Insurance Journal

JANUARY 9, 2025

If insurance carriers want to have dibs on a company’s assets as premium security or collateral, they had better specify that those assets include potential tort-claim settlements, a federal appeals court said Wednesday. In a case that involved a Florida …

Claim 245

Claim Insurance Carrier Premium Insured 245

AMAXX

JANUARY 13, 2025

Navigating workers’ compensation can be complex, with various parties working together to ensure effective claims management and cost containment. Lets explore the roles of these critical players in a workers’ compensation system.

Workers Compensation 80

Workers Compensation Compensation Workers Comp Broker-Agent 80

Insurance Journal

JULY 30, 2024

Injured Minnesota employees who seek services from the Department of Labor and Industry’s Vocational Rehabilitation unit (VRU) while their disputed workers’ compensation claim goes through the litigation process will soon face new eligibility rules. Effective Aug. 1, 2024, if the …

Claim 264

Claim Compensation Workers Compensation 264

AMAXX

NOVEMBER 5, 2024

Successfully settling workers’ compensation (WC) claims can significantly reduce costs and streamline processes for employers and insurers. By adhering to a proven four-step process, organizations can consistently achieve better claim outcomes. One key trigger is the injured worker reaching medical stability.

Workers Compensation 94

Workers Compensation Compensation Claim Workers Comp 94

Insurance Journal

DECEMBER 4, 2024

Claim frequency in California workers’ compensation remains significantly higher in the Los Angeles Basin than in the northern part of the state, a new study shows. The Workers’ Compensation Insurance Rating Bureau of California released its WCIRB Geo Study 2024, …

Workers Comp 245

Workers Comp Claim Compensation Workers Compensation Insurance 245

Insurance Journal

DECEMBER 12, 2024

Mega claims in workers’ compensation represent far less than 1% of total workers’ comp claims yet account for more than 2% of total loss dollars, and total in excess of $1 billion each year, a new study from 10 state …

Workers Comp 237

Workers Comp Claim Compensation Workers Compensation 237

Insurance Journal

OCTOBER 20, 2024

Workers’ compensation medical payments per claim in California were 10% below the median state of a 17-state study sample for claims with experience through March 2023, a study from the Workers Compensation Research Institute shows. The WCRI study, CompScope Medical …

Workers Compensation 147

Workers Compensation Compensation Claim 147

AMAXX

AUGUST 21, 2024

Reserves are the funds set aside by an insurer to cover the future costs of a claim, including medical expenses, lost wages, and other associated costs. However, even the most experienced adjuster can sometimes under-reserve a claim, leading to financial surprises later on. Is the Cost for the Claim for Life?

Workers Compensation 90

Workers Compensation Compensation Workers Comp Injury 90

AMAXX

JANUARY 14, 2025

Exclusivity: Protection Against Lawsuits One of the most significant benefits of workers compensation for employers is the exclusive remedy provision. Under this system, employees who accept workers compensation benefits for a work-related injury or illness forfeit the right to sue their employer for negligence.

Workers Compensation 67

Workers Compensation Compensation Workers Comp Injury 67

AMAXX

OCTOBER 15, 2024

One of the most significant challenges for employers today is managing the rising costs of workers’ compensation claims. The price tag associated with these claims can severely impact a company’s bottom line if not controlled effectively.

Workers Compensation 84

Workers Compensation Compensation Workers Comp Injury 84

LexisNexis

SEPTEMBER 17, 2024

Hamilton, Former Assistant Secretary and Deputy Commissioner, California Workers’ Compensation Appeals Board Over the past several decades California has implemented broad legislative changes aimed at lowering the costs associated with workers’ compensation, especially medical expenditures. Mueller, K.L, Mueller, K.L,

Workers Compensation 74

Workers Compensation Claim Compensation Injury 74

Insurance Journal

NOVEMBER 3, 2024

Workersi compensation medical payments per claim in California were 10% below the median state of a 17-state study sample for claims with experience through March 2023, a study from the Workers Compensation Research Institute shows. The WCRI study, CompScope Medical …

Workers Compensation 147

Workers Compensation Compensation Claim 147

Insurance Journal

NOVEMBER 18, 2024

A construction industry captive insurer along with three construction contractors have filed a lawsuit alleging a massive New York fraud scheme involving staged workplace accidents and bogus workers’ compensation and personal injury lawsuits backed by complicit lawyers and medical providers.

