2023 New York Laws › WKC - Workers' Compensation › Article 9 - Disability Benefits › 226 - The Insurance Contract.

§  226. The insurance contract. 1. Every policy of insurance providing
the benefits required to be paid under  this  article  shall  contain  a
provision setting forth the right of the chairman to enforce in the name
of  the  people  of  the state of New York for the benefit of the person
entitled to the benefits insured by  the  policy,  either  by  filing  a
separate  application  or by making the insurance carrier a party to the
original application, the liability of the insurance carrier in whole or
in part for the  payment  of  such  benefits;  provided,  however,  that
payment  in  whole or in part of such benefits by either the employer or
the insurance carrier shall to the  extent  thereof  be  a  bar  to  the
recovery against the other of the amount so paid.
2.  Every  such  policy shall contain a provision that, as between the
employee and the insurance carrier, the notice to or  knowledge  of  the
occurrence  of  the injury or sickness on the part of the employer shall
be deemed notice or knowledge as the case may be, on  the  part  of  the
insurance  carrier;  that  jurisdiction  of  the employer shall, for the
purpose of this chapter, be jurisdiction of the  insurance  carrier  and
that  the  insurance carrier shall in all things be bound by and subject
to the orders, findings or decisions rendered  in  connection  with  the
payment of benefits under the provisions of this article.
3.  Every such policy shall contain a provision to the effect that the
insolvency or bankruptcy of the employer shall not relieve the insurance
carrier from the payment of  benefits  for  disability  suffered  by  an
employee during the life of such policy.
4.  Every  policy  of  insurance  issued  to  meet the requirements of
section two hundred eleven shall contain a provision reciting in  effect
that  notwithstanding  any other provision of the policy, benefits shall
be paid at least to the extent and in the  manner  and  subject  to  the
conditions  required by the terms of the insured's provision of benefits
under this article.
5. No contract of insurance issued by an insurance  carrier  providing
the benefits to be paid under this article shall be cancelled within the
time  limited in such contract for its expiration unless notice is given
as required by this section. When cancellation is due to non-payment  of
premiums  such  cancellation  shall  not be effective until at least ten
days after a  notice  of  cancellation  of  such  contract,  on  a  date
specified  in such notice, shall be filed in the office of the chair and
also served on the employer. When cancellation  is  due  to  any  reason
other  than  non-payment  of  premiums  such  cancellation  shall not be
effective until at least thirty days after a notice of  cancellation  of
such contract, on a date specified in such notice, shall be filed in the
office  of the chair and also served on the employer; provided, however,
in either case that if insurance with another insurance carrier has been
obtained which becomes effective prior to the  expiration  of  the  time
stated  in  such  notice,  the cancellation shall be effective as of the
date of such other coverage. Such notice shall be served on the employer
as prescribed by the chair, including delivering it to  him  or  her  by
electronic  means; provided that, if the employer be a partnership, then
such notice may be given to any one of the partners, and if the employer
be a corporation then the notice may be given to any agent or officer of
the corporation  upon  whom  legal  process  may  be  served,  provided,
however, the right to cancellation of a policy of insurance in the state
fund  shall  be exercised only for nonpayment of premiums or as provided
in section ninety-four of this chapter.
6. (a) Any insurance carrier or the state insurance fund  who  issues,
reinstates,  amends  or  endorses  any  contract  of  insurance or rider
thereto providing the benefits required to be paid  under  this  article
shall  file  notification  in the office of the chair within thirty days

after such issuance, reinstatement,  amendment  or  endorsement  of  the
contract.  Such  notice shall be filed in the manner and form prescribed
by the chair.
(b) In the event notice required under this subdivision or subdivision
five  of  this section is not filed with the chair within the thirty-day
time period, the chair may impose a penalty of up to one hundred dollars
for each ten-day period the insurance carrier or  state  insurance  fund
failed  to  file  the  notification. All penalties collected pursuant to
this subdivision shall be deposited in the uninsured employers' fund.
7. The chair may require by regulation that  every  policy  of  family
leave  insurance  contain  a  provision  requiring  that all disputes be
resolved  by  designated  alternative  dispute  resolution  process   in
accordance with such regulations.
8. Premiums for policies providing disability or family leave benefits
in  accordance  with this article shall be calculated in accordance with
applicable provisions of the insurance law, including subsection (n)  of
section four thousand two hundred thirty-five of such law.
9.  Except  as  set  forth in subdivision eight of section two hundred
eleven of this article, every policy of  insurance  issued  pursuant  to
this  article  must  offer coverage for both disability and family leave
benefits.