§ 15216. Administration of Defaulted Self-Insurer's Claims.

(a) In the event the self insurer fails to pay workers' compensation benefits due, the cost of administration and legal expenses of existing and new claims shall be made from the security deposit set aside for this purpose pursuant to Labor Code Section 3701.5.

(b) If claims have been administered from out of state, the Director may order all remaining and future claims to be administered from California or may turn them over to the Self-Insurer's Security Fund.

(c) The Manager shall determine the adequacy of the existing security deposit to pay the defaulting self insurer's workers' compensation liabilities within 90 days of the Manager's determination that the self-insured has defaulted, and shall report his/her findings to the Director and the Self Insurer's Security Fund.

(d) If it is necessary for the Director to call or cash any security deposit, a trust shall be established by the Manager to receive the funds from the deposit, except in the following situations:

(1) Where the surety company elects, and the Director approves, handling of the claims directly by the provider of the surety bond; or

(2) Where the funds and responsibility for the claims are turned over to the Self-Insurer's Security Fund pursuant to Labor Code Section 3701.5.

(e) In the event of a default, all security deposits, regardless of form that is posted by the self insured employer, shall be the first in order to be called upon to pay benefits due. If any portion of the defaulting self insurer's liabilities are secured in whole or part by an alternative composite deposit posted by the Security Fund, the alternative composite deposit shall be next in order to be called upon to pay benefits due. The Director may at his/her discretion call any portion of the entire security deposit posted at any time without waiting for the exhaustion of all funds in the prior level or call order contained in this subsection.

(f) The Manager shall advise the Self-Insurers' Security Fund of the receipt of any verified information indicating a self-insurer's failure to pay benefits due, the filing of bankruptcy, or inability to post and maintain required security deposit.

(g) The Director, at his/her discretion, may order the Security Fund to assume full liability for any self insurer's insolvency or failure to pay benefits regardless of whether or not there is a shortfall in the deposit to pay benefits due.

HISTORY

1. New section filed 12-22-92; operative 1-21-93 (Register 93, No. 2).

2. Amendment of section and Note filed 5-30-2003 as an emergency; operative 5-30-2003 (Register 2003, No. 22). A Certificate of Compliance must be transmitted to OAL by 9-29-2003 or emergency language will be repealed by operation of law on the following day.

3. Certificate of Compliance as to 5-30-2003 order transmitted to OAL 9-29-2003 and filed 11-12-2003 (Register 2003, No. 46).

Note

Note: Authority cited: Sections 54, 55, 3701.8 and 3702.10, Labor Code. Reference: Sections 59, 129, 3701, 3701.5, 3701.8, 3702, 3702.3, 3702.6, 3703, 3705 and 3740-3745, Labor Code.