use the prescribed form of report to deputy commissioners and transmits the same to the proper deputy commissioner; and it further agrees that such liability shall not be terminated prior to the expiration of the policy, except in case of cancelation, and then at the time and in the manner which is prescribed in said law, in the regulations of said Bureau, and in the Longshoremen's endorsement referred to.

An insurance carrier desiring to withdraw from such agreement may do so upon giving 30 days' notice to the Bureau by registered mail.

§ 32.19

Report by employer operating temporarily in another compensation district.

Where an employer having operations in one compensation district contemplates engaging in work subject to the said act in another compensation district, a carrier which has executed the agreement provided for by § 32.18 may submit to the deputy commissioner of such latter district a report on the card form prescribed by § 32.16, containing the address of the employer in the first mentioned district with the additional notation "No present address in compensation district. Certificate requested when address given." § 32.20

Name of one employer only shall be reported on one card.

A separate report of the issuance of a policy and endorsement, provided for by § 32.16, shall be made for each employer covered by a policy. If a policy is issued insuring more than one employer, a separate card report for each employer so covered shall be sent to the deputy commissioner concerned, with the name of only one employer on each such report.

§ 33.1

Employers who may be authorized as self-insurers.

The Bureau will consider for the granting of authority to secure by selfinsurance the payment of compensation under the Longshoremen's and Harbor Workers' Compensation Act (44 Stat. 1424; 33 U.S.C. Chapter 18) any employer who pursuant to the regulations in this subchapter furnishes to the Bureau proof satisfactory to it of his financial ability to pay such compensation directly. The following regulations in this subchapter require the deposit of security in the form either of an indemnity bond or negotiable securities (at the option of the employer) of a kind and in an amount determined by the Bureau, and prescribe the conditions under which such deposit shall be made. The term "self-insurer" as used in the regulations in this subchapter means any employer securing compensation in accordance with the provisions of section 32 (a) (2) of said act (44 Stat. 1439; 33 U. S. C. 932 (a) (2)) and the regulations in this subchapter.

§ 33.2 Application for authority to become a self-insurer; how filed; information to be submitted; other requirements.

Application for authority to become a self-insurer may be made by any employer desiring such privilege and shall be addressed to the Bureau and be made upon a form provided by the Bureau. Such application shall contain (a) a statement of the employer's pay roll report for the preceding 12 months; (b) a

statement of the average number of employees engaged in whole or in part in maritime employment upon the navigable waters of the United States (including any drydock), within the purview of said act, for the preceding 12 months; (c) a statement of the number of injuries to such employees resulting in disability of more than 7 days duration, or in death, during each of 3 years next preceding the date of the application; (d) an itemized statement of the assets and liabilities of the employer; (e) a description of the safety organization maintained by the employer for the prevention of injuries within his places of work; (f) a description of the facilities maintained or the arrangements made for the medical and hospital care of injured employees. The Bureau may in its discretion require the applicant to submit such further information or such evidence as the Bureau may deem necessary to have in order to enable it to give adequate consideration to such application. Such application shall be signed by the applicant over his typewritten name and if the applicant is not an individual, by the principal officer of the applicant duly authorized to make such application over his typewritten name and official designation and shall be sworn to by him. If the applicant is a corporation the corporate seal shall be affixed. The application shall be filed with the Bureau in Washington, D. C. The regulations in this part shall be binding upon each applicant hereunder and the applicant's consent to be bound by all requirements of the said regulations shall be deemed to be included in and a part of the application, as fully as though written therein. § 33.3 Decision upon application of employer; deposit of negotiable securities or indemnity bond.

The decision of the Bureau to grant an application of an employer for authority to pay compensation under said act as a self-insurer will be transmitted to the applicant on a form prescribed by the Bureau. Such grant shall be conditioned upon a deposit of security in the form of an indemnity bond or of negotiable securities in an amount fixed by the Bureau, and the execution and filing of an agreement and undertaking in the form prescribed by the Bureau, as provided by § 33.4.

§ 33.4 Filing of agreement and undertaking.

The applicant for the privilege of

self-insurance shall as a condition precedent to receiving authorization to act as a self-insurer, execute and file with the Bureau an agreement and undertaking in a form prescribed and provided by the Bureau in which the applicant shall agree (a) to pay when due, as required by the provisions of said act, all compensation payable on account of injury or death of any of its employees injured within the purview of said act; (b) in such cases to furnish medical, surgical, hospital, and other attendance, treatment and care as required by the provisions of said act; (c) to deposit with the Bureau an indemnity bond in the amount which the Bureau shall fix, or to deposit negotiable securities as provided for by the regulations in this subchapter in the amount which the Bureau shall fix, accordingly as elected in the application; (d) to authorize the Bureau to sell such negotiable securities so deposited or any part thereof and from the proceeds thereof to pay such compensation, medical, and other expense and any accrued penalties imposed by law as it may find to be due and payable. § 33.5 Decision upon application of employer; furnishing of indemnity

bond or deposit of negotiable securities required.

