New York Codes, Rules and Regulations
Chapter VI - State Insurance Fund
Part 450 - Conduct Of The State Insurance Fund
Section 450.6 - Claims

Current through Register Vol. 44, No. 38, September 21, 2022

(a) All notices of claims and accidents shall be indexed and recorded and shall be filed, if required by law, with the Workers' Compensation Board. All claims shall be examined and where necessary shall be investigated. The claims department shall determine promptly whether compensation or benefits shall be paid in advance of an award or whether the right to compensation or benefits shall be controverted. Notices as required by law or of the rules of the Workers' Compensation Board shall be filed promptly and all necessary procedures shall be taken to ascertain and present the facts and the law upon hearings before the Workers' Compensation Board.

(b) Awards for workers' compensation and compensation in advance of awards or benefits for disability shall be audited and paid in the manner prescribed by law, at the times and in the amounts provided by law or the rules or lawful orders of the Workers' Compensation Board, unless such awards are appealed or review requested or the right to compensation controverted.

(c) All charges for medical, surgical or hospital treatment, where required by law or contract, shall be examined and, when found to be reasonable and the treatment required or authorized under the Workers' Compensation Law, shall be paid at the time and in the manner provided in the Workers' Compensation Law.

(d) The claims department shall, in cooperation with the actuary, be responsible for the care and management of the aggregate trust fund provided by section 27 of the Workers' Compensation Law, and shall authorize payments therefrom in accordance with the Workers' Compensation Law and with the orders and awards of the Workers' Compensation Board.

(e) The claims department shall cooperate to the extent required with the actuary in the determination of the reserves to be established for the payment of all such claims.

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