The national guide explains the workers' compensation bargain and the standard policy: Part One pays statutory benefits, Part Two is employers liability, and premium uses payroll, class rates and experience rating. Delaware's Workers' Compensation Act is 19 Del. C. Chapter 23. Rating is governed by 18 Del. C. Chapter 26. Claims are handled by the Industrial Accident Board, not the Department of Insurance.

Administration and market

• Industrial Accident Board: decides compensation disputes after notice from the Department of Labor. A hearing officer may decide instead if the parties agree (19 Del. C. 2301A, 2345).
  • It has 10 members, appointed by the Governor and confirmed by the Senate, for six-year terms.
• Market: Delaware presumes a competitive market unless the Commissioner finds otherwise after a hearing (18 Del. C. 2603). Such an order lasts at most one year.
• Securing coverage: employers insure with an authorized insurer or prove they can self-insure (19 Del. C. 2372).
• Residual market: every workers' comp insurer must take part in a plan for employers who can't get coverage normally (18 Del. C. 2618).
• Uninsured employers: penalty of three times the premium they should have paid (2374(d)).
• Insurer notices: when a policy is canceled or lapses, the insurer notifies the Department of Labor within 14 days (2374(b)).
• Rating:
  • Experience rating compares the employer's losses with its class and produces a credit, debit or unity mod (18 Del. C. 2602(g)).
  • Rates must include workplace safety discounts for employers that pass the safety inspection program (2623, Reg. 802). Employers elect the program at least five months before renewal.
• Medical deductibles: insurers must offer a deductible on medical and death benefits only, from $500 to $5,000 per occurrence. The insurer pays claims from the first dollar, and the employer reimburses it (19 Del. C. 2372(c)). If the employer doesn't respond to the Form B offer within 30 days, it is treated as a rejection.

Who is covered

• Any employment with one or more employees (2306).
• Executive officers are covered, but up to eight stockholder-officers (or eight LLC members) may be exempted by written agreement (2308(a)).
• Sole proprietors and partners are not covered unless they elect coverage. Their immediate family members are covered unless exempted in writing.
• Excluded:
  • farm laborers, unless the employer carries coverage for them
  • household and casual workers in a private home who earn less than $750 cash in any three months from one household (2307)
• Exclusive remedy: workers' comp is the employee's only remedy against the employer, except for UM, UIM and PIP benefits (2304).
• No compensation for injuries caused by the employee's own intoxication, willful misconduct, or willful refusal to use safety devices. The employer must prove it (2353(b)).

Benefits

Deadlines

• Notice of injury: compensation isn't due until the employer has notice or knowledge, unless notice is given within 90 days (2341).
• Claims: barred unless, within two years after the accident, the parties agree on compensation or someone petitions the Board (2361).

Guaranty fund

• The Delaware Insurance Guaranty Association pays covered workers' comp claims of an insolvent insurer in full (18 Del. C. 4208).

Exam traps

• Benefits start on day 4, and are paid back to day 1 once incapacity reaches 7 days.
• The benefit rate is 66 2/3%. Partial disability runs at most 300 weeks. Burial pays $3,500.
• Up to 8 officers may opt out. Sole proprietors are out unless they elect in.
• The Industrial Accident Board decides claims. Notice of injury: 90 days. Claims: 2 years.