Massachusetts General Laws
Chapter 152 - Workers' Compensation
Section 52c - Rating Organizations in General; Subscribers; Co-Operative Activities; Rates; Freedom of Contract; Examination of Records; Confidentiality and Privilege

Section 52C. (a) A corporation, an unincorporated association, a partnership, or an individual, located within this commonwealth may make application to the commissioner of insurance, hereinafter and in sections fifty-two D to fifty-two F, inclusive, called the commissioner, for license as a rating organization and shall file therewith (1) a copy of its constitution, its articles of agreement or association or its certificate of incorporation, and of its by-laws, rules and regulations governing the conduct of its business, (2) a list of its members and subscribers, (3) the name and address of a resident of this commonwealth upon whom notices or orders of the commissioner or process affecting such rating organization may be served and (4) a statement of its qualifications as a rating organization. If the commissioner finds that the applicant is competent, trustworthy and otherwise qualified to act as a rating organization and that its constitution, articles of agreement or association or certificate of incorporation, and its by-laws, rules and regulations governing the conduct of its business conform to the requirements of law, he shall issue a license authorizing it to act as a rating organization. Every such application shall be granted or denied in whole or in part by the commissioner within sixty days of the date of its filing with him. Licenses issued pursuant to this section shall remain in effect for three years unless sooner suspended or revoked by the commissioner. The fee for said license shall be determined annually by the commissioner of administration under the provision of section three B of chapter seven. Licenses issued pursuant to this section may be suspended or revoked by the commissioner, after hearing upon due notice, in the event the rating organization ceases to meet the requirements of this section. Every rating organization shall notify the commissioner promptly of every change in (1) its constitution, its articles of agreement or association or its certificate of incorporation, and its by-laws, rules and regulations governing the conduct of its business, (2) its list of members and subscribers and (3) the name and address of the resident of this commonwealth designated by it upon whom notices or orders of the commissioner or process affecting such rating organization may be served.
(b) Subject to the rules and regulations which have been approved by the commissioner as reasonable, each rating organization shall permit any insurer not a member to be a subscriber to its rating services. Notice of proposed changes in such rules and regulations shall be given to subscribers. Each rating organization shall furnish its rating services without discrimination to its members and subscribers. The reasonableness of any rule or regulation in its application to subscribers, or the refusal of any rating organization to admit an insurer as a subscriber, shall at the request of any subscriber or any such insurer, be reviewed by the commissioner at a hearing held upon at least ten days' written notice to such rating organization and to such subscriber or insurer. If the commissioner finds that such rule or regulation is unreasonable in its application to subscribers, he shall order that such rule or regulation shall not be applicable to subscribers. If the rating organization fails to grant or reject an insurer's application for subscribership within thirty days after it was made, the insurer may request a review by the commissioner as if the application had been rejected. If the commissioner finds that the insurer has been refused admittance to the rating organization as a subscriber without justification, he shall order the rating organization to admit the insurer as a subscriber. If he finds that the action of the rating organization was justified, he shall make an order affirming its action.
(c) No rating organization shall adopt any rule the effect of which would be to prohibit or regulate the payment of dividends, savings or unabsorbed premium deposits allowed or returned by insurers to their policyholders, members or subscribers.
(d) Co-operation among rating organizations or among rating organizations and insurers in rate making or in other matters within the scope of this chapter is hereby authorized, provided the filings resulting from such co-operation are subject to all the provisions of this chapter which are applicable to filings generally. The commissioner may review such co-operative activities and practices and if, after due notice and a hearing, he finds that any such activity or practice is unfair or unreasonable or otherwise inconsistent with this section, he may issue a written order specifying in what respects such activity or practice is unfair or unreasonable or otherwise inconsistent with this section, and requiring the discontinuance of such activity or practice.
(e) The commissioner shall, at least once in five years, make or cause to be made an examination of each rating organization licensed in this commonwealth as provided in this section. The reasonable cost of any such examination shall be paid by the rating organization examined upon presentation to it of a detailed account of such costs. The officers, manager, agents and employees of such rating organization may be examined at any time under oath and shall exhibit all books, records, accounts, documents or agreements governing its method of operation.
