(a) Compensation underthis Article shall be paid periodically, promptly and directly to the personentitled thereto unless otherwise specifically provided.
(b) When the employeror insurer admits the employee's right to compensation, the first installmentof compensation payable by the employer shall become due on the fourteenth dayafter the employer has written or actual notice of the injury or death, onwhich date all compensation then due shall be paid. Compensation thereaftershall be paid in installments weekly except where the Commission determinesthat payment in installments should be made monthly or at some other period. Uponpaying the first installment of compensation and upon suspending, reinstating,changing, or modifying such compensation for any cause, the insurer shallimmediately notify the Commission, on a form prescribed by the Commission, thatcompensation has begun, or has been suspended, reinstated, changed, ormodified. A copy of each notice shall be provided to the employee. The firstnotice of payment to the Commission shall contain the date and nature of theinjury, the average weekly wages of the employee, the weekly compensation rate,the date the disability resulting from the injury began, and the datecompensation commenced.
(c) If the employer orinsurer denies the employee's right to compensation, the employer or insurershall notify the Commission, on or before the fourteenth day after it haswritten or actual notice of the injury or death, or within such reasonableadditional time as the Commission may allow, and advise the employee in writingof its refusal to pay compensation on a form prescribed by the Commission. Thisnotification shall (i) include the name of the employee, the name of theemployer, the date of the alleged injury or death, the insurer on the risk, ifany, and a detailed statement of the grounds upon which the right tocompensation is denied, and (ii) advise the employee of the employee's right torequest a hearing pursuant to G.S. 97‑83. If the employer or insurer, ingood faith, is without sufficient information to admit the employee's right tocompensation, the employer or insurer may deny the employee's right tocompensation.
(d) In any claim forcompensation in which the employer or insurer is uncertain on reasonablegrounds whether the claim is compensable or whether it has liability for theclaim under this Article, the employer or insurer may initiate compensationpayments without prejudice and without admitting liability. The initial paymentshall be accompanied by a form prescribed by and filed with the Commission,stating that the payments are being made without prejudice. Payments madepursuant to this subsection may continue until the employer or insurer contestsor accepts liability for the claim or 90 days from the date the employer haswritten or actual notice of the injury or death, whichever occurs first, unlessan extension is granted pursuant to this section. Prior to the expiration ofthe 90‑day period, the employer or insurer may upon reasonable groundsapply to the Commission for an extension of not more than 30 days. Theinitiation of payment does not affect the right of the employer or insurer tocontinue to investigate or deny the compensability of the claim or itsliability therefor during this period. If at any time during the 90‑dayperiod or extension thereof, the employer or insurer contests thecompensability of the claim or its liability therefor, it may suspend paymentof compensation and shall promptly notify the Commission and the employee on aform prescribed by the Commission. The employer or insurer must provide on theprescribed form a detailed statement of its grounds for denying compensabilityof the claim or its liability therefor. If the employer or insurer does notcontest the compensability of the claim or its liability therefor within 90days from the date it first has written or actual notice of the injury ordeath, or within such additional period as may be granted by the Commission, itwaives the right to contest the compensability of and its liability for theclaim under this Article. However, the employer or insurer may contest thecompensability of or its liability for the claim after the 90‑day periodor extension thereof when it can show that material evidence was discoveredafter that period that could not have been reasonably discovered earlier, inwhich event the employer or insurer may terminate or suspend compensationsubject to the provisions of G.S. 97‑18.1.
(e) The firstinstallment of compensation payable under the terms of an award by theCommission, or under the terms of a judgment of the court upon an appeal fromsuch an award, shall become due 10 days from the day following expiration ofthe time for appeal from the award or judgment or the day after notice waivingthe right of appeal by all parties has been received by the Commission,whichever is sooner. Thereafter compensation shall be paid in installmentsweekly, except where the Commission determines that payment in installmentsshall be made monthly or in some other manner.
(f) The employer's orinsurer's grounds for contesting the employee's claim or its liability thereforas specified in the notice suspending compensation under subsection (d) of thissection are the only bases for the employer's or insurer's defense on the issueof compensability in a subsequent proceeding, unless the defense is based onnewly discovered material evidence that could not reasonably have beendiscovered prior to the notice suspending compensation.