Injury 299

Injury Compensation Claim Insured 299

AMAXX

OCTOBER 24, 2024

Click Link to Access Free PDF Download “8 ‘Think Outside the Box’ Tactics to Settle Workers’ Comp Claims” Take, for instance, an employee who tears their medial meniscus. He is co-author of the #1 selling comprehensive training guide “Your Ultimate Guide to Mastering Workers’ Comp Costs: Reduce Costs 20% to 50%.”

Workers Compensation 87

Workers Compensation Compensation Injury Workers Comp 87

Insurance Journal

OCTOBER 17, 2024

A worker injured when he fell from a ladder is entitled to workers’ compensation benefits despite the fact he was intoxicated at the time of the accident. An appellate court in New York has upheld a decision of the Workers’ …

Claim 264

Claim Compensation Workers Compensation 264

AMAXX

SEPTEMBER 16, 2024

Moreover, a consistent approach allows the employer to control the narrative from the outset, preventing external parties—such as doctors, lawyers, or claims adjusters—from driving the process. Proper documentation not only aids in managing the workers’ compensation claim but also helps protect the employer against potential legal challenges.

Injury 83

Injury Workers Compensation Compensation Workers Comp 83

AMAXX

AUGUST 7, 2024

The higher the risk, the higher the workers’ compensation premium for that classification. These rules are established by rating organizations like the National Council on Compensation Insurance (NCCI) in most states, though some states have their own rating bureaus.

Workers Compensation 73

Workers Compensation Compensation Workers Comp Premium 73

AMAXX

OCTOBER 8, 2024

These programs offer significant benefits, not only by speeding up recovery but also by minimizing the financial impact of workers’ compensation claims on employers. He is co-author of the #1 selling comprehensive training guide “Your Ultimate Guide to Mastering Workers’ Comp Costs: Reduce Costs 20% to 50%.”

Workers Compensation 76

Workers Compensation Compensation Workers Comp Injury 76

LexisNexis

OCTOBER 10, 2024

Rassp, Presiding Judge, WCAB Los Angeles, California Division of Workers’ Compensation Disclaimer: The material and any opinions contained in this article are solely those of the authors and are not the opinions of the Department of Industrial Relations, Division of Workers’ Compensation, or the WCAB, or any other entity or individual.

Workers Compensation 75

Workers Compensation Compensation Workers Compensation Insurance Injury 75

AMAXX

DECEMBER 2, 2024

At the heart of this process is the medical director, medical department, or consultant, who plays a pivotal role in interpreting medical jargon and facilitating smooth communication between medical professionals, injured employees, and the workers’ compensation team.

Workers Compensation 63

Workers Compensation Compensation Workers Comp Injury 63

Insurance Journal

JANUARY 16, 2025

Increases in average medical payments and average indemnity payments drove public self-insureds’ total paid losses up last year even though the number of claims fell, a new report shows. The California Workers’ Compensation Institute reviewed the initial report on fiscal …

Workers Comp 130

Workers Comp Claim Compensation Insured 130

AMAXX

SEPTEMBER 23, 2024

When it comes to calculating workers’ compensation premiums, two critical factors play a significant role: the frequency and severity of claims. Frequency: The Stronger Driver of Premiums In the world of workers’ compensation, frequency refers to how often claims are filed.

Workers Compensation 64

Workers Compensation Premium Compensation Workers Comp 64

Insurance Journal

JULY 17, 2024

Workers’ compensation claim rates and benefits paid in Minnesota continue to be stable or follow their long-term downward trajectories, a new Department of Labor and Industry (DLI) report shows. The 2024 Minnesota Workers’ Compensation System Report presents trend data regarding …

Workers Comp 263

Workers Comp Compensation Claim Workers Compensation 263

Insurance Journal

JANUARY 15, 2025

A recent decision and concurring opinion by a Florida appeals court may have upset years of practice and could raise costs for workers’ compensation insurers. Some claims that carriers were once ready to close out of due to the statute …

Workers Comp 264

Workers Comp Compensation Claim Workers Compensation 264

AMAXX

JULY 15, 2024

One of the most critical aspects of managing workers’ compensation claims is ensuring that injured employees receive prompt medical treatment. Understanding the importance of quickly reporting claims and reducing lag time is key to preventing such scenarios. Initially, this policy faced controversy and skepticism.

