease to the Industrial Commission.

(d) A professional employer organization shall, within 30 days of initiation or termination of the professional employer organization's relationship with any client company, notify the Commission of either the initiation or termination of the relationship and the status of the client company's workers' compensation coverage.

(e) Upon notice from the Commission that an employer is non-insured, coverage has lapsed or been canceled, or coverage or self-insured status cannot be verified, an employer shall show proof of coverage to the Commission by:

(1) a certificate of insurance issued by the insurance agent who procured workers' compensation insurance on behalf of the employer;

(2) submitting a copy of the letter of approval, license or amended license with subsidiary information, if applicable, from the North Carolina Department of Insurance notifying or indicating the employer has qualified as a self-insured employer for workers' compensation purposes;

(3) submitting a copy of the Form 18WC Application for Membership indicating the employer is a member of a self-insurance group or fund;

(4) submitting a copy of a declaration of coverage page from an insurance policy procured in another state that indicates North Carolina is a covered jurisdiction under the workers' compensation policy;

(5) submitting the names of the general contractor, subcontractor, professional employer organization or other entity that has provided workers' compensation coverage for the employer; provided however, that coverage shall be verified by the Commission in order to be removed from the non-insured docket; or

(6) submitting other documentation or information relevant to the workers' compensation claim upon request of the Commission.

(f) A principal contractor, intermediate contractor or subcontractor may satisfy the requirements of G.S. 97-19 by obtaining a certificate of insurance issued by the insurance agent who procured insurance on behalf of the subcontractor or a certificate of compliance issued by the Department of Insurance to a self-insured subcontractor. If the subcontractor has notice that the policy of insurance has lapsed, is cancelled, is not renewed, or the subcontractor ceases to qualify as a self-insured employer, the subcontractor shall, within 24 hours, notify any contractor to whom it has provided a certificate of insurance that the certificate or certificate of compliance is no longer valid.

11 N.C. Admin. Code 23A .0301

Authority G.S. 97-19; 97-80(a); 97-93;
Eff. January 1, 1990;
Amended Eff. January 1, 2013; June 1, 2000;
Recodified from 04 NCAC 10A .0301 Eff. June 1, 2018.

Authority G.S. 97-19; 97-80(a); 97-93;
Eff. January 1, 1990;
Amended Eff. January 1, 2013; June 1, 2000;
Recodified from 04 NCAC 10A .0301 by North Carolina Register Volume 32, Issue 23, June 1, 2018 Eff. 6/1/2018.