(g) If any installmentof compensation is not paid within 14 days after it becomes due, there shall beadded to such unpaid installment an amount equal to ten per centum (10%)thereof, which shall be paid at the same time as, but in addition to, suchinstallment, unless such nonpayment is excused by the Commission after ashowing by the employer that owing to conditions over which he had no control suchinstallment could not be paid within the period prescribed for the payment.
(h) Within 16 daysafter final payment of compensation has been made, the employer or insurershall send to the Commission and the employee a notice, in accordance with aform prescribed by the Commission, stating that such final payment has beenmade, the total amount of compensation paid, the name of the employee and ofany other person to whom compensation has been paid, the date of the injury ordeath, and the date to which compensation has been paid. If the employer orinsurer fails to so notify the Commission or the employee within such time, theCommission shall assess against such employer or insurer a civil penalty in theamount of twenty‑five dollars ($25.00). The clear proceeds of civilpenalties assessed pursuant to this section shall be remitted to the CivilPenalty and Forfeiture Fund in accordance with G.S. 115C‑457.2.
(i) If any bill forservices rendered under G.S. 97‑25 by any provider of health care is notpaid within 60 days after it has been approved by the Commission and returnedto the responsible party, or within 60 days after it was properly submitted, inaccordance with the provisions of this Article, to an insurer or managed careorganization responsible for direct reimbursement pursuant to G.S. 97‑26(g),there shall be added to such unpaid bill an amount equal to ten per centum(10%) thereof, which shall be paid at the same time as, but in addition to,such medical bill, unless such late payment is excused by the Commission.
(j) The employer orinsurer shall promptly investigate each injury reported or known to theemployer and at the earliest practicable time shall admit or deny theemployee's right to compensation or commence payment of compensation as providedin subsections (b), (c), or (d) of this section. When an employee files a claimfor compensation with the Commission, the Commission may order reasonablesanctions against an employer or insurer which does not, within 30 daysfollowing notice from the Commission of the filing of a claim, or within suchreasonable additional time as the Commission may allow, do one of thefollowing:
(1) Notify theCommission and the employee in writing that it is admitting the employee'sright to compensation and, if applicable, satisfy the requirements for paymentof compensation under subsection (b) of this section.
(2) Notify theCommission and the employee that it denies the employee's right to compensationconsistent with subsection (c) of this section.
(3) Initiate paymentswithout prejudice and without liability and satisfy the requirements ofsubsection (d) of this section.
For purposes of this subsection,reasonable sanctions shall not prohibit the employer or insurer from contestingthe compensability of or its liability for the claim. (1929, c. 120, s. 181/2;1967, c. 1229, s. 2; 1979, c. 249, ss. 1, 2; c. 599; 1993 (Reg. Sess., 1994),c. 679, s. 3.1; 1998‑215, s. 114; 2005‑448, s. 4; 2006‑264,s. 91.7.)
(a) Compensation underthis Article shall be paid periodically, promptly and directly to the personentitled thereto unless otherwise specifically provided.
(b) When the employeror insurer admits the employee's right to compensation, the first installmentof compensation payable by the employer shall become due on the fourteenth dayafter the employer has written or actual notice of the injury or death, onwhich date all compensation then due shall be paid. Compensation thereaftershall be paid in installments weekly except where the Commission determinesthat payment in installments should be made monthly or at some other period. Uponpaying the first installment of compensation and upon suspending, reinstating,changing, or modifying such compensation for any cause, the insurer shallimmediately notify the Commission, on a form prescribed by the Commission, thatcompensation has begun, or has been suspended, reinstated, changed, ormodified. A copy of each notice shall be provided to the employee. The firstnotice of payment to the Commission shall contain the date and nature of theinjury, the average weekly wages of the employee, the weekly compensation rate,the date the disability resulting from the injury began, and the datecompensation commenced.
(c) If the employer orinsurer denies the employee's right to compensation, the employer or insurershall notify the Commission, on or before the fourteenth day after it haswritten or actual notice of the injury or death, or within such reasonableadditional time as the Commission may allow, and advise the employee in writingof its refusal to pay compensation on a form prescribed by the Commission. Thisnotification shall (i) include the name of the employee, the name of theemployer, the date of the alleged injury or death, the insurer on the risk, ifany, and a detailed statement of the grounds upon which the right tocompensation is denied, and (ii) advise the employee of the employee's right torequest a hearing pursuant to G.S. 97‑83. If the employer or insurer, ingood faith, is without sufficient information to admit the employee's right tocompensation, the employer or insurer may deny the employee's right tocompensation.
