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Office of Workers' Compensation Programs

Division of Longshore and Harbor Workers' Compensation (DLHWC)


1. Purpose and Scope. This chapter contains guidelines and procedures for the verification and certification of employer's coverage/self-insurance, and prescribes detailed procedures for examining and filing coverage cards, Form LS-570, Card Reports of Insurance (Exhibit 52, PM 10-200). The functions described are performed in the District Offices.

2. Carrier's Report Requirement. Each policy and Longshore Act (or other related statute) endorsement issued to an employer must be reported by the carrier to each DLHWC District Office in which the employer conducts business under the Act, under which coverage is reported. The report is made on Card Report of Insurance, Form LS-570, and is filed with the DD. When accepting the card report, the NO considers it conclusive evidence that the carrier has provided the coverage stated, and the carrier is bound by the report to provide compensation benefits due employees and survivors of the insured employer. The Card Report should clearly indicate, if applicable, that the policy in question is site-limited.

3. Receipt of Coverage Card by District Office. Upon receipt of a Card Report of Insurance, LS-570, by a DO, the Insurance Clerk or other employee assigned to perform the function will:

  1. Date Stamp Card on date received.
  2. Write on Back of the Card the address of the carrier's office submitting the report, if the address is not shown on the face of the card.
  3. Acknowledgments. If requested, acknowledgment of transmittal letters may be made by date stamping with the official stamp and returning letter to carrier.

4. Examination and Verification of LS-570. Check the card report for the following:

  1. Dual Coverage of Employer. Under the Longshore Act, an employer should be insured by only one insurance company for all the employer's operations within a State for a period of one year or more.
  2. Insurance Carrier Must be Authorized. The carrier filing the card report must be a company authorized by the OWCP. Carrier's number may be entered in space provided on the coverage card, if desired, although this practice is optional.
  3. Employer: One Card for Each Insured Employer. Separate card reports should be filed for each employer covered. The correct name of the employer must be written in full, as well as the trade name if the business is conducted under a trade name. If there is a "partnership", the correct name of the partnership must be shown. In no case may the expression "et al." be used on a card. Cards bearing such entries should be returned to the carrier for correction.
  4. Employer's Address Should be Complete, Including ZIP Code Number. If it appears that card report was submitted to the wrong DO, send the card report to the correct district with a brief memorandum or transmittal slip.
  5. Coverage Dates. The beginning and expiration dates of policies must be clearly indicated on the card. They should be written plainly, such as "July 1, 1999 through June 30, 2000". Uncertain abbreviations should not be accepted. The period of coverage should be for at least one year. An explanation must be given if the coverage is for a shorter period.
  6. Check Card to be Certain Full Coverage is Provided. Limited coverage is not permitted. There should be nothing inserted or written on the card which limits the coverage provided by the carrier filing the card. The coverage should be extended generally by one carrier for all federally covered activity in an entire compensation district. If an employer or insurance company attempts to limit the coverage provided, the issue should be referred to NO.

  7. Signature of Official. Each card report must bear the manual signature or a stamped signature of an official authorized by the carrier. The DD will decide whether to accept cards with stamped signatures. Cards with printed signatures are acceptable only if the National Office, DLHWC, has given written authorization to a carrier to file such cards. District Offices are notified if printed signatures are approved for a carrier.

5. Issuing Certificates of Coverage. Certificates of coverage or compliance, Forms LS-240 and LS-239 (Exhibits 29 and 28, PM 10-200), are issued under the following circumstances (resolve any questions which may arise with the carrier by sending Form Ltr. LS-502, Exhibit __, PM 10-200):

  1. LHWCA Certificates.

(1) Certificate Form LS-240 . This form will be issued by the DD to any employer approved by the Director, OWCP, as a self-insurer under the appropriate Act.

(2) Certificate Form LS-239 , will be issued by the DD, upon receipt of an acceptable card report, Form LS-570 to "active employers" (those employers who have known exposure) and to others if requested.

  1. The District Office will issue only one certificate to an employer in a compensation district. An employer desiring duplicates may have photocopies of the Certificate made for use in different places and/or locations within the compensation district. Certificates are issued only to the employer concerned and never to an insurance carrier, agent, or broker.

6. Termination of Policy. When the Card Report of Insurance indicates that the Employer's insurance has expired, the Coverage Clerk, or other employee assigned to perform the function, should send Form LS-501 (Exhibit __, PM 10-200) requesting information regarding renewal of coverage.

7. Cancellation of Policy. Notices of cancellation of insurance policies are acceptable only if in accordance with section 36(b) of the Longshore Act. The policy is considered in full force and effect until properly canceled. Cancellation notices on unexpired policy terms require that Form LS-501, be sent to the employer requesting return of the Certificate. The certificate should be retained for thirty days after receipt.

8. Reinstatement of Policy. If a cancellation notice is received and the carrier reinstates the policy before the expiration of the thirty day period provided in section 36(b) of the Act, the Certificate should be returned to the employer without alterations. If the Certificate is not received, no further effort should be made to obtain it and the DO's records should be denoted only that the policy has been reinstated.

9. Filing of Coverage Cards.

  1. Active Cards. Coverage cards are filed alphabetically by the Employer's name. "Active Employers'" cards (cards for employers having known exposure) should be filed separately from "inactive employers'" cards.
  2. "No Exposure" Cards. District Offices receive numerous cards (Form LS-570) for policies issued to employers who have no conceivable exposure under the Longshore Act in the district where they are filed. Coverage cards should not be filed, even though Longshore Act coverage is provided and the approved endorsement has been added to a compensation policy in the following instances:

(1) The insured employer, though having exposure under the Act or one of its extensions, has no regular business operations and/or no specific address in an OWCP district; or

(2) The insured employer has no Maritime employees and/or the insured's operations clearly do not bring about exposure of its employees within the purview of the Act or one of its extensions.

  1. Misdirected Cards. Insurance coverage cards filed in a DO showing no address within the compensation district should be returned to the insurance carrier, giving the reason for their return. Cards received for another DO should be forwarded immediately to the DO having jurisdiction.
  2. Late Filing. Should an injury be sustained, which comes under the coverage of the Longshore Act or one of its extensions (for which the employer had obtained insurance coverage, but in attempting to follow the instructions above the insurance carrier did not file a coverage card with the District Office), the carrier may at such time be permitted to file a coverage card without being considered to be in violation of its agreement with the National Office of OWCP in this regard. Questions about coverage raised by this provision should be referred to and may be resolved by the DD.