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Mistake: Accepting Every Workers’ Compensation Claim

AMAXX

Many companies operate under an unwritten rule: accept every workers compensation claim, no questions asked. A well-managed workers compensation program should pay 100% of legitimate claimsand 0% of the claims that arent. Employees come to believe that every claim will be accepted, regardless of the circumstances.

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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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Falling Work Comp Rates: The Good, the Bad, and the Ugly

R&R Insurance

On October 1, 2024 Wisconsin continued its trend entering a ninth consecutive year of reduced workers compensation insurance rates. Workers compensation rates are state mandated in Wisconsin, meaning all insurance carriers must use the same rates resulting in premiums from one carrier to another are basically the same.

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Georgia Appeals Court Questions Insolvency Pool’s Subrogation in Comp Cases

Insurance Journal

Georgia employers and their workerscompensation 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.

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Collateral Agreement Didn’t Mention Tort Claims, Cutting SUNZ Out of BP Funds

Insurance Journal

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 …

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

AMAXX

As a result, the workerscompensation insurance carrier decides not to pay for the treatment until they determine the claim’s compensability. Simultaneously, because the injury was reported as work-related, John’s group health insurance also refuses to cover the treatment.

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

Insurance Journal

Defending workerscompensation 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 …

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