(d) In any claim forcompensation in which the employer or insurer is uncertain on reasonablegrounds whether the claim is compensable or whether it has liability for theclaim under this Article, the employer or insurer may initiate compensationpayments without prejudice and without admitting liability. The initial paymentshall be accompanied by a form prescribed by and filed with the Commission,stating that the payments are being made without prejudice. Payments madepursuant to this subsection may continue until the employer or insurer contestsor accepts liability for the claim or 90 days from the date the employer haswritten or actual notice of the injury or death, whichever occurs first, unlessan extension is granted pursuant to this section. Prior to the expiration ofthe 90‑day period, the employer or insurer may upon reasonable groundsapply to the Commission for an extension of not more than 30 days. Theinitiation of payment does not affect the right of the employer or insurer tocontinue to investigate or deny the compensability of the claim or itsliability therefor during this period. If at any time during the 90‑dayperiod or extension thereof, the employer or insurer contests thecompensability of the claim or its liability therefor, it may suspend paymentof compensation and shall promptly notify the Commission and the employee on aform prescribed by the Commission. The employer or insurer must provide on theprescribed form a detailed statement of its grounds for denying compensabilityof the claim or its liability therefor. If the employer or insurer does notcontest the compensability of the claim or its liability therefor within 90days from the date it first has written or actual notice of the injury ordeath, or within such additional period as may be granted by the Commission, itwaives the right to contest the compensability of and its liability for theclaim under this Article. However, the employer or insurer may contest thecompensability of or its liability for the claim after the 90‑day periodor extension thereof when it can show that material evidence was discoveredafter that period that could not have been reasonably discovered earlier, inwhich event the employer or insurer may terminate or suspend compensationsubject to the provisions of G.S. 97‑18.1.
(e) The firstinstallment of compensation payable under the terms of an award by theCommission, or under the terms of a judgment of the court upon an appeal fromsuch an award, shall become due 10 days from the day following expiration ofthe time for appeal from the award or judgment or the day after notice waivingthe right of appeal by all parties has been received by the Commission,whichever is sooner. Thereafter compensation shall be paid in installmentsweekly, except where the Commission determines that payment in installmentsshall be made monthly or in some other manner.
(f) The employer's orinsurer's grounds for contesting the employee's claim or its liability thereforas specified in the notice suspending compensation under subsection (d) of thissection are the only bases for the employer's or insurer's defense on the issueof compensability in a subsequent proceeding, unless the defense is based onnewly discovered material evidence that could not reasonably have beendiscovered prior to the notice suspending compensation.
(g) If any installmentof compensation is not paid within 14 days after it becomes due, there shall beadded to such unpaid installment an amount equal to ten per centum (10%)thereof, which shall be paid at the same time as, but in addition to, suchinstallment, unless such nonpayment is excused by the Commission after ashowing by the employer that owing to conditions over which he had no control suchinstallment could not be paid within the period prescribed for the payment.
(h) Within 16 daysafter final payment of compensation has been made, the employer or insurershall send to the Commission and the employee a notice, in accordance with aform prescribed by the Commission, stating that such final payment has beenmade, the total amount of compensation paid, the name of the employee and ofany other person to whom compensation has been paid, the date of the injury ordeath, and the date to which compensation has been paid. If the employer orinsurer fails to so notify the Commission or the employee within such time, theCommission shall assess against such employer or insurer a civil penalty in theamount of twenty‑five dollars ($25.00). The clear proceeds of civilpenalties assessed pursuant to this section shall be remitted to the CivilPenalty and Forfeiture Fund in accordance with G.S. 115C‑457.2.
(i) If any bill forservices rendered under G.S. 97‑25 by any provider of health care is notpaid within 60 days after it has been approved by the Commission and returnedto the responsible party, or within 60 days after it was properly submitted, inaccordance with the provisions of this Article, to an insurer or managed careorganization responsible for direct reimbursement pursuant to G.S. 97‑26(g),there shall be added to such unpaid bill an amount equal to ten per centum(10%) thereof, which shall be paid at the same time as, but in addition to,such medical bill, unless such late payment is excused by the Commission.