The applicant for the privilege of self-insurance, as a condition precedent to receiving authorization to act as a self-insurer, shall give security for the payment of compensation and the discharge of all other obligations under the said act, in the amount fixed by the Bureau, which may be in the form of an indemnity bond with sureties satisfactory to the Bureau, or of a deposit of negotiable securities as provided in the regulations in this part. The amount of such security so to be fixed and required by the Bureau shall be such as the Bureau shall deem to be necessary and sufficient to secure the performance by the applicant of all obligations by the said act imposed upon him as an employer, but shall not be less than $10,000 in the case of any one employer. fixing the amount of such security the Bureau will take into account the financial standing of the employer, the nature of the work in which he is engaged, the hazard of the work in which the employees are employed, the pay-roll exposure, and the accident experience as shown in the application and the Bureau's records, and any other facts which

In

it may deem pertinent. Additional security may be required at any time in the discretion of the Bureau. The indemnity bond which is required by the regulations in this part shall be in such form, and shall contain such provisions, as the Bureau may prescribe: Provided, That only corporations may act as sureties on such indemnity bonds. In each case in which the surety on any such bond is a surety company, such company must be one approved by the United States Treasury Department under the laws of the United States and the applicable rules and regulations governing bonding companies.

[4 F.R. 1699, Apr. 27, 1939]

§ 33.6

Kinds of negotiable securities which may be deposited; conditions of deposit; acceptance of deposits. An applicant for the privilege of selfinsurance electing to deposit negotiable securities to secure his obligations under said act in the amount fixed by the Bureau under the regulations in this subchapter shall deposit only the following kinds of securities under the following conditions:

(a) Coupon bonds, notes, and certificates of indebtedness of the United States Government, of any issue, including interim certificates or receipts for payments therefor; all at par.

(b) Coupon bonds issued under the United States Farm Loan Act, bonds of the War Finance Corporation, bonds of Puerto Rico, and bonds and certificates of indebtedness of the Philippine Islands; all at par.

(c) The 32 percent coupon bonds of the Territory of Hawaii at 90 percent of market value; and other coupon bonds of said Territory at market value.

(d) Coupon bonds of any State of the United States, at market value; and approved notes, certificates of indebtedness, and warrants issued by any State of the United States, at 90 percent of market value.

(e) Any negotiable securities acceptable as security for the deposit of public moneys of the United States under regulations issued by the Secretary of the Treasury.

(f) No security shall be valued at more than par. No bond, obligation, or evidence of indebtedness shall be accepted if the obligor therein has made default during the past 10 years in payment of principal or interest of any bond issued by it.

(g) The approval, valuation, acceptance, and custody of such securities is hereby committed to the several Federal Reserve Banks when authorized under the regulations in this subchapter to receive deposits of such securities.

CROSS REFERENCE: For Treasury regulations relating to securities acceptable as security for the deposit of public moneys, see 31 CFR 203.7, 203.8.

§ 33.7

Deposits of negotiable securities with Federal Reserve banks; authority to sell such securities; interest thereon.

Deposits of securities provided for by the regulations in this subchapter shall be made with any Federal Reserve bank or any branch of a Federal Reserve bank designated by the Bureau and shall be held subject to the order of the Bureau with power in the Bureau, in its discretion in the event of default by the said self-insurer, to collect the interest and the principal as they may become due, to sell the securities or any of them as may be required to discharge the obligations of the self-insurer under said act and to apply the proceeds to the payment of any compensation or medical expense for which the self-insurer may be liable. The Bureau may, however, whenever it deems it unnecessary to resort to such securities for the payment of compensation, authorize the self-insurer to collect interest on the securities deposited by him. § 33.8

Substitution and withdrawal of negotiable securities.

No substitution or withdrawal of negotiable securities deposited by a selfinsurer shall be made except upon authorization by the Bureau. A selfinsurer discontinuing business, or discontinuing operations within the purview of said act, or providing security for the payment of compensation by insurance under the provisions of said act may apply to the Bureau for the withdrawal of securities deposited under the regulations in this subchapter. With such application shall be filed a sworn statement setting forth (a) a list of all outstanding cases in each compensation district in which compensation is being paid, with the names of the employees and other beneficiaries, giving a description of causes of injury or death, and a statement of the amount of compensation paid; (b) a similar list of all pending cases in which no compensation has as yet been paid; and (c) a similar list of all

Whenever in the opinion of the Bureau the principal sum of the indemnity bond filed or the amount of negotiable securities deposited by a self-insurer is insufficient to afford adequate security for the payment of compensation and medical expenses under said act, the selfinsurer shall, upon demand by the Bureau, file such additional indemnity bond or deposit under the regulations in this subchapter such additional amount of negotiable securities as the Bureau may require. At any time upon application of a self-insurer, or on the initiative of the Bureau, when in its opinion the facts warrant, the principal sum of an indemnity bond required to be given or the amount of negotiable securities required to be deposited may be reduced, but not beyond the minimum fixed in § 33.5. A self-insurer seeking such reduction shall furnish such information as the Bureau may request relative to his current affairs, the nature and hazard of the work of his employees, the amount of the pay roll of his employees engaged in maritime employment within the purview of the said act, his financial condition, his accident experience, and such other evidence as may be deemed material, including a record of payments of compensation made by him.

