03.20.2017By: Karen Atkins
The Tennessee drug formulary has been deemed applicable to all dates of injury, including legacy claims. By legacy claims, I mean those claims where an injured worker was prescribed a certain drug or series of drugs well before the formulary implementation date. The concern with legacy claims is that the immediate cessation of drug use could have dangerous side effects. This prompted me to think more about formularies in general, and specifically the best way...
03.09.2017By: Michael P. Burns
The past decade has seen an explosion in online access and improvements in technology. These changes have naturally resulted in changes in medicine. Smartphone applications and videoconferencing are methods by which business, and now medicine, is conducted. California’s workers compensation system is no stranger to these advancements. But what happens when technology is applied to the century-old workers' compensation system? Several recent cases outline the attempt to bring the system into...
At the 2017 PARMA Conference, a panel discussed cyber liability concerns for public entities. The panel was:John Chino – Arthur J Gallagher Steven Robinson – Risk Placement Services, Inc. Elissa Doroff – XL Catlin
Common Patterns of Cyber /Claims:Missing or stolen laptop or storage devices Mismailing Erroneous data posting Willful release based on fraudulent instruction (social engineering, Phishing), this is sometimes not covered under Cyber but instead crime Compromised system (hacking) Loss or theft of...
Synopsis: The Biggest News in Illinois Workers’ Comp History No One is Reporting—I Assure You The IL Workers’ Comp Commission Is Set To Close Thirty Days From Today!
Editor’s comment: I had a reader tell me Illinois State Government appears to be filling in for the Ringling Bros. and Barnum & Bailey Circus that is soon to close. Everything that is happening in our state government...
01.23.2017By: Lavonya Chapman
The Centers for Medicare & Medicaid Services (CMS) announced the organization will be reconsidering a new policy in 2017 regarding re-reviews of otherwise approved Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) amounts. According to the CMS announcement, this new policy would only apply to claims “where settlement has not occurred.” As such, if settlement has been agreed upon CMS will not consider a re-review. The timing of any such change, however is yet unknown....
01.10.2017By: Robert Wilson
A Japanese insurance company is about to thrust the insurance industry into the future, as well as the ongoing debate over how much technology will really alter our industry.
I’ve spent a good deal of time this past year discussing the future of workers’ compensation at conference presentations around the nation. Obviously, technology is a big part of those discussions. I always caution my audiences that there is plenty of room...
12.14.2016By: Kimberly George, SVP, Corporate Development, M&A, and Healthcare
Nearly all businesses have interest in consumer experience. Whether you fly an airline, shop at a retailer, visit a website, or frequent an eatery, businesses care about your perception of their services and the products you consume. Negative experiences result in loss of business, and potentially sales for a competitor. Designing protocol inclusive of user experience has advanced from the automotive and technology industries to a broad spectrum...
The NJ Workers' Compensation Rating and Inspection Bureau (NJCRIB) reported today 2017 rates effective January 1, 2017.
The Commissioner of Banking and Insurance (“Commissioner”) has approved a 3.0% decrease in rates and rating values applicable to New Jersey workers compensation and employers liability insurance effective January 1, 2017 on a new and renewal basis. The rating components of the decrease are summarized below.
EXPERIENCE AND TREND: Analysis of data for the latest two complete policy years and...
11.29.2016By: Martin Cassavoy
The last half-dozen years have seen Medicare Secondary Payer (MSP) compliance evolve, with the most recent example being its change in focus from mandatory insurer reporting to rolling recovery. But one of the most impactful changes involves Medicare Advantage Organizations (MAOs). Ten years ago, most practitioners didn’t even worry about them, but now insurers in some regions are more concerned about Medicare Advantage enrollees than Medicare beneficiaries without these plans.
11.17.2016By: Robert Wilson
I know, it sounds like a no brainer, but you’d be surprised. Kids’ Chance Awareness Week, which starts this morning and runs through November 18th, is all about awareness. Your awareness; to a cause that is helping kids in need across this country.
In case you are not yet aware, Kids’ Chance is an organization largely staffed by workers’ compensation related volunteers, and primarily funded by the workers...
