An Act To Ensure the Workers' Compensation Board's Regulatory Oversight of the Maine Insurance Guaranty Association
Maine Legislature, Session 124, LD 0620
Committee: Labor
Sponsors: BARTLETT, TUTTLE, BRYANT, JACKSON, MITCHELL, BUTTERFIELD, DRISCOLL, PINGREE
Amends: 24-A MRSA §4438, 39-A MRSA §205, 39-A MRSA §313, 39-A MRSA §324, 39-A MRSA §359, 39-A MRSA §360

Legislative Document 
No. 620 
S.P.236 
In Senate, February 17,2009 
An Act To Ensure the Workers' Compensation Board's Regulatory 
Oversight of the Maine Insurance Guaranty Association 
Reference to the Committee on Labor suggested and ordered printed. 
Presented by Senator BARTLETT of Cumberland. 
Cosponsored by Representative TUTTLE of Sanford and 
9rS2(J~ 
JOY J. O'BRIEN 
Secretary of the Senate 
Senators: BRYANT of Oxford, JACKSON of Aroostook, President MITCHELL of Kennebec, 
Representatives: BUTTERFIELD of Bangor, DRISCOLL of Westbrook, Speaker PINGREE of 
North Haven. 
Pruned Of! leevderi parer 
Be it enacted by the People ofthe State of Maine as follows: 
Sec. 1. 24-A MRSA §4438, sub-§l, c;rA, as amended by PL 2005, c. 603, §1, is 
further amended to read: 
A. 
Be obligated to pay covered claims existing prior to the detennination of the 
insolvency or arising within 30 days after the detemilnation of insolvency, or before 
the policy expiration date if less than 30 days after the detennination of insolvency, 
or before the insured replaces the policy or causes its cancellation, if within 30 days 
of the detennination. The obligation must be satisfied by paying to the claimant: 
(1) Except as provided in tllis paragraph, the full amount of a covered claim for 
benefits, including interest and all penalties payable to a claimant under the 
Maine Workers' Compensation Act of 1992, or unearned prelnium under workers' 
compensation insurance coverage; 
(2) An amount not exceeding $25,000 per policy for a covered claim for the 
return of an unearned prenlium; or 
(3) An amount not exceeding $300,000 per claim for all other covered claims. 
In no event is the association obligated to pay a claimant an amount in excess of the 
obligation of the insolvent insurer under the policy or coverage from which the claim 
arises. The association shall pay only that amount of unearned prenlium in excess of 
$50. Notwithstanding any other provisions of tllis subchapter, a covered claim does 
not include any claim filed with the association after the earlier of 24 months after the 
date of the order of liquidation or the final date set by the court for the filing of 
claims against the liquidator or receiver of an insolvent insurer. The association, in 
its discretion, may accept a late filed claim as a covered claim when the claimant 
demonstrates good cause. The demonstration of good cause by a claimant includes 
showing that the existence of the claim was not known to the claimant prior to the bar 
date and that the claimant filed the claim witllin 60 days ofleaming of the claim; 
Sec. 2. 24-A MRSA §4438, sUlb-§l, 9TH, as enacted by PL 1969, c. 561, is 
amended to read: 
H. Pay the other expenses of the association authorized by this subchapter.,.; and 
Sec. 3. 24-A MRSA §4438, sub-§l, ~ is enacted to read: 
1. 
Pay all penalties, sanctions, forfeitures and fines provided for under the Maine 
Workers' Compensation Act of 1992 including penalties payable to the Workers' 
Compensation Board and the General Fund, except the penalty provided for in Title 
39-A, section 359, subsection 2. 
Sec. 4. 39-A MRSA §205, sub-§3, as enacted by PL 1991, c. 885, Pt. A, §8 and 
affected by § § 9 to 11, is amended to read: 
3. PelDJ.alty for delay. When there is not an ongoing dispute, if weekly compensation 
benefits or accrued weekly benefits are not paid by the employer or insurance carrier 
within 30 days after beconling due and payable, $50 per day must be added and paid to 
the worker for each day over 30 days in which the benefits are not paid. Not more than 
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25. 
