The Division of Workers’ Compensation’s annual report about its audits of workers’ compensation claims adjusting locations shows it inspected 48 shops and that 46 were able to pass the audit at the initial stage. Of the two shops that failed to meet the Profile Audit Review (PAR) standard, one passed a more in-depth Full Compliance …
The Workers’ Compensation Insurance Rating Bureau will conduct targeted inspection audits on the food and beverage service industry next year. The audits will target many of the 16,000 experience-rated risks currently in the 9079 classification. That, as it prepares to deconstruct the 9079 Restaurants or Taverns classification into six new classes effective this year on …
The California Department of Insurance’s Fraud Assessment Commission voted 3-2 to increase the workers’ comp fraud assessment on California employers by 5% next year to $89,985,405. The two commissioners who voted against the proposal wanted an increase closer to the 16% that the District Attorneys requested and would have boosted the total bill to nearly …
District Attorneys around the state are decrying a sharp drop in the number of suspected fraud referrals over the past few years and complain that pandemic-induced changes to carrier operations are sabotaging the prosecution of cases. But employers and insurance carriers say that many DAs are unresponsive when fraud cases are brought to their attention, …
The Fraud Assessment Commission is heading into 2024 with two of its seven commissioner positions vacant, and now the two longest-serving members on the commission have announced that the January meeting will be their last. FAC chairman Don Marshall of Zenith Insurance and self-insured representative John Riggs of Disney are stepping down after each has …
The California Department of Insurance Fraud Assessment Commission members will reconvene this morning to decide how much employers will pay next year to fight workers’ comp fraud. It is a foregone conclusion it will be more than this year. A majority of the members already expressed support for an increase at a meeting of the …
The Second District Court of Appeal says Allstate Insurance Company can proceed with its lawsuits alleging that a group of radiologists and other affiliates have been defrauding workers’ comp and auto insurance carriers by overbilling for radiology services. The carrier alleges the medical corporations are controlled by an unlicensed individual and operated as a referral …
Insurance Commissioner Ricardo Lara changed the funding allocations for two counties as he signed off on workers’ comp anti-fraud funding recommendations. The commissioners at the Fraud Assessment Commission consented to the changes without any objections. The money comes from all California employers. It is in addition to the regular funding District Attorney’s get from their …