Workers Compensation 52

Workers Compensation Compensation Claim Workers Comp 52

Insurance Journal

AUGUST 22, 2024

Insurance Group has expanded its Hanover Work Safe, a group of services promising a personalized approach to worker safety and claims handling. The Hanover’s claims specialists proactively gain insights into … The Hanover Enhances Its Holistic Work Safe Program The Hanover.

Liability 264

Liability Claim Insured Insurer 264

Insurance Journal

AUGUST 12, 2024

The South Carolina Court of Appeals has signaled that employers who offer on-site health clinics may not be immune from tort claims from injured or sickened workers. It’s the latest twist to a question that has bounced around courts and …

Workers Comp 264

Workers Comp Protection Claim Workers Compensation 264

AMAXX

OCTOBER 7, 2024

Claims audits and reviews are one of the most commonly used tactics by companies to control workers’ compensation costs. In fact, according to the RIMS 2009 Annual Benchmark Survey, 90% of companies had conducted a claim audit or review of at least some of their claims within the previous six months.

Workers Comp 84

Workers Comp Claim Workers Compensation Compensation 84

AMAXX

OCTOBER 1, 2024

When managing workers’ compensation, a claim audit or review is a crucial opportunity for employers, carriers, TPAs (Third-Party Administrators), and brokers to come together and optimize claim-handling practices. Here’s how to effectively plan and prepare for a successful claim audit or review.

Workers Comp 73

Workers Comp Claim Workers Compensation Compensation 73

AMAXX

DECEMBER 9, 2024

Some claims do not benefit from having a nurse assigned to the file because the role of educating, advocating, or ensuring compliance with medical treatment is already fulfilled in another manner. He is co-author of the #1 selling comprehensive training guide Your Ultimate Guide to Mastering Workers Comp Costs: Reduce Costs 20% to 50%.

Workers Compensation 70

Workers Compensation Compensation Workers Comp Injury 70

AMAXX

JULY 1, 2024

Issues concerning permanent total disability (PTD) benefits are a significant cost driver in workers’ compensation claims. When facing these claims, members of the claim management team and other interested stakeholders need to identify the issues early on, evaluate and develop defenses, and avoid costly mistakes.

Workers Compensation 52

Workers Compensation Compensation Workers Comp Injury 52

Insurance Journal

AUGUST 22, 2024

The West Virginia insurance commissioner’s office has adopted a new policy: It will soon begin destroying workers’ compensation claim files that are 10 years old or older. “Given increasing cybersecurity concerns and the type of information contained in the closed …

Workers Comp 279

Workers Comp Cyber Compensation Risk 279

Insurance Journal

AUGUST 12, 2024

Claims that a workers’ compensation insurer’s conduct after it canceled a policy were negligent are for a court, not the state’s workers’ compensation board, to decide, the Connecticut Appellate Court has ruled. Liberty Mutual Insurance Co. had succeeded before both …

Policy 264

Policy Compensation Claim Workers Compensation 264

Insurance Journal

SEPTEMBER 19, 2024

A Washington man who claimed he was too injured to work while operating a metal fabrication shop faces a felony charge in an alleged $340,000 workers’ compensation scam. Travis Lee Johnson, 52, of Spokane Valley, pleaded not guilty recently to …

Workers Comp 264

Workers Comp Compensation Claim Workers Compensation 264

Insurance Journal

OCTOBER 29, 2024

Scheduled airline ground crews, including baggage handlers and maintenance workers, file injury claims for work-related musculoskeletal disorders at more than 10 times the statewide average, according to the Washington State Department of Labor & Industries. WMSDs, which include strains, sprains …

Injury 263

Injury Claim Workers Compensation Compensation 263

Insurance Journal

JULY 17, 2024

Georgia employers and their workers’ compensation insurers can rest a little easier after an appeals court this week narrowed the circumstances in which a state guaranty association can seek reimbursement on claims paid after staffing firms’ insurance carriers become insolvent.

Insurance Carrier 263

Insurance Carrier Compensation Claim Insured 263

Insurance Journal

OCTOBER 24, 2024

The owner of a Fresno, California-based for-profit vocational school was charged with engaging in fraudulent billing practices related to workers’ compensation. The fraudulent insurance claims could reach … Paul Steve Ramirez, 59, was charged with 11 felony counts, including insurance fraud.

Workers Comp 264

Workers Comp Compensation Insurance Claim Claim 264