C. L. 330 - Revised Form 113 - Agreement to Pay Compensation

CIRCULAR LETTER #330

TO:           All Interested Parties

FROM:     Paul V. Buckley, Commissioner

RE:         Revised Form 113 - Agreement to Pay Compensation

Date:       April 9, 2009

___________________________________________________________________

Please be advised, effective today the Form 113 - Agreement to Pay Compensation has been modified.  This form should only be used for all agreements in which liability has been accepted by the Insurance Company.  Any agreement in which liability has not been accepted should be presented to the Board in the usual narrative format of a § 19 agreement.

Paul V. Buckley
Commissioner