Kentucky Administrative Regulations › Title 806 - PUBLIC PROTECTION CABINET - DEPARTMENT OF INSURANCE › Chapter 13 - Rates and Rating Organizations › Section 806 KAR 13:140 - Notice of right to seek review of application of workers' compensation insurance rates

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO:
				KRS
				304.13-057,
				304.13-161,
				304.13-415,
				Chapter 342 et seq.
NECESSITY, FUNCTION, AND CONFORMITY:
				KRS
				304.2-110 provides that the Commissioner of
				Insurance may make reasonable administrative regulations necessary for or as an
				aid to the effectuation of any provision of the Kentucky Insurance Code.
				KRS
				304.13-161 provides that each insurer or
				agent shall notify in writing each insured at the time a workers' compensation
				policy is issued or renewed, on or after May 1, 1997, of the insured's right to
				seek a review of the manner in which the rating system was applied.
				KRS
				304.13-161 requires the commissioner to
				promulgate an administrative regulation setting forth the manner and format of
				the written notice. This administrative regulation prescribes the manner and
				format of this notice.
Section 1. With
			 every workers' compensation insurance policy issued or renewed on or after May
			 1, 1997, insurers or agents shall include the following written "Notice of
			 Insured's Rights" at the time the policy is issued or renewed. If the policy is
			 a new policy, the notice shall be provided with the policy. If a policy is
			 renewed, the notice shall be provided at the time of renewal.
Section 2. The notice shall clearly state in
			 substance:
NOTICE OF INSURED'S RIGHTS
If you are insured under a workers' compensation insurance
				policy and believe that the rates or the rating system have been incorrectly or
				improperly applied, you may request a review of the manner in which the rate or
				rating system has been applied. You must make your request in writing to the
				insurance company or advisory organization. The insurance company or advisory
				organization has thirty (30) days to grant or reject your request for a review
				and to notify you in writing whether your request has been granted or rejected.
				If your request is granted, the insurance company or advisory organization
				shall conduct the review within ninety (90) days of receiving your request. If
				your request is rejected or if you are dissatisfied with the results of the
				review, you may appeal to the commissioner for further review. You must make
				your appeal within thirty (30) days of receipt of the rejection or of the
				results of the review. Your appeal is to be sent to:
Legal Division
Department of Insurance
P.O. Box 517
Frankfort, KY 40602
Your request for an appeal should include a statement of the
				facts and how the rates or rating system were incorrectly or improperly
				applied. Also, enclose copies of the results of the review and any other
				correspondence from the insurance company or advisory organization. If your
				appeal shows good cause, the commissioner shall hold a hearing. The
				commissioner may after the hearing issue a final order affirming, modifying, or
				reversing the action of the insurance company or advisory
				organization.
STATUTORY AUTHORITY:
				  KRS
				  304.13-161