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In connection with any such application the following shall be submitted, the Bureau reserving the right to call for such additional information as it may deem necessary in any particular case:

(a) A copy of the last annual report made by the applicant to the insurance department or other authority of the State in which it is incorporated, or to the insurance department of the State of New York, or the State in which its principal business is done.

(b) A certified copy from the proper State authorities of the paper purporting to show the action taken upon such report, or such other evidence as the applicant may care to submit in respect of such report, which may obviate delay incident to an inquiry by the Bureau of the State authorities relative to the standing and responsibility of the applicant.

(c) If not otherwise shown, the applicant shall furnish a full and complete statement of its financial condition, and, if a stock company, shall show specifically its capital stock and surplus.

(d) A copy of its charter or other formal outline of its organization, its rules, its by-laws, and other documents, writings, or agreements by and under which it does business, and such other evidence as it may deem proper to make a full exposition of its affairs and financial condition. 8 32.3 Stock companies holding Treas

ury certificates of authority. A stock company furnishing evidence that it is authorized to write workmen's compensation insurance under the laws of the United States or of any State, which holds a certificate of authority from the Secretary of the Treasury as an acceptable surety on Federal bonds, unless requested to do so, need not transmit to the Bureau with its application copies of such financial reports as are on file in the Department of the Treasury. The acceptance by said Department of such a company will be considered by the Bureau in conjunction with the application of such company provided there has been compliance with the other requirements of the regulations in this subchapter. 8 32.4. Applicants currently authorized

to write insurance under the District of Columbia workmen's compensa.

tion law. Any applicant currently authorized by the Bureau to write insurance under

the District of Columbia workmen's compensation law (45 Stat. 600; 19 D.C. Code 11, 12) need not support its application with the evidence required by the regulations in this subchapter, except the form of policy and endorsement which it proposes to use, unless specifically requested by the Bureau, but instead its application may refer to the fact that it has been so authorized. $ 32.5 Copies of forms of policies to be

submitted with application. With each application for authority to write insurance there shall be submitted for the approval of the Bureau copies of the forms of policies which the applicant proposes to issue in writing insurance under the Longshoremen's Act, to which shall be attached the Longshoremen's endorsement to be used in connection therewith as provided for in § 32.9. § 32.6 Certificate of authority to write

insurance. No corporation, company, association, person, or fund shall write insurance under said act without first having received from the Bureau a certificate of authority to write such insurance. Any such certificate issued by the Bureau, after application therefor as provided by these regulations, may authorize the applicant to write such insurance in a limited territory as determined by the Bureau. The Bureau may suspend or revoke any such certificate prior to its expiration, for good cause shown, after a hearing if applied for or deemed necessary, but no suspension or revocation shall affect the liability of any carrier already incurred. § 32.7 Period of certificate of authority.

No certificate of authority to write insurance under said act and the regulations in this subchapter shall be issued by the Bureau for a period in excess of 18 months and the expiration date thereof, which shall be stated in the certificate of authority, shall fall on the 30th day of June.

32.8 Applications for reauthorization.

Any carrier holding an unexpired certificate of authority and desiring reauthorization to write insurance for the period of a year from the expiration of such certificate shall apply to the Bureau by letter over the signature of its principal oficer for such a certificate of authority. No evidence of the financial condition of such carrier need be furnished with such application unless requested by the Bureau after the application is received. The Bureau may require such carrier to submit for the Bureau's consideration in connection with such reauthorization evidence or explanation relating to the experience and practice of such carrier in the conduct of its affairs with respect to the said act or with reference to the fidelity and punctuality of the performance by such carrier of its past or current obligations under the law. Such application, to avoid break in the period of authorization of the carrier to write such insurance, should be filled with the Bureau not later than June 1 of each year. § 32.9 Longshoremen's endorsement.

(a) The following form of endorsement applicable to the standard workmen's compensation and employer's Liability policy, shall be used with the form of policy approved by the Bureau for use by an authorized carrier:

For attachment to Policy No. ---

The obligations of paragraph one (a) of the policy include the Longshoremen's and Harbor Workers' Compensation Act, being Public Act No. 803 of the 69th Congress, approved March 4, 1927, and all laws amendatory thereof or supplementary thereto which may be or become effective while this policy is in force.

The company will carry out the provisions of section 35 of said act. Insolvency or bankruptcy of the employer and/or discharge therein shall not relieve the Company from payment of compensation and other benefits lawfully due for disability or death sustained by an employee during the life of the policy.

The Company agrees to abide by all the provisions of this act and all lawful rules, regulations, orders, and decisions of the Bureau of Employees' Compensation, Federal Security agency, and of the deputy commissioner, having jurisdiction, unless and until set aside, modified, or reversed by a court having jurisdiction of the parties and the subject matter.

