The New Hampshire Supreme Court recently ruled in a case that affects how insurers notify the state about potential claims for workers' compensation reimbursements. The decision came from the appeal of the Commissioner of the New Hampshire Department of Labor against the New Hampshire Compensation Appeals Board (CAB). This ruling clarifies the requirements for insurers to notify the Commissioner of possible claims against the Special Fund for Second Injuries.
The case, known as Appeal of Comm’r of N.H. Dep't of Labor, was filed under docket number 2025-0416 and was decided on September 3, 2026. The ruling is significant as it determines the responsibilities of insurers in notifying the state about claims, which can have implications for both employers and employees.
The parties involved in the case include the Commissioner of the New Hampshire Department of Labor and ESIS, Inc., the former insurer of BAE Systems, Inc. The dispute arose when an employee was injured while working for BAE on January 7, 2020. The employee was also working for another employer at the time of the injury. The insurer, ESIS, paid the employee workers' compensation benefits based on her combined wages from both jobs.
In 2020 and 2022, ESIS filed memoranda of payment with the New Hampshire Department of Labor, documenting the benefits paid to the injured employee. However, on August 29, 2022, the insurer applied for reimbursement from the Special Fund for Second Injuries. This application was submitted more than 100 weeks after the employee's injury, which raised questions about the timeliness of the notice provided to the Commissioner.
The Fund coordinator denied the insurer's claim, stating that the memoranda of payment did not constitute adequate notice of a possible claim against the Special Fund. The coordinator argued that the memoranda only indicated the insurer's obligations to make indemnity payments to the injured worker and did not reference a claim against the Fund. The insurer disagreed and requested a hearing.
After a hearing, the hearing officer upheld the Fund coordinator's decision, stating that the memoranda did not provide sufficient notice. The hearing officer emphasized that accepting the memoranda as notice would undermine the statutory requirement for timely notification. The insurer then appealed this decision to the CAB, which reversed the hearing officer's ruling. The CAB assumed that the Department of Labor employee who received the memoranda should have recognized the potential claim against the Fund, despite lacking explicit language indicating such a claim.
The Commissioner subsequently appealed the CAB's decision to the New Hampshire Supreme Court. The court ruled that the CAB erred in concluding that the insurer had provided timely notice of its possible claim against the Fund. The court stated, "We hold that the CAB erred when it concluded that the Insurer provided the Commissioner with notice of its possible claim against the Fund no later than 100 weeks after the injury as required by RSA 281-A:55-a, II."
The ruling emphasized that the responsibility lies with the employer or insurer to notify the Commissioner of any possible claims against the Fund. The court clarified that the memoranda of payment did not adequately inform the Commissioner of the insurer's intent to seek reimbursement from the Fund. The decision reinforces the importance of clear communication and adherence to statutory requirements in the workers' compensation process.
This ruling has significant implications for insurers and employees in New Hampshire. It underscores the necessity for insurers to provide explicit and timely notice of any potential claims to the Commissioner. Failure to do so may result in the denial of reimbursement claims, which can impact the financial responsibilities of insurers and the benefits available to injured workers.
Moving forward, the ruling sets a precedent for how similar cases will be handled in the future. Insurers must ensure they comply with the notification requirements outlined in the law to avoid complications in their claims processes. The decision may also prompt a review of internal procedures among insurers to ensure that they are meeting their obligations under the law.
As for what’s next, the case has been reversed and remanded for further proceedings consistent with the Supreme Court's opinion. This means that the CAB will need to reconsider the case in light of the court's ruling. It remains to be seen whether the insurer will take additional steps to comply with the notice requirements or if there will be further appeals related to this matter.