287.280. Employer's entire liability to be covered, self-insurer or approved carrier--exception--group of employers may qualify as self-insurers--uniform experience rating plan--failure to insure, - Missouri Statutes

Employer's entire liability to be covered, self-insurer or approvedcarrier--exception--group of employers may qualify asself-insurers--uniform experience rating plan--failure to insure,effect--rules--confidential records.

287.280. 1. Every employer subject to the provisions of this chaptershall, on either an individual or group basis, insure his entire liabilitythereunder, except as hereafter provided, with some insurance carrierauthorized to insure such liability in this state, except that an employer orgroup of employers may themselves carry the whole or any part of the liabilitywithout insurance upon satisfying the division of their ability so to do. Ifan employer or group of employers have qualified to self-insure theirliability under this chapter, the division of workers' compensation may, if itfinds after a hearing that the employer or group of employers are willfullyand intentionally violating the provisions of this chapter with intent todefraud their employees of their right to compensation, suspend or revoke theright of the employer or group of employers to self-insure their liability.If the employer or group of employers fail to comply with this section, aninjured employee or his dependents may elect after the injury either to bringan action against such employer or group of employers to recover damages forpersonal injury or death and it shall not be a defense that the injury ordeath was caused by the negligence of a fellow servant, or that the employeehad assumed the risk of the injury or death, or that the injury or death wascaused to any degree by the negligence of the employee; or to recover underthis chapter with the compensation payments commuted and immediately payable;or, if the employee elects to do so, he or she may file a request with thedivision for payment to be made for medical expenses out of the second injuryfund as provided in subsection 5 of section 287.220. If the employer or groupof employers are carrying their own insurance, on the application of anyperson entitled to compensation and on proof of default in the payment of anyinstallment, the division shall require the employer or group of employers tofurnish security for the payment of the compensation, and if not given, allother compensation shall be commuted and become immediately payable; provided,that employers engaged in the mining business shall be required to insure onlytheir liability hereunder to the extent of the equivalent of the maximumliability under this chapter for ten deaths in any one accident, but theemployer or group of employers may carry their own risk for any excessliability. When a group of employers enter into an agreement to pool theirliabilities under this chapter, individual members will not be required toqualify as individual self-insurers.

2. Groups of employers qualified to insure their liability pursuant tochapter 537, RSMo, or this chapter, shall utilize a uniform experience ratingplan promulgated by an approved advisory organization. Such groups shalldevelop experience ratings for their members based on the plan. Nothing inthis section shall relieve an employer from remitting, without any charge tothe employer, the employer's claims history to an approved advisoryorganization.

3. For every entity qualified to group self-insure their liabilitypursuant to this chapter or chapter 537, RSMo, each entity shall not authorizetotal discounts for any individual member exceeding twenty-five percentbeginning January 1, 1999. All discounts shall be based on objectivequantitative factors and applied uniformly to all trust members.

4. Any group of employers that have qualified to self-insure theirliability pursuant to this chapter shall file with the division premium rates,based on pure premium rate data, adjusted for loss development and losstrending as filed by the advisory organization with the department ofinsurance, financial institutions and professional registration pursuant tosection 287.975, plus any estimated expenses and other factors or based onaverage rate classifications calculated by the department of insurance,financial institutions and professional registration as taken from the premiumrates filed by the twenty insurance companies providing the greatest volume ofworkers' compensation insurance coverage in this state. The rate isinadequate if funds equal to the full ultimate cost of anticipated losses andloss adjustment expenses are not produced when the prospective loss costs areapplied to anticipated payrolls. The provisions of this subsection shall notapply to those political subdivisions of this state that have qualified toself-insure their liability pursuant to this chapter as authorized by section537.620, RSMo, on an assessment plan. Any such group may file with thedivision a composite rate for all coverages provided under that section.

5. Any finding or determination made by the division under this sectionmay be reviewed as provided in sections 287.470 and 287.480.

6. No rule or portion of a rule promulgated under the authority of thissection shall become effective unless it has been promulgated pursuant to theprovisions of section 536.024, RSMo.

7. Any records submitted pursuant to this section, and pursuant to anyrule promulgated by the division pursuant to this section, shall be consideredconfidential and not subject to chapter 610, RSMo. Any party to a workers'compensation case involving the party that submitted the records shall be ableto subpoena the records for use in a workers' compensation case, if theinformation is otherwise relevant.

(RSMo 1939 § 3713, A.L. 1957 p. 560, A.L. 1965 p. 397, A.L. 1974 S.B. 417, A.L. 1980 H.B. 1396, A.L. 1981 S.B. 382, A.L. 1993 S.B. 251, A.L. 1995 S.B. 3, A.L. 1998 H.B. 1237, et al.)

Prior revision: 1929 § 3323

(1959) Insurer of partnership operating glass company held not obligated under terms of workmen's compensation policy to defend action by a farm employee of one of the parties for injuries sustained in the course of his employment on the farm. McKinney v. Truck Ins. Exchange (A.), 324 S.W.2d 773.

(1973) Where employer is uninsured and claimant elects to recover damages from employer, the operative facts are those on the date of death of employee and claimant may recover a commuted award without regard to later contingencies. Mays v. Williams (Mo.), 494 S.W.2d 289.