A Sacramento jury, in a significant decision, awarded three former Zurich American Insurance Company claims executives a staggering $80 million in regular and punitive damages in a defamation case. The executives were terminated for taking ‘off the record’ paid time off that had been given to them as a reward for their performance by their …
The Fourth District Court of Appeal says it was proper to dismiss a case alleging a workers’ comp carrier, its claims administrator, and the claims adjuster violated Insurance Code section 1871.7 – the Insurance Frauds Prevention Act (IFPA). The Court maintains that the act’s purpose is to prevent and punish fraudulent claims made to insurance …
California’s workers’ comp claims adjusters are failing to pay one out of every ten injured workers all the workers’ comp benefits owed, according to the Division of Workers’ Compensation’s Audit and Enforcement Unit. But claims operations are showing modest improvement in cutting down on the amount owed to employees. The findings come in the latest …
The Division of Workers’ Compensation has a new report out on the performance of workers’ comp claims adjusters, and the results show a sharp regression in the adjusters’ performance. The results from audits performed in 2018 show that over one in ten injured workers were illegally denied at least some of their workers’ comp indemnity …
A senior claims adjuster for AmTrust North America and a former claims adjuster at the carrier were accused of stealing over half-a-million-dollars through a scheme of submitting and paying fraudulent invoices. The San Francisco District Attorney’s office is charging the pair with 13 felonies including conspiracy to commit insurance fraud, submitting false and fraudulent claims, …
The cost of doing business in California for Liberty Mutual Insurance Company and its Golden Eagle Insurance company is about to go up under a new ruling by the Court of Appeals in Los Angeles. Under order from the state Supreme Court, the Los Angeles court reexamined the class action lawsuit filed by claims adjusters …
The California Supreme Court may have handed insurance carriers a victory when it overturned a lower-court decision finding that certain claims adjusters were nonexempt employees and thus eligible for overtime pay. But we’ll have to wait for a court of appeal to digest its opinion and reconsider the case before there’s a definitive answer and …
Employers, claims adjusters and health care providers doing business with California’s workers’ comp system will have to use a new set of standardized paper forms beginning this fall while the system as a whole prepares for implementation of electronic billing standards a year later. The rules approved by the Office of Administrative Law promise quicker …