The commissioner shall furnish two copies of the examination report to the organization, group or association examined and shall notify such organization, group or association that it may, within twenty days thereafter, request a hearing on said report or on any facts or recommendations therein. Before filing any such report for public inspection, the commissioner shall grant a hearing to the organization, group or association examined. The commissioner may withhold the report of any such examination from public inspection for such time as he may deem proper.
Notwithstanding any other provision of the General Laws, including clause Twenty-sixth of section 7 of chapter 4 and chapter 66, documents, materials or other information, including but not limited to, all working papers and copies thereof created, produced or obtained by or disclosed to the commissioner or any other person in the course of an examination made pursuant to this subsection or in the course of analysis by the commissioner of the financial condition or market conduct of a rating organization shall be confidential by law and privileged, shall not be a public record under said clause Twenty-sixth, shall not be subject to subpoena and shall not be subject to discovery or admissible in evidence in any private civil action. The commissioner may use the documents, materials or other information in the furtherance of any regulatory or legal action brought as part of the commissioner's official duties.
Documents, materials or other information, including but not limited to, all working papers and copies thereof in the possession or control of the National Association of Insurance Commissioners and its affiliates and subsidiaries shall be confidential by law and privileged, shall not be subject to subpoena and shall not be subject to discovery or admissible in evidence in any private civil action if they are:
(i) created, produced, obtained by or disclosed to the National Association of Insurance Commissioners and its affiliates and subsidiaries in the course of the National Association of Insurance Commissioners and its affiliates and subsidiaries assisting an examination made pursuant to this subsection or assisting the commissioner in the analysis of the financial condition or market conduct of a rating organization; or
(ii) disclosed to the National Association of Insurance Commissioners and its affiliates and subsidiaries pursuant to this subsection by any member of the National Association of Insurance Commissioners.
Neither the commissioner nor any person who received the documents, material or other information while acting under the authority of the commissioner, including the National Association of Insurance Commissioners and its affiliates and subsidiaries, shall be permitted to testify in any private civil action concerning any confidential documents, materials or information subject to this subsection.
In order to assist in the performance of the commissioner's duties, the commissioner:
(i) may share documents, materials or other information, including the confidential and privileged documents, materials or information subject to this subsection, with other state, federal and international regulatory agencies, the National Association of Insurance Commissioners and its affiliates and subsidiaries and state, federal and international law enforcement authorities provided that the recipient agrees to maintain the confidentiality and privileged status of the document, material, communication or other information;
(ii) may receive documents, materials, communications or information, including otherwise confidential and privileged documents, materials or information, from the National Association of Insurance Commissioners and its affiliates and subsidiaries and regulatory and law enforcement officials of other foreign or domestic jurisdictions and shall maintain as confidential or privileged any document, material or information received with notice or the understanding that it is confidential or privileged under the laws of the jurisdiction that is the source of the document, material or information; and
(iii) may enter into agreements governing sharing and use of information consistent with this subsection.
No waiver of any applicable privilege or claim of confidentiality in the documents, materials or information shall occur as a result of disclosure to the commissioner under this subsection or as a result of sharing as authorized in this subsection.
A privilege established under the law of any state or jurisdiction that is substantially similar to the privilege established under this subsection shall be available and enforced in any proceeding in, and in any court of the commonwealth.
(f) All rates shall be made in accordance with the following provisions:—(1) Due consideration shall be given to past and prospective loss experience within and outside this commonwealth, to catastrophe hazards, if any, to a reasonable margin for underwriting profit and contingencies, and to past and prospective expenses both countrywide and those specially applicable to this commonwealth, and to all other relevant factors within and outside this commonwealth; (2) the systems of expense provisions included in the rates for use by any insurer or group of insurers may differ from those of other insurers or groups of insurers to reflect the requirements of the operating methods of any such insurer or group of insurers.
(g) Nothing in this chapter shall abridge or restrict the freedom of contract between insurers and agents or brokers, or between agents and brokers, nor affect the customary right of insurers, agents or brokers to pay to or receive from each other, commission or brokerage; nor shall it abridge or restrict the freedom of contract between insurers, agents or brokers and their employees with respect to compensation.

