section .0300 - insurance
04 NCAC 10A .0301 Proof of Insurance Coverage
(a) Every employer, either personally or through its carrier
or third party administrator, subject to the provisions of the Workers'
Compensation Act shall file with the Commission proof that it has obtained
workers' compensation insurance, and shall post notice of proof of insurance to
employees consistent with Rule .0201 of this Subchapter.
(b) Upon actual notice of a workers' compensation claim or
upon reporting a workers' compensation claim to a carrier, third party
administrator, servicing agent, professional employer organization as defined
in G.S. 58-89A-5(14), or the Commission, all employers shall provide the
injured worker with the name of their insurance carrier and policy number or
shall inform the injured worker of their self-insured status, membership in a
self-insurance group or relationship with a professional employer organization
that provides the insurance coverage.
(c) Every carrier, third party administrator, servicing
agent, or other entity filing a Form 19 Employer's Report of Employee's
Injury or Occupational Disease to the Industrial Commission shall identify
by name and address any professional employer organization and the name of the
client company employing the employee who is the subject of the Form 19 Employer's
Report of Employee's Injury or Occupational Disease to the Industrial Commission.
(d) A professional employer organization shall, within 30
days of initiation or termination of the professional employer organization's
relationship with any client company, notify the Commission of either the
initiation or termination of the relationship and the status of the client
company's workers' compensation coverage.
(e) Upon notice from the Commission that an employer is
non-insured, coverage has lapsed or been canceled, or coverage or self-insured
status cannot be verified, an employer shall show proof of coverage to the
(1) a certificate of insurance issued by the
insurance agent who procured workers' compensation insurance on behalf of the
(2) submitting a copy of the letter of
approval, license or amended license with subsidiary information, if
applicable, from the North Carolina Department of Insurance notifying or
indicating the employer has qualified as a self-insured employer for workers'
(3) submitting a copy of the Form 18WC
Application for Membership indicating the employer is a member of a
self-insurance group or fund;
(4) submitting a copy of a declaration of
coverage page from an insurance policy procured in another state that indicates
North Carolina is a covered jurisdiction under the workers' compensation
(5) submitting the names of the general
contractor, subcontractor, professional employer organization or other entity
that has provided workers' compensation coverage for the employer; provided
however, that coverage shall be verified by the Commission in order to be
removed from the non-insured docket; or
(6) submitting other documentation or
information relevant to the workers' compensation claim upon request of the
(f) A principal contractor, intermediate contractor or
subcontractor may satisfy the requirements of G.S. 97-19 by obtaining a
certificate of insurance issued by the insurance agent who procured insurance
on behalf of the subcontractor or a certificate of compliance issued by the
Department of Insurance to a self-insured subcontractor. If the subcontractor
has notice that the policy of insurance has lapsed, is cancelled, is not
renewed, or the subcontractor ceases to qualify as a self-insured employer, the
subcontractor shall, within 24 hours, notify any contractor to whom it has
provided a certificate of insurance that the certificate or certificate of
compliance is no longer valid.
History Note: Authority G.S. 97-19; 97-80(a); 97-93;
Eff. January 1, 1990;
Amended Eff. January 1, 2013; June 1, 2000.