(j) The employer orinsurer shall promptly investigate each injury reported or known to theemployer and at the earliest practicable time shall admit or deny theemployee's right to compensation or commence payment of compensation as providedin subsections (b), (c), or (d) of this section. When an employee files a claimfor compensation with the Commission, the Commission may order reasonablesanctions against an employer or insurer which does not, within 30 daysfollowing notice from the Commission of the filing of a claim, or within suchreasonable additional time as the Commission may allow, do one of thefollowing:
(1) Notify theCommission and the employee in writing that it is admitting the employee'sright to compensation and, if applicable, satisfy the requirements for paymentof compensation under subsection (b) of this section.
(2) Notify theCommission and the employee that it denies the employee's right to compensationconsistent with subsection (c) of this section.
(3) Initiate paymentswithout prejudice and without liability and satisfy the requirements ofsubsection (d) of this section.
For purposes of this subsection,reasonable sanctions shall not prohibit the employer or insurer from contestingthe compensability of or its liability for the claim. (1929, c. 120, s. 181/2;1967, c. 1229, s. 2; 1979, c. 249, ss. 1, 2; c. 599; 1993 (Reg. Sess., 1994),c. 679, s. 3.1; 1998‑215, s. 114; 2005‑448, s. 4; 2006‑264,s. 91.7.)
(a) Compensation underthis Article shall be paid periodically, promptly and directly to the personentitled thereto unless otherwise specifically provided.
(b) When the employeror insurer admits the employee's right to compensation, the first installmentof compensation payable by the employer shall become due on the fourteenth dayafter the employer has written or actual notice of the injury or death, onwhich date all compensation then due shall be paid. Compensation thereaftershall be paid in installments weekly except where the Commission determinesthat payment in installments should be made monthly or at some other period. Uponpaying the first installment of compensation and upon suspending, reinstating,changing, or modifying such compensation for any cause, the insurer shallimmediately notify the Commission, on a form prescribed by the Commission, thatcompensation has begun, or has been suspended, reinstated, changed, ormodified. A copy of each notice shall be provided to the employee. The firstnotice of payment to the Commission shall contain the date and nature of theinjury, the average weekly wages of the employee, the weekly compensation rate,the date the disability resulting from the injury began, and the datecompensation commenced.
(c) If the employer orinsurer denies the employee's right to compensation, the employer or insurershall notify the Commission, on or before the fourteenth day after it haswritten or actual notice of the injury or death, or within such reasonableadditional time as the Commission may allow, and advise the employee in writingof its refusal to pay compensation on a form prescribed by the Commission. Thisnotification shall (i) include the name of the employee, the name of theemployer, the date of the alleged injury or death, the insurer on the risk, ifany, and a detailed statement of the grounds upon which the right tocompensation is denied, and (ii) advise the employee of the employee's right torequest a hearing pursuant to G.S. 97‑83. If the employer or insurer, ingood faith, is without sufficient information to admit the employee's right tocompensation, the employer or insurer may deny the employee's right tocompensation.
(d) In any claim forcompensation in which the employer or insurer is uncertain on reasonablegrounds whether the claim is compensable or whether it has liability for theclaim under this Article, the employer or insurer may initiate compensationpayments without prejudice and without admitting liability. The initial paymentshall be accompanied by a form prescribed by and filed with the Commission,stating that the payments are being made without prejudice. Payments madepursuant to this subsection may continue until the employer or insurer contestsor accepts liability for the claim or 90 days from the date the employer haswritten or actual notice of the injury or death, whichever occurs first, unlessan extension is granted pursuant to this section. Prior to the expiration ofthe 90‑day period, the employer or insurer may upon reasonable groundsapply to the Commission for an extension of not more than 30 days. Theinitiation of payment does not affect the right of the employer or insurer tocontinue to investigate or deny the compensability of the claim or itsliability therefor during this period. If at any time during the 90‑dayperiod or extension thereof, the employer or insurer contests thecompensability of the claim or its liability therefor, it may suspend paymentof compensation and shall promptly notify the Commission and the employee on aform prescribed by the Commission. The employer or insurer must provide on theprescribed form a detailed statement of its grounds for denying compensabilityof the claim or its liability therefor. If the employer or insurer does notcontest the compensability of the claim or its liability therefor within 90days from the date it first has written or actual notice of the injury ordeath, or within such additional period as may be granted by the Commission, itwaives the right to contest the compensability of and its liability for theclaim under this Article. However, the employer or insurer may contest thecompensability of or its liability for the claim after the 90‑day periodor extension thereof when it can show that material evidence was discoveredafter that period that could not have been reasonably discovered earlier, inwhich event the employer or insurer may terminate or suspend compensationsubject to the provisions of G.S. 97‑18.1.