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$1,500 in total may be added pursuant to this subsection. For purposes of ratemaking, 
daily charges paid, under this subsection do not constitute elements of loss. For purposes 
of this subsection, "employer or insurance carrier" includes the Maine Insurance 
Guaranty Association under Title 24-A, chapter 57, subchapter 3. 
Sec. 5. 39-A MRSA §205, sub-§4, as amended by PL 2007, c. 218, §1, is further 
amended to read: 
4. Payment of bills for medical or health care services. When there is no ongoing 
dispute, . if bills for medical or health care serVices are not pa:id within 30 days after the 
carrier has received notice of nonpayment by certified mail from the provider of the 
medical or health care services or, if the bill was paid by the employee, from the 
employee who paid :for the medical or health care services, $50 or the amount of the bill 
due, whichever is less, must be added and paid to the provider of the medical or health 
care serviees or, if the bill was paid by the employee, to the employee who paid for the 
medical or health care services for each day over 30 days in which the bills for medical or 
health care services are not paid. Not more than $1,500 in total may be added pursuant to 
this subsection. For purposes of this subsection, "carrier" includes the Maine Insurance 
Guaranty Association under Title 24-A, chapter 57, subchapter 3. 
Sec. 6. 39-A MRSA §313,sub-§4, as enacted by PL 1991, c .. 885, Pt. A, §8 and 
affected by § §9 to 11, is amended to read: 
4. 
Co~peration; sanctions. The parties shall cooperate with the mediator assigned 
to the case. The assigned mediator shall report to the board the failure of a party to 
cooperate or to produce requested material. The board may impose sanctions against a 
party who dO,es not cooperate or produce requested materials, including the following: 
A, 
Assessment of costs and attorney's fees; 
B. 
Reductions of attorneY's fees; or 
C. 
If the party is the moving party, suspension of proceedings until the party has 
coeperated or produced the requested material. 
For purposes of this subsection, "party" includes the Maine Insurance Guaranty 
Association under Title 24-A, chapter 57, subchapter 3. 
Sec. 7. 39.-A MRSA §313,. sub-:§5, as enacted by PL 1991, c. 885, Pt. A, §8 and 
affected by § § 9 to 11; is amended to read: 
5. Duties of employer or representative of the employee, employer or insurer. 
The employer or representative of the employee, employer or insurer who' participates in 
mediation must be familiar with the employee's claim and has authority to make decisions 
regarding the claim. The board may assess a forfeiture in the amount of $1 00 against any 
employer or representative of the employee, employer or insurer who participates in 
mediation without full authority to make decisions regarding the claim. 
If a 
representative of the employer, insurer or employee participates in mediation or any other 
proceeding of the board, the representative shall notify the employer, insurer or employee 
of all actions by the representative on beh~lf of the employer, insurer or employee and. 
any other actions at the proceeding. 
For purposes of this subsection, "employer or representative of the employee, employer .. 
or insurer" includes the Maine Insurance Guaranty Association under Title 24-A, chapter 
57, subchapter 3. 
Sec. 8. 39-A MRSA §324, sub-§l, as amended by PL 2007, c. 240, Pt. JJJ, §6 
and c. 311, §3, is further amended to read: 
1. Order or decision. The employer or insurance carrier shall· make compensfltion 
payments within 10 days after the receipt of notice of an approved agreement for payment 
of compensation or within 10 days after any order or decision of the !board awarding 
compensation. If the board enters a decision awarding compensation and an appeal is 
filed with the Law Court pursuant to section 322; payments may not be suspended while 
the appeal is pending. The employer or insurer may recover from an employee payments 
made pending appeal to the Law Court'if and to the extent that the Law Court has decided 
that the employee was not entitled to the compensation paid. The board has full 
juri~diction to determine the amount of overpayment, if any,and the amount and schedule 
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of repayment, if any. The board, in determining whether or not repayment should be 
made ~d the extent and schedule of repayment, shall consider the financial situation of 
the employee and the employee's family and may not order repayment that would work 
hardship or mjustice. The board shall notify the Commissioner of Health and Human 
Services within 10 days after the receipt of notice of an approved agreement for payment 
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of·compensation or within 10 days after any order. or decision. of the board awarding 
compensation identifying the employee who is to receive the compensation. 
