Nevada § 616C.220 - Compensation from Uninsured Employers' Claim Account: Administration and payment of claims; eligibility of employee; liability of employer; powers and duties of Division; appeals; collection

§ 616C.220. Compensation from Uninsured Employers' Claim Account: Administration and payment of claims; eligibility of employee; liability of employer; powers and duties of Division; appeals; collection

1. The Division shall designate one: (a) Third-party administrator who has a valid certificate issued by the Commissioner

pursuant to NRS 683A.085 ; or (b) Insurer, other than a self-insured employer or association of self-insured public

or private employers, to administer claims against the Uninsured Employers' Claim Account. The designation must be made pursuant to reasonable competitive bidding procedures

established by the Administrator. 2. Except as otherwise provided in this subsection, an employee may receive compensation

from the Uninsured Employers' Claim Account if: (a) The employee was hired in this State or is regularly employed in this State; (b) The employee suffers an accident or injury which arises out of and in the course

of his or her employment: (1) In this State; or (2) While on temporary assignment outside the State for not more than 12 months; (c) The employee files a claim for compensation with the Division; and (d) The employee makes an irrevocable assignment to the Division of a right to be

subrogated to the rights of the injured employee pursuant to NRS 616C.215 . An employee who suffers an accident or injury while on temporary assignment outside

the State is not eligible to receive compensation from the Uninsured Employers' Claim

Account unless the employee has been denied workers' compensation in the state in

which the accident or injury occurred. 3. If the Division receives a claim pursuant to subsection 2, the Division shall immediately

notify the employer of the claim. 4. For the purposes of this section and NRS 616C.223 , the employer has the burden of proving that the employer provided mandatory industrial

insurance coverage for the employee or that the employer was not required to maintain

industrial insurance for the employee. 5. Any employer who has failed to provide mandatory coverage required by the provisions

of chapters 616A to 616D, inclusive, of NRS is liable for all payments made on behalf

of the employer, including any benefits, administrative costs or attorney's fees paid

from the Uninsured Employers' Claim Account or incurred by the Division. 6. The Division: (a) May recover from the employer the payments made by the Division that are described

in subsection 5 and any accrued interest by bringing a civil action or filing an application

for the entry of summary judgment pursuant to NRS 616C.223 in a court of competent jurisdiction. For the purposes of this paragraph, the payments made by the Division that are described

in subsection 5 are presumed to be: (1) Justified by the circumstances of the claim; (2) Made in accordance with applicable law; and (3) Reasonable and necessary. (b) In any civil action or application for the entry of summary judgment filed pursuant

to NRS 616C.223 against the employer, is not required to prove that negligent conduct by the employer

was the cause of the employee's injury. (c) May enter into a contract with any person to assist in the collection of any liability

of an uninsured employer. (d) In lieu of a civil action or filing an application for the entry of summary judgment

pursuant to NRS 616C.223 , may enter into an agreement or settlement regarding the collection of any liability

of an uninsured employer. 7. The Division shall: (a) Determine whether the employer was insured within 30 days after receiving notice

of the claim from the employee. (b) Assign the claim to the third-party administrator or insurer designated pursuant

to subsection 1 for administration and payment of compensation. Upon determining whether the claim is accepted or denied, the designated third-party

administrator or insurer shall notify the injured employee, the named employer and

the Division of its determination. 8. Upon demonstration of the: (a) Costs incurred by the designated third-party administrator or insurer to administer

the claim or pay compensation to the injured employee; or (b) Amount that the designated third-party administrator or insurer will pay for administrative

expenses or compensation to the injured employee and that such amounts are justified

by the circumstances of the claim, the Division shall authorize payment from the Uninsured Employers' Claim Account. 9. Any party aggrieved by a determination made by the Division regarding the assignment

of any claim made pursuant to this section may appeal that determination by filing

a notice of appeal with an appeals officer within 30 days after the determination

is rendered. The provisions of NRS 616C.345 to 616C.385 , inclusive, apply to an appeal filed pursuant to this subsection. 10. Any party aggrieved by a determination to accept or to deny any claim made pursuant

to this section or by a determination to pay or to deny the payment of compensation

regarding any claim made pursuant to this section may appeal that determination, within

70 days after the determination is rendered, to the Hearings Division of the Department

of Administration in the manner provided by NRS 616C.305 and 616C.315 . 11. All insurers shall bear a proportionate amount of a claim made pursuant to chapters

616A to 616D, inclusive, of NRS, and are entitled to a proportionate amount of any

collection made pursuant to this section as an offset against future liabilities. 12. An uninsured employer is liable for the interest on any amount paid on his or

her claims from the Uninsured Employers' Claim Account. The interest must be calculated at a rate equal to the prime rate at the largest

bank in Nevada, as ascertained by the Commissioner of Financial Institutions, on January

1 or July 1, as the case may be, immediately preceding the date of the claim, plus

3 percent, compounded monthly, from the date the claim is paid from the account until

payment is received by the Division from the employer. 13. Attorney's fees recoverable by the Division pursuant to this section must be: (a) If a private attorney is retained by the Division, paid at the usual and customary

rate for that attorney. (b) If the attorney is an employee of the Division, paid at the rate established by

regulations adopted by the Division. Any money collected must be deposited to the Uninsured Employers' Claim Account. 14. If the Division has not obtained a civil judgment or an entry of summary judgment

pursuant to NRS 616C.223 and the Division assigns a debt that arises under this section to the State Controller

for collection pursuant to NRS 353C.195 , the State Controller may bring an action in his or her own name in a court of competent

jurisdiction to recover any amount that the Division is authorized to recover pursuant

to this section.