§ 662 - Agreements; required payments in absence of
§ 662. Agreements; required payments in absence of
(a) If the employer and an injured employee or the dependents of a deceased employee enter into an agreement in regard to compensation payable under the provisions of this chapter, a memorandum thereof shall be filed with the commissioner. If approved by the commissioner, such agreement shall be enforceable and subject to modification as provided by sections 668 and 675 of this title. The commissioner shall approve such an agreement only when the terms thereof conform to the provisions of this chapter. However, a compromise agreement may be approved by the commissioner when he or she is clearly of the opinion that the best interests of such employee or such dependents will be served thereby. A compromise settlement during pendency of an appeal to superior court or to supreme court shall be effective only with the approval of the commissioner in accordance with this section.
(b) In the absence of an agreement pursuant to subsection (a) of this section, the employer or insurance carrier shall notify the commissioner and the employee in writing that the claim is denied and the reasons therefor. Upon the employee's application for a hearing under section 663 of this title, within 60 days, the commissioner shall review the evidence upon which denial is based and if the evidence does not reasonably support the denial, the commissioner shall order that payments be made until a hearing is held and a decision is rendered. Payments pursuant to this subsection shall not be deemed an admission of liability by the employer nor shall such payments preclude subsequent agreement under subsection (a) of this section or prejudice the rights of either party to hearing or appeal under this chapter. If the commissioner's decision, after a hearing, is that the employee was not entitled to any or all benefits paid between the initial denial and the final decision, upon request of the employer, the commissioner may order that the employee repay all benefits to which the employee was not entitled. The employer may enforce such a repayment order in any court of law having jurisdiction of the amount involved. Nothing in this section shall require the commissioner to order payments pending a hearing if the commissioner concludes that the benefit at issue is not compensable regardless of the lack of evidence supporting the denial. For the purposes of this section, any written communication by an unrepresented claimant that questions the denial of any benefit shall be deemed to be an application for hearing under section 663 of this title.
(c) Whenever payment of a compensable claim is refused, on the basis that another employer or insurer is liable, the commissioner, after notice to interested parties and a review of the claim, but in no event later than 30 days, shall order that payments be made by one employer or insurer until a hearing is held and a decision is rendered. For the purposes of this review, the employer or insurer at the time of the most recent personal injury for which the employee claims benefits shall be presumed to be the liable employer or insurer and shall have the burden of proving another employer's or insurer's liability. Payments pursuant to this subsection shall not be deemed an admission or conclusive finding of an employer's or insurer's liability nor shall payments preclude subsequent agreement under subsection (a) of this section or prejudice the rights of either party to a hearing or appeal under this chapter.
(d) Where more than one employer or insurer may be liable for an employee's occupational disease, the employer in whose service the employee was last injuriously exposed to the hazard that caused the disease, and the insurance carrier, if any, on the risk when the employee was last exposed, shall be liable if it can be proven that the service for the last employer causally contributed to the disease.
(e) In any dispute between employers and insurers arising under subsection (c) or (d) of this section, after payment to the claimant, the commissioner may order that the dispute be resolved through arbitration rather than the formal hearing process under sections 663 and 664 of this title. Qualifications for arbitrators and standards for the arbitration process shall be established by the commissioner by rule. If arbitration is ordered, the process shall proceed as follows:
(1) The parties shall select an arbitrator from a list provided by the commissioner.
(2) The arbitrator shall:
(A) Determine apportionment of the liability for the claim, including costs and attorney fees, among the respective employers or insurers, or both. The apportionment may be limited to one or more parties. If the parties do not agree, the costs of arbitration may be apportioned among the parties by the arbitrator.
(B) Issue a written decision which shall be final. (Amended 1973, No. 193 (Adj. Sess.), § 3, eff. April 9, 1974; 1981, No. 204 (Adj. Sess.), § 9; 1983, No. 164 (Adj. Sess.), eff. April 20, 1984; 1993, No. 225 (Adj. Sess.), § 10a; 1999, No. 41, § 7; 1999, No. 97 (Adj. Sess.), § 4; 2005, No. 212 (Adj. Sess.), § 6, eff. May 29, 2006.)