806 KAR 13:140. Notice of right to seek review of

application of workers' compensation insurance rates.

 

      RELATES TO: KRS 304.13-057, 304.13-161, 304.13-415,

Chapter 342 et seq.

      STATUTORY AUTHORITY: KRS 304.13-161

      NECESSITY, FUNCTION, AND CONFORMITY: KRS 304.2-110

provides that the Executive Director 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 executive director 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 executive director 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

Office 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 executive director shall hold a hearing. The executive

director may after the hearing issue a final order affirming, modifying, or

reversing the action of the insurance company or advisory organization. (24

Ky.R. 432; Am. 896; eff. 10-13-97; TAm eff. 8-9-2007.)