Compensation from uninsured employers’ claim account: Administration and payment of claims; eligibility of employee; liability of employer; powers and duties of Division; appeals; penalty.
1. The Division shall designate one:
(a) Third-party administrator who has a valid certificate issued by the Commissioner pursuant to NRS 683A.085; or
(b) Insurer, other than a self-insured employer or association of self-insured public or private employers,
Ê to administer claims against the Uninsured Employers’ Claim Account. The designation must be made pursuant to reasonable competitive bidding procedures established by the Administrator.
2. Except as otherwise provided in this subsection, an employee may receive compensation from the Uninsured Employers’ Claim Account if:
(a) He was hired in this state or he is regularly employed in this state;
(b) He contracts an occupational disease that arose out of and in the course of employment:
(1) In this state; or
(2) While on temporary assignment outside the State for not more than 12 months;
(c) He files a claim for compensation with the Division; and
(d) He makes an irrevocable assignment to the Division of a right to be subrogated to the rights of the employee pursuant to NRS 616C.215.
Ê An employee who contracts an occupational disease that arose out of and in the course of employment while on temporary assignment outside the State is not entitled to receive compensation from the Uninsured Employers’ Claim Account unless he has been denied workers’ compensation in the state in which the disease was contracted.
3. If the Division receives a claim pursuant to subsection 2, the Division shall immediately notify the employer of the claim.
4. For the purposes of this section, the employer has the burden of proving that he provided mandatory coverage for occupational diseases for the employee or that he was not required to maintain industrial insurance for the employee.
5. Any employer who has failed to provide mandatory coverage required by the provisions of this chapter is liable for all payments made on his behalf, including, but not limited to, any benefits, administrative costs or attorney’s fees paid from the Uninsured Employers’ Claim Account or incurred by the Division.
6. The Division:
(a) May recover from the employer the payments made by the Division that are described in subsection 5 and any accrued interest by bringing a civil action in a court of competent jurisdiction.
(b) In any civil action brought against the employer, is not required to prove that negligent conduct by the employer was the cause of the occupational disease.
(c) May enter into a contract with any person to assist in the collection of any liability of an uninsured employer.
(d) In lieu of a civil action, may enter into an agreement or settlement regarding the collection of any liability of an uninsured employer.
7. The Division shall:
(a) Determine whether the employer was insured within 30 days after receiving the claim from the employee.
(b) Assign the claim to the third-party administrator or insurer designated pursuant to subsection 1 for administration and payment of compensation.
Ê Upon determining whether the claim is accepted or denied, the designated third-party administrator or insurer shall notify the injured employee, the named employer and the Division of its determination.
8. Upon demonstration of the:
(a) Costs incurred by the designated third-party administrator or insurer to administer the claim or pay compensation to the injured employee; or
(b) Amount that the designated third-party administrator or insurer will pay for administrative expenses or compensation to the injured employee and that such amounts are justified by the circumstances of the claim,
Ê the Division shall authorize payment from the Uninsured Employers’ Claim Account.
9. Any party aggrieved by a determination made by the Division regarding the assignment of any claim made pursuant to this section may appeal that determination by filing a notice of appeal with an appeals officer within 30 days after the determination is rendered. The provisions of NRS 616C.345 to 616C.385, inclusive, apply to an appeal filed pursuant to this subsection.
10. Any party aggrieved by a determination to accept or to deny any claim made pursuant to this section or by a determination to pay or to deny the payment of compensation regarding any claim made pursuant to this section may appeal that determination, within 70 days after the determination is rendered, to the Hearings Division of the Department of Administration in the manner provided by NRS 616C.305 and 616C.315.
11. All insurers shall bear a proportionate amount of a claim made pursuant to this chapter, and are entitled to a proportionate amount of any collection made pursuant to this section as an offset against future liabilities.
12. An uninsured employer is liable for the interest on any amount paid on his claims from the Uninsured Employers’ Claim Account. The interest must be calculated at a rate equal to the prime rate at the largest bank in Nevada, as ascertained by the Commissioner of Financial Institutions, on January 1 or July 1, as the case may be, immediately preceding the date of the claim, plus 3 percent, compounded monthly, from the date the claim is paid from the Account until payment is received by the Division from the employer.
13. Attorney’s fees recoverable by the Division pursuant to this section must be:
(a) If a private attorney is retained by the Division, paid at the usual and customary rate for that attorney.
(b) If the attorney is an employee of the Division, paid at the rate established by regulations adopted by the Division.
Ê Any money collected must be deposited to the Uninsured Employers’ Claim Account.
14. In addition to any other liabilities provided for in this section, the Administrator may impose an administrative fine of not more than $10,000 against an employer if the employer fails to provide mandatory coverage required by the provisions of this chapter.
Last modified: February 25, 2006