Do you have questions on the Guarantee Insurance Company Liquidation? On November 27, 2017, Guarantee Insurance Company (“GIC”) was ordered into liquidation by the Second Judicial Circuit Court in Leon County, Florida (“Court”). The Florida Department of Financial Services is the court-appointed Receiver of the company. The Florida Receiver began working to transition claim files and claim data to the New York Workers Compensation Security Fund (NYWCSF). However, as of January 03, 2018 the Ancillary Receivership Order has not been approved, causing a delay in the transition and processing of open and new claims.
Employers insured through GIC began receiving notifications from the New York Liquidation Bureau (NYLB) on specific claims, advising of the delayed transition and that employers would be responsible for providing WC benefits. Payments made by employers may be reimbursed if the claim is covered and subject to the WCB rates.
This poses a significant challenge for employers who are not equipped to decide which claims to pay, how much to pay and what documentation may be sufficient to seek reimbursement. In an effort to assist folks struggling with this unfortunate turn of events contact was made with the New York Liquidation Bureau to get instructions regarding employer responsibilities pending the transition.
We learned that the Ancillary Receivership Order is expected to be signed by a judge at a hearing scheduled for January 25, 2017. Until that time, it was recommended employers handle existing and new claims as follows:
- New claims should be reported through the normal channels to get the claim on record. If the employee is losing time from work the employer should seek medical documentation regarding the disability. If the disability exceeds 7 days, we recommend employers pay at the minimum rate of $150.00 until the transition takes place or until the Workers Compensation Board establishes the appropriate rate. Paying the minimum ensures payments are made timely to the injured worker but limits the risk of an overpayment.
- On existing claims where benefits were being disbursed, the injured worker was already receiving compensation benefits will continue to be paid for a period of time. It was not specified who is making those payments, but it seems the employer does not need to initiate disability payments on these claims.
- On the handling of newer claims where a compensability decision was not made by Guarantee Insurance, this is more of a gray area. It is possible some of these claims need investigations completed and potentially a controversion filed (formal denial). To protect employers from potential fines or other adverse consequences, it may be necessary to hire an independent adjuster to conduct a compensability investigation. If the investigation warrants a controversion, clients may need to hire an attorney to assist with filing the forms with the Workers Compensation Board. We recommend you contact your claims advocate for assistance with cases like this. We can recommend an independent adjusting firm and law firm. We will also assist with the assignment to ensure only the necessary work is performed. It is not clear at this point if these expenses would be reimbursed once the transition takes place.
- Our contact @ (NYLB) indicated employers are not expected to pay medical bills. If the order is signed late January as expected, medical bills will be processed by an assigned claims administrator.
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