Structure Massachusetts General Laws

Massachusetts General Laws

Part I - Administration of the Government

Title XXI - Labor and Industries

Chapter 152 - Workers' Compensation

Section 1 - Definitions

Section 2 - Powers and Duties of Department; Investigation of Causes of Injuries

Section 2a - Application of Amendments of Statute

Section 5 - Rules and Regulations

Section 6 - Notice of Injuries; Forms; Additional Reports; Statistical Summaries

Section 6a - Informational Brochures; Monitoring of Benefits; Resolution of Disputes

Section 6b - Disposition of Fines

Section 7 - Commencement of Payments

Section 7a - Presumptions; Employee Unable to Testify

Section 7b - Admissibility Of, or Reference To, Statement Given Insurer or Self-Insurer by Claimant or in His Behalf

Section 7c - Representation of Claimants; Compensation; Denial or Suspension of Right to Practice or Appear

Section 7f - Record of Filing Fees, Penalties and Attorneys' Fees

Section 7g - Documentation Attached to Claims

Section 8 - Termination or Modification of Payments

Section 9a - Physicians Engaged to Testify or Depose for Employee; Fees Paid by Insurer

Section 10 - Claims for Benefits; Complaints Requesting Modification or Discontinuation of Benefits; Conciliation

Section 10a - Assignments of Cases; Conferences; Orders; Appeals

Section 10b - Arbitration; Agreements; Proceedings

Section 10c - Collective Bargaining Agreements; Binding Obligations and Procedures

Section 11 - Hearings; Evidence; Continuances

Section 11a - Impartial Medical Examiners

Section 11b - Procedure for Hearings; Depositions; Record of Proceedings

Section 11c - Appeals to Reviewing Board

Section 11d - Earnings Reports by Employees; Recovery of Overpayments

Section 12 - Enforcement of Orders; Appeals From Decisions of Reviewing Board; Costs; Reported Questions; Copies of Judgments

Section 12a - Award of Costs and Attorney's Fees

Section 13 - Rate of Payment by Insurers; Review of Clinical Health Care Providers; Health Care Services Board

Section 13a - Attorney's Fees for Employees

Section 14 - Actions Not Based on Reasonable Grounds; Illegal or Fraudulent Conduct; Costs and Penalties

Section 14a - Employee Leasing Companies

Section 15 - Liability of Person Other Than Insured

Section 15a - Controversy as to Which of Two or More Insurers Is Liable

Section 16 - Subsequent Findings Discontinuing Compensation; Finality

Section 17 - Enforcement of Orders or Decisions

Section 18 - Independent and Sub-Contractors; Liability of Insurer and Others

Section 19 - Agreements by Parties

Section 20 - Hospital Records as Evidence; Medical Records and Reports Open to Inspection

Section 20a - Copies of Reports of Medical Examinations Furnished Employees; Reports as Evidence

Section 20b - Medical Reports of Disabled or Deceased Physicians as Evidence

Section 21 - Notice by Insured to Employees

Section 22 - Notice by Insured to New Employees; Notice of Cessation of Insurance; Filing Copy

Section 23 - Release of Claims or Demands at Common Law

Section 24 - Waiver of Right of Action for Injuries

Section 25 - Insurer's Liability on Judgment for Employee

Section 25a - Purchase of Insurance; Self-Insurance; Reinsurance; Deductibles

Section 25b - Applicability of Statute Relating to Insurance and Self-Insurers; Employer Bringing Employees Within Statute

Section 25c - Failure to Provide for Payment of Compensation; Stop Work Orders; Penalties; Liens; Actions Brought by Losing Bidders; Civil Actions for Violations of Chapter

Section 25d - Service Companies; Investigation, Adjustment or Settlement of Claims for Self-Insurers

Section 25e - Self-Insurance Groups; Definitions

Section 25f - Certification to Act as Self-Insurance Group

Section 25g - Application for Certificate; Requirements; Issuance

Section 25h - Termination of Certificate

Section 25i - Examination of Affairs, Transactions, Accounts, Records and Assets of Each Group; Confidentiality and Privilege

Section 25j - Boards of Trustees

Section 25k - Applications for Membership; Cancellation of Members; Insolvency or Bankruptcy of Members

Section 25l - Solicitation of Membership by Licensed Agents

Section 25m - Misrepresentations or Omissions in Solicitations of Membership

Section 25n - Performance Reports; Statements of Financial Condition

Section 25o - Uniform Classification System; Premium Contributions; Application to Make Own Rates; Audits

Section 25p - Refunds

Section 25q - Premium Payment Plans; Loss Reserves; Bad Debt Reserves

Section 25r - Deficiencies; Assessments; Liquidation of Groups

Section 25s - Penalties

Section 25t - Cease and Desist Orders

Section 25u - Revocation of Certificates of Approval

Section 25v - Applicability of Chapter 176v to Groups Governed by Secs. 25e to 25u

