What happens when an insurance carrier defaults on its obligations under the Longshore and Harbor Workers' Compensation Act due to insolvency?
I’ll discuss several insolvency scenarios in four separate entries. Part One will cover default by an insurance carrier, Part Two will cover defaults by both the insolvent insurance carrier and by the insured employer due to bankruptcy, Part Three will cover uninsured employer bankruptcy, and Part Four will cover the bankruptcy of an authorized self-insured employer. Here is Part One. The other Parts will appear intermittently in the future.
PART ONE – INSURANCE CARRIER INSOLVENCY
First, what are the consequences to the insured employer if its insurance carrier becomes insolvent?
Section 935 of the Longshore Act (33 U.S.C. 935) provides that discharge of an obligation by an insurance carrier discharges the employer’s liability. If the insurance carrier defaults, thus failing to discharge this obligation, then the primary obligation remains with/returns to the insured employer.
PARENTHETICAL NOTE: In the reverse situation, that is, the insured employer becomes bankrupt, section 936(a) provides that, “Every policy or contract of insurance issued under authority of this Act shall contain…(2) a provision that insolvency or bankruptcy of the employer and/or discharge therein shall not relieve the carrier from payment of compensation for disability or death sustained by an employee during the life of such policy or contract.” This provision refers to first dollar insurance policies issued by insurance carriers authorized by the U.S. Department of Labor to write coverage under the Longshore Act as required by section 932. It does not apply to reinsurance or excess insurance contracts.
So, Mr. Employer, if your insurance carrier becomes insolvent and defaults then you must immediately assume responsibility for all benefits due and payable (and all interest and penalty provisions of the Act apply).
Here is a generic sequence of events when an insurance carrier becomes insolvent:
Here is what the insured employer must do if its insurance carrier becomes insolvent:
Note that the Special Fund administered by DOL is not yet involved. The Special Fund under section 918(b) provides the injured employee with a possible source of payments if there is a default by an employer, not a default by an insurance carrier.
And especially note that in the event of an insurance carrier insolvency and default it is likely that the DOL will take the position that any collateral it holds will be reserved for those cases that cannot be paid because both the carrier and the insured employer are insolvent. In other words, solvent insured employers will be required to pay their own cases. In states like California and West Virginia, where the state guarantee funds do not pay benefits in Longshore cases, and in states like Louisiana and New Jersey, whose guarantee funds pay only under restricted conditions, the insured employers are exposed to possible significant liability for their Longshore Act obligations. For a more complete discussion of the various states please refer back to the August 5, 2010 discussion.
Main Point Number One: Under the Longshore Act, when an insurance carrier becomes insolvent and defaults, the insured employer must immediately meet its primary obligation to assume responsibility for and to pay its own claims.
Main Point Number Two: In many states maritime employers cannot rely on protection from state guarantee funds. As noted, this blog’s August 5, 2010 entry contained detailed information with regard to the expected responses of each state guarantee fund in the event of an insurance carrier’s default in Longshore cases.
Next: What if both the insurance carrier is insolvent and the insured employer is bankrupt?