This endorsement shall not be canceled prior to the date specified in this policy for its expiration until at least thirty days have elapsed after a notice of cancelation has been sent to the Deputy Commissioner and to this Employer.

All terms, conditions, requirements, and obligations expressed in this policy or in any other endorsement attached thereto which are not inconsistent with or inapplicable to the provisions of this endorsement are hereby made a part of this endorsement as fully and completely as 11 wholly written herein.

References to the law of any state in Conditions B and D of this policy are hereby declared to include, for the purpose of this endorsement only, the provisions of the Longshoremen's and Harbor Workers' Compensation Act.

(b) The following paragraphs may at the option of the insurer be included in the form of endorsement which is provided above. No other provision, alteration of any prescribed provision, or alteration of any optional provision shall be made or used in any such endorsement except after submission to the Bureau and its specific approval thereof.

If this Employer is a contractor the subJect of whose contract includes operations covered by this policy and he shall subcontract all or any part of such contract to one or more sub-contractors, the remuner. ation of all the direct employees of all such sub-contractors shall be included in the return of remuneration under the provisions of this policy upon which premium is computed. Such remuneration so reported shall be considered the remuneration of employees of this Employer and shall in all instances be governed by the same terms, conditions, requirements, and obligations of the policy as the remuneration of the direct employees of this Employer. The requirements of this paragraph shall not apply as respects any such sub-contractor who has secured compensation for his direct employees as required by the Longshoremen's and Harbor Workers' Compensation Act, but this Employer shall not claim the benefit of this exemption unless and until he shall satisfy the Company by certificate or otherwise that any such subcontractor has legally secured the payment of compensation to his own direct emplovee. and then only respecting any sub-contractor who has furnished such proof.

If the premium as determined in accordance with the provisions of the policy is less than $300, there shall be added thereto en Expense Constant of $10, unless such addition shall increase the premium to an amount in excess of $300, in which event only such part of the Expense Constant shall be added as will bring the amount of the premium up to 8300. Inclusion of the Expense Constant or any part thereof in the Estimated Advance Premium is subject to inal adjustment upon audit, all in accordance with the provisions hereof. The Minimum Premium of the policy Includes the Expense Constant. & 32.10 Other forms of endorsements

and policies. Where the form of endorsement prescribed by $ 32.9 is not appropriate when used in conjunction with a form of policy approved for use by the Bureau, no modi. fication thereof shall be used unless specifically approved by the Bureau. Where the form of policy is designed to

include therein the obligations of the insurer under said act without the use of the Longshoremen's endorsement, the policy shall contain the provisions required to be included in the Longshoremen's endorsement, as stated in said section. The policy may include the optional provisions authorized in said section. Such a policy, however, shall not be used until expressly approved by the Bureau. $ 32.11 Submission of new forms of

policies for approval; other endorse

ments. No new forms of policies or modification of existing forms of policies shall be used by an insurer authorized by the Bureau under the regulations in this subchapter to write insurance under said act except after submission to and approval by the Bureau. No endorsement altering any provisions of a policy approved by the Bureau shall be used except after submission to and approval by the Bureau. $ 32.12 Terms of policies.

A policy or contract of insurance shall be issued for the term of not less than 1 year from the date that it becomes effective, but if such insurance be not needed except for a particular contract or operation, the term of the policy may be limited to the period of such contract or operation. $ 32.13 Marine insurance contracts.

A Longshoremen's policy, or the Longshoremen's endorsement provided for by $32.9 for attachment to a marine policy, may specify the particular vessel or vessels in respect of which the policy applies and the address of the employer at the home port thereof. The card report of the issue of a policy or endorsement required by $ 32.16 to be made by the carrier shall be made to the deputy commissioner for the compensation district in which the home port of such vessel or vessels is located, and such report shall show the name and address of the owner as well as the name or names of such vessel or vessels. § 32.14 Notice of cancelation.

Cancelation of a contract or policy of insurance issued under authority of said act shall not become effective otherwise than as provided by section 36(b) of said act (44 Stat. 1442; 33 U.S.C. 936(b)); and notice of a proposed cancelation shall be given to the deputy commissioner and to

the employer in accordance with the provisions of subdivision (c) of section 12 of said act (44 Stat. 1431; 33 U. S. C. 912 (c)) 30 days before such cancelation is intended to be effective. & 32.15 Discharge by the carrier of ob