Section 25w - Applicability of Chapter 176w to Workers' Compensation Self-Insurance Groups Governed by Secs. 25e to 25u

Section 26 - Injuries Arising Out of and in Course of Employment

Section 26a - Suicide

Section 26b - Concurrent Service of Two or More Employers; Joint and Several Liability of Insurers

Section 27 - Willful Misconduct of Employee

Section 27a - False Representation of Physical Condition by Employee; Right to Benefits

Section 28 - Wilful Misconduct of Employer; Defense; Reimbursement of Insurer; Employment of Minor; Mentally Retarded Persons; Injuries at Sheltered Workshops

Section 29 - Required Period of Incapacitation; Personnel Actions

Section 30 - Adequate and Reasonable Health Care Services; Preferred Health Care Provider

Section 30a - Medical Reports

Section 30e - Development of Voluntary Agreements

Section 30f - Identification of Cases in Which Vocational Rehabilitation Services May Be Required

Section 30g - Meetings With Injured Employees Requiring Vocational Rehabilitation Services

Section 30h - Applications for Vocational Rehabilitation Services

Section 30i - Availability of New Jobs and Job Training Programs

Section 31 - Death; Compensation for Dependents; Hearings

Section 32 - Persons Presumed Dependent on Employee; Division of Benefits and Payments for Children of Former Marriage; Parent Surviving Dependent Parent; Dependency Determined by Facts; Division of Benefits

Section 33 - Burial Expenses

Section 34 - Total Incapacity; Compensation

Section 34a - Permanent and Total Incapacity; Compensation

Section 34b - Review Date; Supplemental Benefits to Secs. 31 or 34a

Section 35 - Partial Incapacity; Compensation

Section 35a - Added Compensation for Dependents; Payment; Presumed Dependents; Dependency Determined by Facts

Section 35b - Return to Work; Subsequent Injury; Rate of Compensation

Section 35c - Date of Eligibility; Benefits Applicable; Adjustments

Section 35d - Computation of Weekly Wage

Section 35e - Persons Eligible for Old Age Benefits or Pension; Entitlement to Benefits Under Secs. 34 or 35

Section 36 - Specific Injuries

Section 36a - Death Before Full Payment of Compensation for Specified Injuries; Brain Damage

Section 36b - Unemployment Compensation Benefits; Eligibility

Section 37 - Compensation for Disability Subsequent to Physical Impairment; Reimbursement

Section 37a - Compensation for Disabled War Veteran; Reimbursement

Section 38 - Consideration of Employee's Savings, Insurance and Other Benefits

Section 39 - Payment of Compensation Payable in Case of Death; Payment of Expenses and for Legal Services

Section 40 - Guardian or Next Friend Exercising Employee's Rights

Section 41 - Notice of Proceedings for Compensation; Limitation of Actions

Section 42 - Notice in General

Section 43 - Service of Notice

Section 44 - Inaccuracies In, and Want Of, Notice

Section 45 - Examination by Physician; Filing Copy of Report; Refusing or Obstructing Examination; Reimbursement of Travel Expenses and Wages

Section 46 - Waiver of Rights to Compensation; Arbitration

Section 46a - Reimbursement for Accident and Health Insurance Benefits Paid on Compensable Injuries; Lien of Insurers, Et al., Against Award; Child Support Claims

Section 47 - Assignments; Attachments; Liability for Debts

Section 48 - Lump Sum Agreements

Section 49 - Claim in General

Section 50 - Interest on Unpaid Claims

Section 51 - Natural Increase Considered in Determining Weekly Wages

Section 51a - Decision in Compensation Case; Law in Effect

Section 52b - Priority of Premiums and Interest Charges Over Other Claims

Section 52c - Rating Organizations in General; Subscribers; Co-Operative Activities; Rates; Freedom of Contract; Examination of Records; Confidentiality and Privilege

Section 52d - Appeal From Action or Decision of Rating Organization; Rating Information

Section 52e - Violation of Statutes; Failure to Comply With Commissioner's Orders; Suspension and Revocation of Licenses

Section 52f - Hearing on Order or Decision of Commissioner; Suspension or Postponement of Action; Review; Stay of Order or Decision

