Insurance Coverage Disputes

(A) In any case filed pursuant to the provisions of G.L. 1956 § 28-30-13, involving a dispute regarding coverage under the provisions of a workers' compensation insurance contract, the party seeking review of the insurance contract shall file with the court a petition for determination of an insurance controversy which shall contain: (1) a statement of the claim stating Page 17 of 35 February 2024 the basis for which the petitioner is entitled to relief, and (2) a prayer setting forth the relief sought by the petitioner. Relief in the alternative or in several different types may be demanded. The petition shall set forth the name, address, email address if known, and agent for service of each respondent. (B)(1) Upon the filing of the petition, the court shall issue a notice to the petitioner, or his/her attorney of record, stating the name of the judge assigned to hear the matter and the date and time the parties shall appear before the judge for an initial hearing. The petitioner shall effect service of the petition and notice upon each respondent in accordance with W.C.C.-R.P. 1.5. (2) At the initial hearing, the parties shall be prepared to consider: (a) the determination of the issues; (b) any amendments to the pleadings; (c) the need to add or join additional parties to the action; (d) any admissions of fact and documents which will be entered by stipulation of the parties; (e) the names of any expert witnesses; and (f) such other matters which may aid in the efficient disposition of the action. At the close of the initial hearing, the trial judge shall establish dates for the closing of discovery, the submission of all pretrial memoranda designated by the trial judge, and the date(s) for the trial. (C) Following the trial on the merits, the trial judge shall render a decision which responds to the petitioner's prayer for relief and prepare an appropriate decree pursuant to W.C.C-R.P.2.20 of these rules. Rule 2.33. Procedure Regarding Stop Work Orders Pursuant to G.L. 1956 § 28-36-15(i). - (A)(1) In the event that the Director of the Department of Labor and Training issues an order suspending the operation of an employer for failure to secure workers' compensation insurance, the employer may appeal the entry of the order to the Workers' Compensation Court. (2) The court shall schedule a hearing within five (5) days of the filing of the appeal to determine whether the order of suspension may be stayed. In order to obtain a court order staying the Director's order of suspension, it shall be the burden of the employer/appellant to present specific facts to demonstrate that the substantial rights of the employer have been prejudiced because the Director's order is (a) in violation of the Department's constitutional or statutory authority, (b) made upon unlawful procedure, (c) arbitrary, capricious, or characterized by clear abuse of discretion, or (d) clearly erroneous and that immediate and irreparable loss, damage, or injury will result to the employer if the order of suspension remains in effect during the pendency of the appeal. Page 18 of 35 February 2024 (3) The proceeding to stay the order of suspension pending a hearing on the merits shall be on the record. All agreements or stipulations entered during the course of the proceeding shall be binding. (4) Following the hearing, the court shall issue an order determining whether the Director's order of suspension may be stayed during the pendency of the appeal on the merits or whether the order shall remain in full force and effect. The court shall set a date for a full hearing on the merits within twenty-one (21) days. (B)(1) In the event that the Director of the Department of Labor and Training issues an order suspending the operation of an employer for failure to secure workers' compensation insurance and the employer has failed to comply with said order, the Director may file a petition with the court for an emergency hearing to enforce the terms of her/his order. The petition shall state the facts establishing the basis for the order of suspension, the dates on which the order was entered by the Department and served upon the employer, and that the employer has continued to operate its business following the entry of said order. (2) The court shall schedule a hearing on the petition to enforce within forty-eight (48) hours of the date of filing and provide notice of the date and time of the hearing to the Director. The Director shall effect service of the petition and notice on the employer by delivering a copy of the petition and notice to a person individually or, if a private corporation, by delivering a copy of the petition and notice to an officer, or a managing or general agent, or by delivering a copy of the petition and notice at an office of the corporation to a person employed by said corporation, or by delivering a copy of the petition and notice to an agent authorized by appointment or by law to receive service of process. If the employer is a public corporation, body, or authority, service shall be made by delivering a copy of the petition and notice to any officer, director, or manager thereof. Service of the petition and notice shall be made by a sheriff or the sheriff's deputy within the sheriff's county, or by a person who is not a party to the proceedings and who is at least eighteen (18) years of age. The Director shall certify to the court that such service has been effected prior to the time of the hearing. (3) The court shall conduct a pretrial conference in connection with the Director's petition to enforce in accordance with G.L. 1956 § 28-35-20 and W.C.C.-R.P. 2.3 of the Rules of Practice of the Workers' Compensation Court. Following the pretrial conference, the court shall enter a pretrial order granting or denying the petition to enforce. The pretrial order shall be binding on the parties as of the date of entry and the filing of a claim for trial shall not stay its operation. If either party is aggrieved by the court's pretrial order, they may file a claim for trial which shall proceed in accordance with the Workers' Compensation Act and the Rules of Practice of the Workers' Compensation Court. Page 19 of 35 February 2024 Rule 2.34. Appeals from Determinations of the Retirement Board Pursuant to G.L. 1956 § 45-21.2-9. - (A) Any appeal from a determination of the Retirement Board made pursuant to G.L. 1956 § 45-19-1 shall be heard by the Court, de novo, in accordance with the Rules of Practice of the Workers' Compensation Court and G.L. 1956 § 45-21.2-9. (B) The party claiming an appeal shall file a notice of appeal with the Retirement Board and with the court within twenty (20) days of the entry of the Retirement Board's decision and shall serve copies of said notice of appeal upon the opposing parties. The notice of appeal shall be accompanied by a statement of claim together with the Orders and Findings adopted by the Retirement Board. (C) When a notice of appeal is timely filed with the court, the order of the Retirement Board shall be stayed pending further action by the court. (D) Upon receipt of the notice of appeal and statement of claim, a judge shall conduct a mandatory pretrial conference within twenty-one (21) days, pursuant to G.L. 1956 § 28-35-20. Notice of said conference shall be sent by the court to the appellant and/or attorneys of record stating the name of the judge assigned to hear the matter as well as the date, time, and location of the pretrial conference. The appellant shall serve the notice of appeal and notice of hearing upon the opposing parties in accordance with W.C.C.-R.P. 1.5. (E) No later than seventy-two (72) hours prior to the pretrial conference all parties shall submit and exchange the medical records and reports in support of their respective positions regarding the claim. (F) Upon receipt of a notice of appeal and prior to the pretrial conference, the municipality/agency affected by the decision of the Retirement Board may intervene as a party to the case without leave of the court. Following the pretrial conference, and only with leave of the court, the municipality/agency may intervene as a party and shall then be entitled to notice and an opportunity to be heard. (G) Any party aggrieved by a decision or decree of the Workers' Compensation Court shall file an appeal in accordance with G.L. 1956 § 28-35-28 and Article IV of the Rules of Practice of the Workers' Compensation Court. (H) The court shall retain jurisdiction in these matters to review its orders and decrees. Such petitions shall be filed directly with the court and shall be subject to the Rules of Practice of the Workers' Compensation Court and procedures for case management and dispute resolution as set forth in Title 28, Chapters 29 through 38. III. RECORDS