§ 33.10 Reports required of self-insurers; examination of accounts of self-insurer.

At such times as the Bureau may require or prescribe, each self-insurer shall submit such of the following reports as may be requested:

(a) A sworn itemized statement of the self-insurer's assets and liabilities, or a balance sheet.

(b) A sworn statement showing by classifications the pay roll of employees of the self-insurer who are engaged in

maritime employment within the purview of the said act. For this purpose Form LSI-8 has been prescribed.

(c) A sworn statement of payments of compensation in current cases during any specified quarter, showing the nature of injury in each case. For this purpose Form LSI-9 has been prescribed.

(d) A sworn statement covering the 6 months' period preceding the date of such report, listing by compensation districts all death and injury cases which have occurred during such period, together with a report of the status of all outstanding claims, showing the particulars of each case. For this purpose Form LSI-10 has been prescribed.

Whenever it deems it to be necessary, the Bureau may inspect or examine the books of account, records, and other papers of a self-insurer for the purpose of verifying any financial statement submitted to the Bureau by such self-insurer or verifying any information furnished to the Bureau in any report required by this section, or any other section of the regulations in this subchapter, and such self-insurer shall permit the Bureau or its duly authorized representative to make such an inspection or examination as the Bureau shall require. In lieu of this requirement the Bureau may in its discretion accept an adequate report of a certified public accountant. § 33.11

Period of authorization as selfinsurer; renewals.

No initial authorization as a self-insurer shall be granted for a period in excess of eighteen months, and the expiration date thereof shall fall on the 30th day of June. A self-insurer who has made an adequate deposit of negotiable securities as required by the Bureau under the regulations in this subchapter will be reauthorized for the ensuing fiscal year without additional security if the Bureau finds that his experience as a self-insurer warrants such action. A self-insurer who currently has on file an indemnity bond, will receive from the Bureau on or about May 10 of each year a bond form for execution in contemplation of reauthorization, and the submission of such bond duly executed in the amount indicated by the Bureau will be deemed and treated as such self-insurer's application for reauthorization for the ensuing fiscal year; the privilege of such self-insurer will, however, terminate with the termination of his current

Every employer who has secured the payment of compensation as provided by section 32 of said act and by the regulations in this subchapter will receive from the deputy commissioner in the compensation district in which he has operations a certificate that such employer has secured the payment of such compensation. Only one such certificate will be issued to an employer in a compensation district, and it will be valid only during the period for which such employer has secured such payment. An employer so desiring may have photostatic copies of such a certificate made for use in different places within the compensation district. A certificate of compliance will be issued by the deputy commissioner to any employer having operations in his district (a) upon receipt by the deputy commissioner and acceptance by him of a card report of the issuance of a policy to the employer concerned, as provided by § 32.16 of this subchapter, by an authorized insurance carrier which has filed an agreement to

be bound by such card report in conformity with § 32.18 of this subchapter, or (b) upon presentation to the deputy commissioner by the employer concerned (and not by an insurance carrier, insurance agent, or broker) of the policy of insurance, and endorsement thereon, issued to the employer in conformity with Part 32 of this subchapter, by an authorized insurance carrier which has not filed the agreement provided for by § 32.18 of this subchapter, or (c) upon receipt by the deputy commissioner of advice from the Bureau that the employer concerned has been duly authorized by the Bureau as a self-insurer under Part 33 of this subchapter. Three forms of such certificates have been provided by the Bureau, one form for use where the employer has obtained insurance generally under these regulations in this subchapter, one for use where the employer has been authorized as a self-insurer, and one for use in cases where a policy has been issued limited to a particular specified vessel or vessels in respect of which employment within the purview of said act is carried on by the insured. Such last named certificate shall be accepted as evidence of compliance with said act in any district in which the vessel or vessels named therein may touch in the course of their voyages; but such certificate shall in no case be accepted in lieu of a certificate of compliance on the part of any employer other than the owners and operators of the vessel or vessels named therein.

§ 34.2 Same; employer operating temporarily in another compensation district.

A deputy commissioner receiving a card report of the issue of a policy of insurance with the notation authorized by § 32.19 of this subchapter, will file such card report until he receives from the insured employer named therein a request for a certificate of compliance, giving the address of the employer within the compensation district of such deputy commissioner. Upon receipt of such a request the deputy commissioner will send the proper certificate of compliance to such employer at such address.

§ 34.3 Return of certificates of compliance.

Upon the termination by expiration, cancelation or otherwise, of a policy of insurance issued under the provisions