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AB-2586 Workers’ compensation.(2017-2018)



Current Version: 02/15/18 - Introduced

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AB2586:v99#DOCUMENT


CALIFORNIA LEGISLATURE— 2017–2018 REGULAR SESSION

Assembly Bill
No. 2586

Introduced by Assembly Member Mayes

February 15, 2018

An act to amend Section 11753.1 of the Insurance Code, and to amend Section 5814.1 of the Labor Code, relating to workers’ compensation.


LEGISLATIVE COUNSEL'S DIGEST


AB 2586, as introduced, Mayes. Workers’ compensation.
Existing law regulates workers’ compensation insurance rates and, among other things, requires rates to be adequate to cover an insurer’s losses and expenses. Existing law provides that a person aggrieved by a decision, action, or omission of a rating organization may request reconsideration, and if the request for reconsideration is rejected or is not acted upon within 30 days, the person may file an appeal with the Insurance Commissioner, as specified.
This bill would extend the timeline for reconsideration to 45 days, after which a person may then appeal the decision, action, or omission of the rating organization with the commissioner.
Existing law establishes the Workers’ Compensation Appeals Board to exercise all judicial powers vested in it, as specified, including workers’ compensation proceedings for the recovery of compensation. Existing law authorizes the director of the Department of Industrial Relations to provide compensation at his or her discretion from the Uninsured Employers Fund in specified workers’ compensation cases if compensation is not being provided to the applicant. Existing law provides that if payment of compensation has been unreasonably delayed or refused before the issuance of an award, and the director has paid that discretionary compensation, the Workers’ Compensation Appeals Board is required to award the director 10% of the compensation paid by the director, to be paid by the employer in addition to other specified penalties.
This bill would instead require the Workers’ Compensation Appeal Board to award the director an amount not to exceed 10% of the compensation paid to an applicant by the director.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

The people of the State of California do enact as follows:


SECTION 1.

 Section 11753.1 of the Insurance Code is amended to read:

11753.1.
 (a) Any A person aggrieved by any a decision, action, or omission to act of a rating organization may request that the rating organization reconsider the decision, action, or omission. If the request for reconsideration is rejected or is not acted upon within 30 45 days by the rating organization, the person requesting reconsideration may, within a reasonable time, appeal from the decision, action, or omission of the rating organization. The appeal shall be made to the commissioner by filing a written complaint and request for a hearing specifying the grounds relied upon. If the commissioner has information on the subject appealed from and believes that probable cause for the appeal does not exist or that the appeal is not made in good faith, the commissioner may deny the appeal without a hearing. The commissioner shall otherwise hold a hearing to consider and determine the matter presented by the appeal.
(b) Any An insurer adopting a change in the classification assignment of an employer that results in an increased premium shall notify the employer in writing, or if the insurance was transacted through an insurance agent or broker, the insurer shall notify the agent or broker who shall notify the employer in writing of the change and the reasons for the change. Any An employer receiving this notice shall have the right to request reconsideration and appeal the reclassification pursuant to this section. The notice required by this section shall inform the employer of his or her rights pursuant to this section. No A notification shall not be required when if the change is a result of a regulation adopted by the Department of Insurance or other action by or under the authority of the commissioner.
An insurer shall provide written notification of the revised classification assignment to an employer within 30 days after adoption.

SEC. 2.

 Section 5814.1 of the Labor Code is amended to read:

5814.1.
 When If the payment of compensation has been unreasonably delayed or refused prior to before the issuance of an award, and the director has provided discretionary compensation pursuant to Section 4903.3, the appeals board shall award to the director a penalty to be paid by the employer in the an amount of not to exceed 10 percent of the compensation so provided by the director, such that penalty to be in addition to the penalty imposed by Section 5814. The question of delay and the reasonableness of the cause therefor shall be determined by the appeals board in accordance with the facts.