Rule 4123-21-06 | Default, retroactive coverage.
(A) Payment of a renewal premium received after the expiration date shall be ineffective to continue the coverage of the insured employer.
(B) The administrator of workers' compensation may, upon request, and for good cause shown:
(1) Approve the original black lung coverage to take effect retroactively, upon payment of past due premiums, interest thereon, and such other terms, conditions or exclusions as the administrator may find appropriate; or
(2) Approve retroactive coverage for cancelled periods, upon payment of past due premiums, interest thereon, and with such other terms, conditions, or exclusions as the administrator may find appropriate.
(C) Such request shall be in writing. It shall be properly signed in handwriting by the employer concerned or by its duly authorized representative. The reason for the relief sought shall be fully explained. Unsigned requests shall be held in abeyance until they are properly completed, and the applicant shall be notified accordingly.
(D) The administrator may refer all such requests to the adjudicating committee, appointed by the administrator of workers' compensation, for a determination pursuant to rule 4123-14-06 of the Administrative Code.