(1) The servicing
carrier may cancel a policy after its issuance, with the approval of the
Insurance Commissioner, for any of the reasons stated in this section. The
servicing carrier must first provide an opportunity for cure and must file the
reasons for cancellation with the Insurance Commissioner for necessary approval
before issuance of the cancellation notice and inform the Plan Administrator of
the reason for the cancellation. A proposed cancellation shall be deemed
approved unless disapproved by the Insurance Commissioner on or before the 15th
day after the servicing carrier filed the reasons for cancellation. A servicing
carrier may initiate cancellation when the employer:
(a) Has failed to comply with reasonable
health, safety or audit requirements;
(b) Has violated any of the terms and
conditions under which the insurance was issued;
(c) Is not eligible for workers' compensation
insurance under the Plan;
(d)
Refuses to allow the servicing carrier or NCCI reasonable access to its
facilities or its files and records for audit or inspection;
(e) Refuses to disclose to the servicing
carrier the full nature and scope of the employer's exposure;
(f) Has had the employer's worker leasing
company license denied, revoked or suspended; or
(g) The employer does not properly report
changes in ownership.
(2) The servicing carrier may cancel a policy
without the approval of the Insurance Commissioner when cancellation is for any
of the following reasons:
(a) Nonpayment of
Plan premium, except that a servicing carrier must provide a minimum of 10
days' notice of additional premium owed prior to the obligation becoming past
due;
(b) Failure to complete,
submit and pay a payroll report due the insurer, if the insurer has given the
employer the following notice:
Important Notice: This Policy is subject to
periodic payroll reporting. Reports will be sent to you in accordance with the
section entitled "Reporting Frequency" on the Information Page of your policy.
Your failure to complete, submit and pay these reports to the insurance company
when due may result in cancellation of your policy.
(c) Nonpayment of a premium finance
agreement, as defined in ORS
746.405 with notice pursuant to
ORS 656.427; or
(d) The employer properly reported changes in
ownership.
(3) An
insured employer whose coverage is canceled as provided in this rule must
reestablish eligibility or must demonstrate entitlement to the Plan
Administrator before any further assignment can be made under the
Plan.
(4) If an employer fails or
refuses to file any report of payroll required by the servicing carrier, the
servicing carrier may estimate the payroll and make demand for premiums due
thereon. If the required report and the premium due thereon are not received
within ten days of actual notice of demand, the employer shall be considered in
default of premium payment.
(5) The
servicing carrier shall keep the Plan Administrator fully informed of any
cancellation and of any reestablishment of eligibility or of compliance by the
employer. Any employer whose coverage is cancelled must reestablish eligibility
or demonstrate eligibility for coverage under this Plan to the Plan
Administrator before the Plan Administrator may make any further assignment
under the Plan.
Notes
Or. Admin. Code
§
836-043-0068
ID 10-1996, f. 6-27-96,
cert. ef. 7-1-96; ID 3-2008, f. &cert. ef. 4-7-08; ID 18-2008, f. 12-9-08,
cert. ef. 1-1-09
Stat. Auth.: ORS
656.427,
656.730 &
731.244
Stats. Implemented: ORS
656.427,
656.730 &
737.265
