Thursday, November 4, 2010

Longshore & 3c

The out of state problem for Longshore has long been around but has recently been brought to the surface by new claims being denied.   Here's the situation in a nutshell.

  • Client is based in one state and that state is listed in 3A of the WC policy.
  • Client has all other states (except monopolistic) in 3c
  • Client has a Longshore endorsement with the 3A state listed
  • One of client’s employees goes to neighboring state for ONE DAY to do a Longshore job.
  • Claim is denied in that state:

WHY?  simple, but illogical.

The LONGSHORE endorsement only covers accidents in a state listed in the Longshore endorsement's schedule!    As the 3A state was not the location of the injury - no coverage.

This makes no sense - Longshore is federal coverage so why restrict it to a listed state...    but if you read the endorsement that is what it says and that is how it is being used today by certain carriers to deny claims.

The problem is increased when the carrier is a state fund, assigned risk, JUA or pseudo state fund as many of those are not ABLE to provide out of state coverages.

HOW TO SOLVE

  1. Add EVERY state the client could work in to the Longshore endorsement.   Usually free or low cost if added on an if any basis...   Problem:  many carriers cannot or will not do this.
  2. Add an other states LONGSHORE endorsement to the policy (only one or two carriers will do this) Problem: follows 3C so no coverage in monopolistic states.
  3. Add “ALL STATES" Longshore coverage - only one carrier will do, but great solution.
  4. Put your E&O carrier on speed dial...   if you don't take care of this by 1, 2 or 3 you WILL have the uncovered claim... the only questions is when.