For 
purposes of this subsection, "employer or insurance carrier" includes the Maine Insurance 
Guaranty Association under Title 24-A, chapter 57, subchapter 3. 
"24·· 
Sec .. 9. 39-A MRSA §324, sub-§2, as amended byPL 2007, c. 265, §1, is further 
amended to read: 
2. Failure to pay within time limits. An employer or insurance carrier who fails to 
pay compensation, as provided in tIlls section, is penalized as follows. For purposes of 
this subsection, "employer or insurance carrier" includes the Maine I11surance Guaranty 
Association under Title 24-A, chapter 57, subchapter. 3. 
A. Except as otherwise provided by section 205, if an employer or insurance carrier 
fails to pay compensation as provided.in this section, the board may assess against the 
employer or insurance carrier a fine of up to $200 for each day of noncompliance .. If 
the board finds that the employer or insurance carrier was prevented from complying 
with this section because of circumstances beyond its control, a fine may not be 
assessed. 
(1) The fine for each day of noncompliance must be divided as follows: Of each 
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day's fine amoUnt, the first $50 is paid to the employee to whom compensation is 
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due and the remainder must be paid to the board and be credited to the Workers' 
Compensation Board Administrativ.eFund. 
·(2) If a fine is assessed against any employer or insurance carrier under this 
subsection on petition by an employee,the employer or in~urance carrier shan 
pay reasonable costs and attorney's fees related to the fme, as determined by the 
board, to the employee. 
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(3) Fines assessed under this subsection may be enforced by the Superior Court 
in the same manner as provided in section 323. 
B. Payment. of a fine assessed under this subsection is not considered an element of 
loss for the purpose of establishing rates for workers' compensation insurance. 
Sec. 10. 39-A MRSA §359, sub-§l, as amended by PL 2005, c. 603, §4, is 
further amended to read: 
~ . Audits. The board shall audit· claims, including insurer, self-insurer, Maine 
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Insurance Guaranty Association and 3rd-partyadministrator claim files, on an ongoing 
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basis to determine whether insurers, self-insured· employers, the Maine msurance 
Guaranty Association and 3rd-party administrators have met their obligations under this 
Act and to identify the disputes that arose, the reasons for the disputes, the method and 
manner of their resolution, the costs incurred, the reasons for attorney involvement and 
the services rendered by the attorneys. 
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14. 
If as a result of an examination and after providing the opportunity for a hearing the board 
determines that any compensation, interest, penalty or other obligation is due and unpaid 
to an employee, dependent Bf." service provider or any other entity, the board shall issue a 
notice of assessment detailing the amounts due and unpaid in each case and shall· order 
the amounts paid to the unpaid party or parties. 
Sec. 11. 39-A MRSA §360, sub-§6 is enacted to read: 
6. Maine Insurance Guaranty Association. The provisions of this section apply to 
the Maine Insurance Guaranty Association under Title 24-A, chapter 57, subchapter 3. 
SUMMARY 
This bill ensures that the Maine Insurance Guaranty Association is responsible for all 
penalties under the Maine Workers' Compensation Act of 1992 and any rules adopted 
pursuant to the Maine Workers' Compensation Act of 1992 with the exception of the 
penalty under the Maine Revised Statutes, Title 39-A, section 359, subsection 2.