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Engrossed Version Senate Bill 531 History

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WEST virginia legislature

2019 regular session

Engrossed

Senate Bill 531

By Senator Trump

[Introduced February 5, 2019; Referred
to the Committee on Banking and Insurance
]

A BILL to amend and reenact §23-5-7 of the Code of West Virginia, 1931, as amended, relating generally to workers’ compensation claims pending in the administrative or appellate process; and providing that hearing loss and impairment claims are not occupational disease claims for the purpose of the requirement that a claimant be represented by counsel in a settlement for medical benefits.

Be it enacted by the Legislature of West Virginia:


ARTICLE 5. REVIEW.


§23-5-7. Compromise and settlement.

(a) The claimant, the employer, and the Workers’ Compensation Commission, the successor to the commission, other private insurance carriers, and self-insured employers, whichever is applicable, may negotiate a final settlement of any and all issues in a claim wherever the claim is in the administrative or appellate processes: Provided, That in the settlement of medical benefits for nonorthopedic occupational disease claims, the claimant shall be represented by legal counsel: Provided, however, That for the purposes of this section, the term “nonorthopedic occupational disease claim” does not include an occupational hearing loss or hearing impairment claim. If the employer is not active in the claim, the commission, the successor to the commission, other private insurance carriers, and self-insured employers, whichever is applicable, may negotiate a final settlement with the claimant and the settlement shall be made a part of the claim record. Except in cases of fraud, no issue that is the subject of an approved settlement agreement may be reopened by any party, including the commission, the successor to the commission, other private insurance carriers, and self-insured employers, whichever is applicable. Any settlement agreement may provide for a lump-sum payment or a structured payment plan, or any combination thereof, or any other basis as the parties may agree. If a self-insured employer later fails to make the agreed-upon payment, the commission shall assume the obligation to make the payments and shall recover the amounts paid or to be paid from the self-insured employer and its sureties or guarantors, or both, as provided in §23-2-5 or §23-2-5a of this code.

(b) Each settlement agreement shall provide the toll-free number of the West Virginia State Bar Association and shall provide the injured worker with five business days to revoke the executed agreement. The Insurance Commissioner may void settlement agreements entered into by an unrepresented injured worker which are determined to be unconscionable pursuant to criteria established by rule of the commissioner.

(c) The amendments to this section enacted during the regular session of the Legislature, 2015, apply to all settlement agreements executed after the effective date.


 

 

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