ligations and duties of employer. Every obligation and duty in respect of payment of compensation, the providing of medical and other treatment and care, the payment or furnishing of any other benefit required by said act and in respect of the carrying out of the administrative procedure required or imposed by said act or the regulations in this subchapter upon an employer shall be discharged and carried out by the carrier except that the prescribed report of injury or death shall be sent by the employer to the deputy commissioner and to the insurance carrier as required by section 30 of said act (44 Stat. 1439; 33 U.S.C. 930). Such carrier shall be jointly responsible with the employer for the submission of all reports, notices, forms, and other administrative papers required by the deputy commissioner or the Bureau in the administration of said act to be submitted by the employer, but any form or paper so submitted where required therein shall contain in addition to the name and address of the carrier, the full name and address of the employer on whose behalf it is submitted. Notice to or knowledge of an employer of the occurrence of the injury or death shall be notice to or knowledge of such carrier. Jurisdiction of the employer by a deputy commissioner, the Bureau, or any court under said act shall be jurisdiction of such carrier. Any requirement by a deputy commissioner, the Bureau, or any court under any compensation order, finding, or decision shall be binding upon such carrier in the same manner and to the same extent as upon the employer. (Sec. 85, 44 Stat. 1441; 38 U. S. C. 935) 8 32.16 Report by carrier of issuance of

policy or endorsement; form. A carrier which has executed the agreement provided for in $ 32.18 shall report to the deputy commissioner assigned to a compensation district each policy and endorsement issued by it to an employer who carries on operations in such compensation district. The report shall be made upon a printed card to be provided by such carrier. Such card shall be 50 percent rag, white, light

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Date notice received by deputy This card to be sent to the Deputy Commissioner of the Bureau of Employees' Com. pensation, Federal Security Agency, in the compensation district indicated by the Employer's address.

Each such carrier will print its name at the place indicated. The note at the bottom designating the place to which the card shall be sent should be in small type, about 6 point, and if desired this designation may be printed on the back of the card. The space below the word "employer" should be suficient to allow two additional lines of typewriting and space should be left to allow two additional lines for typing below the word "address." The word "employer" should be about 34 of an inch from the top margin. The line for cancelation date will be filled in only by the office of the deputy commissioner. § 32.17 Report; by whom sent.

The report of issuance of a policy and endorsement provided for in § 32.16 shall be sent by the home ofice of the carrier, except that any carrier may authorize its agency or agencies in any compensation district to make such reports to the deputy commissioner, provided the carrier shall notify the deputy commissioner in such district of the agencies so duly authorized § 32.18 Agreement to be bound by card

report. Except as provided in this section, each employer shall present to the deputy commissioner in the compensation district in which he has operations the policy which he has procured in compliance with section 32 of said act (44 Stat. 1439; 33 U. S. C. 932) covering his operations in such district. Any carrier desiring to do so may make such presentation of such policy unnecessary in any particular case by transmitting to

the Bureau an agreement signed by its President and Secretary (or other authorized officers in case of foreign or mutual companies or State funds), in the following form, and making reports accordingly of the issuance of a policy in such particular case: The

------ Insurance Company hereby agrees. In consideration of the acceptance by the Bureau of Amployees' Oompensation, United States Department of Labor, and its deputy commissioners of reports of issue of approved form of policy and endorsement under the Longshoremen's and Harbor Workers' Compensation Act in the form prescribed by the Bureau in 82.16 of its regulations, that it will be lable and hereby accepts the full lability expressed in the approved form of endorsement under said Longshoremen's Act in all cases in which it has heretofore and may hereafter 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.


SELF-INSURERS Sec. 89.1 Employers who may be authorized as

self-Insurers. 88.2 Application for authority to become &

self-insurer; how filed; information to be submitted; other require

ments. 33.8 Decision upon application of em

ployer; deposit of negotiable securi

ties or indemnity bond. 83.4 Filing of agreement and undertaking. 83.5 Decision upon application of em

ployer; furnishing of indemnity bond or deposit of negotiable securi

ties required. 83.6 Kinds of negotiable securities which

may be deposited; conditions of de

posit; acceptance of deposits. 33.7 Deposits of negotiable securities with

Federal Reserve banks; authority to

sell such securities; interest thereon. 33.8 Substitution and withdrawal of nego

tiable securities. 83.9 Increase or reduction in the amount

of indemnity bond or negotiable 89

curities. 88.10 Reports required of self-Insurers; ex

amination of accounts of sell-in

surer. 83.11 Period of authorization as sell-in

surer; renewals. 83.12 Revocation of privilege of self-insur

ance. AUTHORITY: The provisions of this part 83 issued under sec. 39, 44 Stat. 1442; 38 U.S.C. 989.

SOURCE: The provisions of this Part 38 contained in Regulations under the Longshoremen's and Harbor Workers' Compensation Act, May 31, 1938, unless otherwise noted. § 33.1 Employers who may be author

ized 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. 8. C. 932 (a) (2)) and the regulations in this subchapter. § 33.2 Application for authority to be

come a self-insurer; how filed; in. formation 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) & 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 afixed. 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.

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