- SOLUTION ARC: How employers can avoid potential pitfalls dealing with Medicare liens and set-asides
Business Insurance’s latest Solution Arc explores the costly and complicated Medicare Secondary Payer process, reveals the best ways to navigate Medicare recovery rules, and details the rewards of Medicare compliance strategies.
- Spouse of workers comp claimant entitled to payment for his care
The wife of a man rendered a paraplegic as a result of a workplace accident is entitled to pay for providing care for her spouse, a New York appellate court ruled.
- OFF BEAT: Chiropractor billing fraud scheme runs in the family
A bogus billing scheme has come back to bite a crooked chiropractor in Ohio.
- Injured worker cannot prove employer intended to harm him: Court
An employer is not liable for an intentional tort in a worker-injury case because the employee failed to prove the employer intended deliberate harm, Ohio’s Supreme Court ruled Thursday.
- Workers comp claim denied because injury took place before state reforms
An Oklahoma worker’s injury occurred before state workers compensation reforms that require a higher burden of proof in case reviews were put in place, allowing an employer to deny part of his workers comp claim.
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Workers Compensation Press Updates
- Former risk manager of Pennsylvania county charged with insurance fraud
A former Dauphin County, Pa., risk manager charged with theft for allegedly running an insurance scam is scheduled to be arraigned on Friday, according to the county district attorney’s office.
Workers Compensation Press Updates
- Fewer Texas employers opting out of state workers comp system
Fewer Texas employers are opting to leave the state’s workers compensation system, according to a biennial report released by the Texas Department of Insurance.
- Washington workers comp advisory rates to remain flat in 2013
Workers compensation advisory rates will remain flat next year for Washington businesses thanks to a series of comp reforms passed in 2011, according to the state’s Department of Labor & Industries.
- Alleghany unit PacificComp names Janet Frank as top executive
Alleghany Corp. announced Monday that James E. Little, president and CEO of its California workers compensation insurer, Pacific Compensation Corp., is being replaced by Janet D. Frank, effective immediately.
- Calif. insurance commissioner recommends 2.8% workers comp rate increase
California Insurance Commissioner Dave Jones recommended workers compensation insurers raise their pure premium rates by an average of 2.8% beginning Jan. 1.
- Texas Mutual Insurance seeks to sever ties with state government
Texas Mutual Insurance Co. will seek to sever ties with the state government during the 2013 legislative session, the workers compensation insurer said in a statement.
- Woman disfigured in chimp attack settles with owner’s estate for $4M
A Connecticut woman disfigured by a chimpanzee named Travis will receive $4 million in cash and property from the estate of the animal’s owner, who had argued it was a workers compensation case.
Workers Compensation Press Updates
- Workers comp claimants’ medical information released by former employee of Berkshire unit
Oak River Insurance Co., a unit of Berkshire Hathaway Insurance Group, recently announced that a former employee released personal medical information belonging to about 2,700 workers compensation claimants.
- Workplace Warriors Revisited
Read the Disability Management Employer Coalition’s best practices for employers wanting to help wounded veterans returning to the workforce cope with new disabilities and mental health issues such as depression or post-traumatic stress disorder.
- Employer not required to reimburse injured worker for self-procured medical care: Court
A California health system does not have to reimburse a former employee for self-procured medical care that she sought after receiving “nightmare” care from an authorized physician.
- Wal-Mart class action settlement raises liability questions
Settlement of a class action lawsuit alleging that Wal-Mart Stores Inc. went too far in controlling injured workers’ treatment raises concerns because it challenges management practices in general, workers compensation observers say.
- Three RICO plaintiffs prevail in court in 2012
Three lawsuits alleging violations of the federal Racketeer Influenced and Corrupt Organizations Act by employers and their workers compensation service providers have resulted in plaintiff victories during 2012:
Workers Compensation Press Updates
- Former insurance broker sentenced for trying to bribe N.J. school superintendent
A federal judge has sentenced a former insurance broker to 135 months behind bars for scheming to bribe a New Jersey school superintendent in order to obtain workers compensation insurance business, prosecutors announced November 16.
- Coventry to pay $3 million to settle Medicare set-aside investigation
Coventry Health Care Inc. has agreed to pay a $3 million settlement as part of a federal investigation into its handling of Medicare set-aside agreements, according to the U.S. Attorney’s Office.
- RGA Global Disability Insurance Survey finds insurers fail to sell the benefits of rehabilitation
Read the results of the RGA Reinsurance Company survey “Rehabilitation Services and Disability Insurance: A Global Analysis of Utilization and Value.”
- Exclusive remedy bars family’s bad-faith claim against son’s workers comp insurer
An Indiana man cannot sue an insurer for the emotional distress that he believes caused his wife’s death while the couple handled their son’s workers compensation case, an Indiana appellate court has ruled.
- Widow of workers comp claimant entitled to survivor benefits: Appeals court
The widow of a workers compensation claimant who died after ingesting multiple prescription pain medications and alcohol is entitled to survivor benefits, the Court of Appeals of the State of Washington ruled.
