Forms and Rate Regulation Applicable to Workers' Compensation

Section 412:35

    412:35 Auditable Basis Policies. –
I. All workers' compensation policies issued in this state shall be issued on an auditable basis. A final premium shall be charged based upon actual exposure existing during the term of the policy coverage.
II. Audits shall be conducted by either physical inspection of an insured's records and operations, or by telephone or mail request by the insurer to the insured.
III. Audits shall be completed promptly, no more than 120 days after the expiration or cancellation of the policy, provided that there is no bona fide dispute. Any insurer that violates the provisions of this paragraph shall be subject to the penalty provisions of RSA 412:40.
IV. (a) In cases where there is a bona fide dispute, the insurer shall notify the insured in writing that there is a bona fide dispute and this notice shall toll the 120-day time period until the dispute is resolved. Upon resolution of the dispute, the insurer shall proceed to complete the audit within the time remaining in the 120-day time period. A bona fide dispute includes the insured's failure to cooperate with the audit, provided the insurer has notified the insured of:
(1) The acts or omissions that constitute the insured's failure to cooperate; and
(2) The consequences of the insured's failure to cooperate, including delay in the completion of the audit.
(b) The consequence of the insured's failure to cooperate with this paragraph within 30 days of the notice shall be the assessment of a penalty equaling 3 times the estimated premium and setting the estimated premium as the final premium. Upon receipt of the penalty and final premium, the insured shall have an additional 10 days to request that the penalty be waived and to have the final premium be recalculated based upon actual exposure by completing the audit that is required by paragraph III. No timely request by an insured for a waiver and recalculation shall be denied by the insurer. The request shall be granted upon completion of the audit.
V. Gross unearned premium shall be returned pursuant to RSA 402:81.

Source. 2003, 150:1. 2008, 211:1. 2014, 31:9, eff. July 26, 2014. 2020, 37:119, eff. Sept. 27, 2020.