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Glossary of WCB Terms

Third Party Administrators


§ 50 3-b of the New York State Workers' Compensation Law

  1. Except as provided in subdivision three-d of this section, no person, firm or corporation, other than an attorney and counselor-at-law, shall solicit the business of representing, or engage in representing self-insurers, as defined in subdivision three of this section, before the board or any officer, agent or employee of the board assigned to conduct any hearing, investigation or inquiry relative to a claim for compensation or benefits under this chapter, unless he shall be a citizen of the United States or an alien lawfully admitted for permanent residence in the United States, or a corporation organized under the laws of the state of New York, and shall have obtained from the board a license authorizing him to appear in matters or proceedings before the board. Such license shall be issued by the board in accordance with the rules established by it. Any person, firm or corporation violating the aforesaid provisions shall be guilty of a misdemeanor.
  2. The board, in its rules, may provide for the issuance of licenses to persons, firms or corporations, upon such proof of character and fitness as it may deem necessary, and may provide for a license fee in an amount not exceeding one hundred dollars a year, and an authorization fee in an amount not exceeding one hundred dollars a year for each designated representative, and for the giving of a bond running to the people of the state of New York, conditioned upon the faithful performance of all duties required of such person, firm or corporation, and in an amount to be fixed by the board in its rules. Such bond shall be approved by the board as to form and sufficiency and shall be filed with it. All license and authorization fees collected under the provisions of this section shall be paid into the state treasury.
  3. There shall be maintained in each office of the board a registry or list of all persons to whom licenses have been issued, as provided herein, which list shall be corrected as often as licenses are issued or revoked. Absence of record of the license issued, as herein provided, shall be prima facie evidence that a person, firm or corporation is not licensed to represent self-insurers.
  4. Any such license may be revoked by the board for cause after a hearing before it.
  5. No license shall be issued hereunder for a period longer than three years from the date of its issuance. The provisions of this section shall not apply to a regular employee of a self-insured employer or to the state insurance fund acting in accordance with an insuring agreement with the state as authorized pursuant to the provisions of section eighty-eight-c of this chapter.

§ 50 3-d of the New York State Workers' Compensation Law

The state insurance fund, an insurance company duly authorized or licensed to write workers` compensation insurance in this state, a subsidiary or an affiliate of such an insurance company, or a licensed or authorized adjusting company or association may apply for a license from the board to solicit the business of representing and engage in representing self-insurers, as defined in subdivision three of this section, before the board or any officer, agent or employee of the board assigned to conduct any hearing, investigation or inquiry relative to a claim for compensation or benefits under this chapter. Any corporation formed solely for the purpose of engaging in the activities described by this subdivision shall be formed under the laws of the state of New York.

The state insurance fund, an insurance company, its subsidiary or affiliate, or such adjusting company or association shall designate those employees who are to appear in matters or proceedings before the board on behalf of self-insurers. Such employees shall obtain an authorization from the board. Upon application to the board for such authorization all such employees who, on the effective date of this subdivision, have been appearing in matters or proceedings before the board on behalf of insurers for a period of at least two years shall automatically receive a temporary authorization from the board. Such temporary authorization shall remain in effect until the applicant employee has been granted or denied final authorization by the board. The board in its rules shall provide for the issuance of authorizations to such employees and other designated employees. If the board, in its rules, provides for the issuance of authorization to persons, firms or corporations under subdivision three-b of this section upon such proof of character and fitness as it may deem necessary, the same proof of character and fitness shall be required for an authorization issued under this subdivision.

The state insurance fund, an insurance company duly authorized or licensed to write workers` compensation insurance in this state, a subsidiary or an affiliate of such an insurance company, or a licensed or authorized adjusting company or association shall apply to the board for the issuance of a license upon such proof of character and fitness as the board may deem necessary. Such proof of character and fitness shall be the same as that required by the board of persons, firms or corporations under subdivision three-b of this section. If the board charges a fee for a license issued under subdivision three-b of this section, the same amount shall be charged for a license issued under this subdivision.

If the board requires for the giving of a bond running to the people of the state of New York, conditioned upon the faithful performance of all duties required of such person, firm, or corporation licensed under subdivision three-b of this section, the same shall be required for a license under this subdivision. Such bond shall be approved by the board as to form and sufficiency and shall be filed with it. All license and authorization fees collected under the provisions of this subdivision shall be paid into the state treasury.

Any person, insurance company, its subsidiary or affiliate, or adjusting company or association which violates the aforesaid provisions of this paragraph shall be guilty of a misdemeanor.

There shall be maintained in each office of the board a registry list of all persons to whom authorizations and licenses have been issued as provided herein, which list shall be corrected as often as authorizations and licenses are issued or revoked. Absence of record of the authorization or license issued, as herein provided, shall be prima facie evidence that a person, firm or corporation is not authorized or licensed to represent self-insurers. Any such authorization or license may be revoked by the board for cause after a hearing before it. No authorization or license shall be issued hereunder for a period longer than three years from the date of its issuance. The board shall make rules pertaining to when conflicts of interest arise in individual cases which shall apply to those who are licensed or authorized to represent self-insurers under subdivision three-b of this section or under this subdivision.

The provisions of article twenty-four of the insurance law, insofar as applicable, shall apply to the state insurance fund, insurance companies, their subsidiaries and affiliates or adjusting companies or associations in their activities representing self-insurers before the board.