Section 52g - Partial Invalidity of Statute

Section 53 - Mutual Companies; Distribution of Risks Into Groups

Section 53a - Classification of Risks and Premiums; Distribution of Premiums Among Employers

Section 54a - Necessity of Insurance Contract Insuring Payment of Compensation

Section 55 - Approval of Policy by Commissioner; Review; Issuance of Policy in Violation of Statute

Section 55a - Mid-Term Notice of Cancellation

Section 56 - Joint and Several Policies

Section 57 - Deposits of Value of Outstanding Claims Under Contracts

Section 58 - Computation of Value of Claims

Section 59 - Holding Deposits in Trust; Payment of Claims; Transfer to Trustee; Accounts; Refunds; Return of Balance

Section 60 - Effect of Appointment of Receiver on Order, Deposit or Payments; Deposit by Receiver

Section 60a - Review, Suspension and Reduction of Order Requiring Deposit

Section 60b - Liability for Expenses for Custody and Disbursement of Deposit; Determination; Deduction From Deposit

Section 60c - Failure to Comply With Order Requiring Deposit; Certificate Authorizing Resumption of Issuance of Policies

Section 60d - Forfeiture for Failure to Comply With Order Requiring Deposit; Issuance of Policy While in Default; Enforcement of Order, Fine or Forfeiture

Section 61 - Bond for Foreign Company; Other Security

Section 62 - Deposits by Foreign Companies; Payment of Obligations

Section 63 - Insurance Company Information Requested by Department; Rating Organizations; Notices Furnished by Companies

Section 64 - Insurer's Regulations for Prevention of Injuries; Review; Inspector's Access to Premises

Section 65 - Special Fund; Trust Fund; Assessment Base; Assessment Rates; Payments; Reports; Audits

Section 65a - Designation of Insurer to Issue Policy; Equitable Distribution of Risks; Servicing Carriers; Service Fees

Section 65b - Cancellation or Termination of Policy; Review

Section 65c - Equitable Distribution of Losses; Reinsurance Pools; Necessity of Membership; Plan of Operation; Cost Containment Programs

Section 65d - Issuance of Policy to Employer Assigned to Another Insurer

Section 65g - ''losses Incurred'' Defined; Determination of Amounts to Be Paid

Section 65h - Adjustment of Payments

Section 65i - Primary Liability to Pay Benefits

Section 65j - Inspection of Risks; Rules

Section 65k - Appeal on Ground Premium Is Unreasonable or Discriminatory; Effect of Determined Rates

Section 65l - Failure of Insurer to Comply With Statutes, Order or Rule; Revocation or Suspension of Licenses; Injunction

Section 65m - Review of Orders or Rulings; Time; Suspension and Stay of Order or Rulings

Section 65o - Employer's Choice of Insurance Agent or Broker; Commission Fees; Service Fees

Section 66 - Actions for Injuries Sustained by Employees; Limitations; Defenses

Section 67 - Application to Insureds and Employers Having Right of Election, of Statutes Relating to Defenses to Actions

Section 68 - Applicability of Statutes Relating to Employers' Liabilities

Section 69 - Commonwealth, Counties, Cities, Towns and Districts in General; Members of a Police or Fire Force in Work Under a Contract

Section 69b - Vouchers; Examinations and Investigations; Reports

Section 70 - Procedure and Jurisdiction; Compensation Paid by Commonwealth and Its Subdivisions

Section 71 - Liability of County, City, Town or District for Employee's Injuries

Section 72 - Employee Claiming or Waiving Rights Against County, City, Town or District

Section 73 - Election to Receive Compensation or Pension; Retirement Boards; Prosecuting Claims; Attorney; Notice to Boards; Special Pensions

Section 73a - Employment of Partially Disabled Employee; Temporary Employment to Fill Vacancy

Section 74 - Application of Statutes to All Public Employees; Inmates of Institutions; Employees of Boards or Commissions and Welfare Districts

Section 74a - Employee of One Governmental Unit or Electric Company Aiding Another Unit or Company; Reimbursement of Compensation

Section 75 - Agents Designated to Furnish Benefits and Carry Out Statutes

Section 75a - Preferences for Hiring

Section 75b - Qualified Handicapped Persons; Discrimination Against Employees Exercising Rights Under This Chapter; Disclosure of Data

Section 86 - Public Employees; Certified Copy of Order, Decision, or Agreement Mailed to Public Employee Retirement Administration Commission, Etc.