section .0300 - insurance

Link to law: 04 - commerce/chapter 10 - industrial commission/subchapter a/04 ncac 10a .0301.html
Published: 2015

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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

Commission by:

(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'

compensation purposes;

(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.