11.09.2016By: Gary L. Wickert
A recent Texas Court of Appeals decision parsing the wording of a workers’ compensation policy’s waiver of subrogation endorsement reminds us that, like an onion, a waiver endorsement has many layers and should be peeled back fully before giving up on subrogation and/or reimbursement potential. In Insurance Co. of the State of Pennsylvania v. Exxon, No. 01-15-0453-CV (Tex. Civ. App. – Houston [1st Dist.] July 14, 2016), Kevin Roberts...
At the 2016 PCI Annual Meeting, a panel of retiring insurance executives discussed lessons learned over their careers. The panel included:
Marguerite Tortorello – moderator Terrance Cavanaugh – President and CEO – Erie Insurance Group Kenneth Ciak – Vice Chairman – Ameriprise Auto and Home Insurance Tad Montross – Retired CEO – Gen Re J. Douglas Robinson – Chairman of the Board – Utica National Insurance Group
What keeps you up at night, then and now?<...
Kids’ Chance awareness week 2016 is November 14-18, 2016. There will be activities throughout the United States to raise awareness of the need for scholarships and the impact of work injuries on families.
What happens when a child loses a parent to a work-related fatality? How do families cope with a dramatic decrease in income because Mom or Dad cannot return to work due to an injury? In many cases, a college...
By Donald R. Barthel
Welcome to the internet age. For those of you—like me—who are of a "certain" age, a life without computers has been replaced Google, email, texts, online shopping, instant messages, LinkedIn, Twitter, Skype, Facebook...and all those other means of communication that my 15 year old children try to explain to me. (I've got to admit: I've been on electronic overload ever since the introduction of the game ...
This session at Business Insurance’s Absolute Inclusion Conference gathered industry regulators to discuss progress in creating a more diverse insurance industry.
Dave Jones, Commissioner of Insurance, State of California
According to Commissioner Dave Jones, California is home to the majority of the nation’s diverse suppliers. Every one of those diverse suppliers wants the ability to compete on price and quality and demonstrate what they can do. This caused him to investigate...
To save you time, here’s a sampling of workers' compensation and insurance news, each in 350 words or less.
The National Association of Insurance Commissioners has appointed Peter L. Hartt, director of New Jersey's insurance division, to a two-year term as the state insurance commissioner representative on the Financial Stability Oversight Council (FSOC). In this role, Hartt will represent the interests of the nation's state insurance regulators on the council. naic
The Denver Post editorial board is taking Colorado’s regulators and lawmakers to task over workers’ compensation.
What seems to have pushed them over the edge is a impending shuttering of Trep Cafe, a student-run nonprofit at the University of Colorado. After failing to provide workers’ compensation insurance off and on over several years, the students racked up fines of more than $224,000. An appeal failed to resolve the issue.
The troubles at the cafe and other small businesses, the editorial claims, are the result of changes in 2005 that created new, tougher fines for non-compliance regarding workers’ compensation coverage.
When does 2 plus 2 not equal 4?
In the land of workers’ compensation premiums.
In an article at Claims Management magazine. attorney Jonathan M. Kuller explains a new “shell game” that some companies are using to reduce their workers’ compensation premiums.
For his example, Kuller creates a scenario of a full-service trucking operation that divides itself into several different corporations and LLCs. Only one of these enterprises has employees, and therefore, only one must pay for workers’ compensation coverage.
Is the owner doing anything wrong? And if so, will the workers’ compensation auditor catch on?
08.29.2016By ADAM KLASFELD
Since receiving a $182 billion bailout, the American International Group has been roundly mocked for lawsuits demanding more government money, but the insurer's lawyers agreed on Friday, August 26, to let a jury decide the last of these cases. As U.S. District Judge Louis Stanton noted at a hearing August 26, AIG did not have much of a choice.
The government already filed a demand for a jury trial on AIG's lawsuit from six...
Missouri employers should see a reduction in workers’ compensation rates for the third straight year in a row according to preliminary figures collected by the Missouri Department of Insurance from the National Council on Compensation Insurance (NCCI). The NCCI recently proposed an overall decrease of 3.7 percent for 2017 workers’ compensation loss costs.
“Missouri businesses will be pleased to hear that workers’ compensation rates on average should decrease again in 2017,” said Missouri Department of...