Or. Admin. Code § 836-043-0068

Current through Register Vol. 63, No. 12, December 1, 2024

Section 836-043-0068 - Cancellation

(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.

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