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Three Charged With Auto Insurance Fraud in Miami After False Injury Claims

Insurance Journal

Florida authorities have charged a Miami-area nurse practitioner and two others with creating false medical reports and attempting to defraud an auto insurance carrier out of more than $47,000. Local news reports said that investigators with the state Department of …

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With Unrevealed Previous Injury, Later Claim Cannot be Denied, Georgia Court Says

Insurance Journal

Defending workers’ compensation claims from employees who have not disclosed previous injuries may have just become a little more complicated for employers and insurance carriers in Georgia. The Georgia Court of Appeals last week found that a long-standing defense against …

Injury 165
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Mistake: Accepting Every Workers’ Compensation Claim

AMAXX

This opens the door to exaggerated injuries, unrelated medical issues being attributed to work, and even outright fraudulent claims. Heres how: Establish a Clear Injury Investigation Process Not all injuries that occur at work are work-related, and not all reported injuries are legitimate.

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Avoid 2 Common Pitfalls That Delay Care in Workers’ Compensation Claims

AMAXX

This delay typically occurs when there is uncertainty about whether the injury is work-related, resulting in neither workers’ compensation nor general health insurance covering the initial treatment. Example: Consider John, who reports a shoulder injury first thing on a Monday morning.

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Understanding the Key Parties in Workers’ Compensation

AMAXX

Third-Party Administrator (TPA): Claims Specialists For employers who are self-insured or insurance companies without an in-house claims department, TPAs play a crucial role. TPAs operate independently of the insurance carrier, focusing on streamlined claims handling rather than insurance services.

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Part 3: Permanent Total Disability – Other Defenses to Consider

AMAXX

When examining this decision, there are several aspects of how the employee changes their economic position following the work injury: Moving within or to another state: There are various factors to consider when analyzing an employee’s move. Never discount the opportunity for the employee to return to the date of injury to the employer.

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Increase Your Commissions by Selling Disability Insurance

Word & Brown

Having disability insurance can help an individual maintain a regular income (and associated lifestyle) when unable to work due to a new illness or injury. Disability insurance can help your clients avoid depleting their emergency funds or retirement savings when facing disability. LTD plans may differ.