- Worker’s inability to speak English appropriately considered in disability ruling: Court
Consideration of an injured worker’s inability to speak English was “entirely appropriate” in finding he suffered a 100% earning capacity loss after falling at work, the Iowa Court of Appeals ruled.
- New York workers comp board considers changes to medical treatment guidelines
New York’s Workers’ Compensation Board is considering changes to its workers comp medical treatment guidelines that would aim to reduce administrative costs and delays for claims.
Workers Compensation Press Updates
- Rise in comorbidities contributes to increasing medical costs: Study
The share of workers compensation claimants suffering from comorbidities is on the upswing, nearly tripling in recent years and driving up medical costs, according to a study released Wednesday.
- California Department of Industrial Relations provides information on workers compensation reform
To help employers understand the wide-ranging changes created by California’s new workers compensation reform laws, the California Department of Industrial Relations has posted a new information Web page on its site.
- Wal-Mart, claims manager settle workers comp class action in Colorado
Wal-Mart Stores Inc. and Concentra Claims Management Inc. will pay $8 million and retrain claims adjusters and other employees to settle a class action lawsuit tied to their handling of workers compensation claims in Colorado.
- Workers compensation rates in Colorado to rise 5.2% in 2013
Increasing workers compensation claim frequency and rising comp costs have led to a 5.2% increase in Colorado workers comp rates for 2013, according to the Colorado Division of Insurance.
- OFF BEAT: San Diego County billboards warn would-be workers comp fraudsters
“Commit workers compensation fraud, get a new outfit” warns a new San Diego County District Attorney billboard campaign, with the new outfit being a prison jumpsuit.
- Workers compensation line of business sees 10% growth in premium volume
The workers compensation line of business stabilized, along with U.S. employment and payrolls, during 2011, showing 10% growth in premium volume during the year, Oldwick, N.J.-based A.M. Best Co. reported Monday.
- Employee cannot receive disability benefits for injury in off-duty boxing match
A New York porter who moonlighted as a featherweight boxer cannot receive workers compensation disability benefits for an arm injury that apparently happened during a boxing match, a New York appellate court ruled.
- Aetna says DOJ asked for more information on Coventry buy
(Reuters) — Aetna Inc., which in August agreed to buy smaller Coventry Health Care Inc. for $5.6 billion, on Friday said antitrust regulators have asked the companies for more information related to their review of the deal.
- Court rules employer cannot change injured worker’s doctors
A Florida appeals court on Wednesday sided with a narcotics officer who was injured in a flash-grenade accident and then suffered a second injury three months later during a 1993 shooting.
Workers Compensation Press Updates
- Exclusive remedy does not apply in death of worker during robbery: Appeals court
Exclusive remedy provisions do not apply in the death of a Georgia man who was killed during a robbery at a convenience store that was affiliated with his employer, the Georgia Court of Appeals said last week.
- Aging workforce not as costly as some think: NCCI report
An aging workforce has far less negative impact on workers compensation claims costs than observers may think, concludes a report released Monday by NCCI Holdings Inc.
Workers Compensation Press Updates
- Workers compensation prices will continue to rise in 2013
An “enormous amount” of insurable workers compensation payroll exposure will be unlocked as the economy creates more jobs, said Robert Hartwig, president of the Insurance Information Institute Inc.
- Unifying benefits programs can prevent employers from wasting resources
Employers must take charge to realize an optimal return on investment from the wide array of employee health, absence management and disability programs they fund, according to a prominent benefits manager.
- The pros and cons of predictive modeling
The challenges and benefits of predictive modeling were the focus of one presentation during Business Insurance’s 2012 Worker’s Compensation Virtual Conference on Oct. 25.
- Aetna collaboration prompted by growing employer demand for data integration
A growing demand among employers for integrated disability and absence management is one of the driving forces in a new collaboration between Aetna Inc. and three workers compensation third-party administrators.
Workers Compensation Press Updates
- Integrate Mental Health Counseling with Welllness, Workers’ Comp
Coordinating employee assistance program counseling with workers compensation benefits can help employees address issues that accompany job-related injuries such as depression and pain medication abuse.
- Florida set to approve 6.1% workers compensation rate hike
Florida Insurance Commissioner Kevin McCarty announced Friday that he intends to approve a 6.1% workers compensation rate increase effective Jan. 1, 2013.
- Health, safety lapses in lab tied to fungal meningitis outbreak
Investigators found “serious health and safety deficiencies” at the compound pharmaceutical lab tied to the fungal meningitis outbreak, according to a preliminary report released Monday.
- GALLERY: Top 10 highest workers comp premium rates
This gallery looks at the states with the highest workers compensation premium rate rankings according to the newly released Oregon Workers’ Compensation Premium Rate Ranking Summary.
Workers Compensation Press Updates
- GALLERY: Top 10 lowest workers compensation premium rates
This gallery looks at the states with the lowest workers compensation premium rate rankings according to the newly released Oregon Workers’ Compensation Premium Rate Ranking Summary.
- Delaware sets hearings on proposed 38% workers compensation rate hike
The Delaware Department of Insurance is set to hold a series of public hearings in the next few weeks to discuss a proposed 38.27% hike in the state’s workers compensation rates.