(e) The firstinstallment of compensation payable under the terms of an award by theCommission, or under the terms of a judgment of the court upon an appeal fromsuch an award, shall become due 10 days from the day following expiration ofthe time for appeal from the award or judgment or the day after notice waivingthe right of appeal by all parties has been received by the Commission,whichever is sooner. Thereafter compensation shall be paid in installmentsweekly, except where the Commission determines that payment in installmentsshall be made monthly or in some other manner.
(f) The employer's orinsurer's grounds for contesting the employee's claim or its liability thereforas specified in the notice suspending compensation under subsection (d) of thissection are the only bases for the employer's or insurer's defense on the issueof compensability in a subsequent proceeding, unless the defense is based onnewly discovered material evidence that could not reasonably have beendiscovered prior to the notice suspending compensation.
(g) If any installmentof compensation is not paid within 14 days after it becomes due, there shall beadded to such unpaid installment an amount equal to ten per centum (10%)thereof, which shall be paid at the same time as, but in addition to, suchinstallment, unless such nonpayment is excused by the Commission after ashowing by the employer that owing to conditions over which he had no control suchinstallment could not be paid within the period prescribed for the payment.
(h) Within 16 daysafter final payment of compensation has been made, the employer or insurershall send to the Commission and the employee a notice, in accordance with aform prescribed by the Commission, stating that such final payment has beenmade, the total amount of compensation paid, the name of the employee and ofany other person to whom compensation has been paid, the date of the injury ordeath, and the date to which compensation has been paid. If the employer orinsurer fails to so notify the Commission or the employee within such time, theCommission shall assess against such employer or insurer a civil penalty in theamount of twenty‑five dollars ($25.00). The clear proceeds of civilpenalties assessed pursuant to this section shall be remitted to the CivilPenalty and Forfeiture Fund in accordance with G.S. 115C‑457.2.
(i) If any bill forservices rendered under G.S. 97‑25 by any provider of health care is notpaid within 60 days after it has been approved by the Commission and returnedto the responsible party, or within 60 days after it was properly submitted, inaccordance with the provisions of this Article, to an insurer or managed careorganization responsible for direct reimbursement pursuant to G.S. 97‑26(g),there shall be added to such unpaid bill an amount equal to ten per centum(10%) thereof, which shall be paid at the same time as, but in addition to,such medical bill, unless such late payment is excused by the Commission.
(j) The employer orinsurer shall promptly investigate each injury reported or known to theemployer and at the earliest practicable time shall admit or deny theemployee's right to compensation or commence payment of compensation as providedin subsections (b), (c), or (d) of this section. When an employee files a claimfor compensation with the Commission, the Commission may order reasonablesanctions against an employer or insurer which does not, within 30 daysfollowing notice from the Commission of the filing of a claim, or within suchreasonable additional time as the Commission may allow, do one of thefollowing:
(1) Notify theCommission and the employee in writing that it is admitting the employee'sright to compensation and, if applicable, satisfy the requirements for paymentof compensation under subsection (b) of this section.
(2) Notify theCommission and the employee that it denies the employee's right to compensationconsistent with subsection (c) of this section.
(3) Initiate paymentswithout prejudice and without liability and satisfy the requirements ofsubsection (d) of this section.
For purposes of this subsection,reasonable sanctions shall not prohibit the employer or insurer from contestingthe compensability of or its liability for the claim. (1929, c. 120, s. 181/2;1967, c. 1229, s. 2; 1979, c. 249, ss. 1, 2; c. 599; 1993 (Reg. Sess., 1994),c. 679, s. 3.1; 1998‑215, s. 114; 2005‑448, s. 4; 2006‑264,s. 91.7.)
