Correction: The article has been updated to reflect the number of positions currently authorized for the Division of Workers’ Compensation’s Audit and Enforcement unit at 34 positions. The 1,081 positions initially referenced in the article are the authorized positions for the Division as a whole. Intercare, a third-party administrator (TPA), is suing the Department of …
The Division of Workers’ Compensation agreed to drop nearly $200,000 in administrative penalties against Keenan and Associates, a Third-Party Administrator that failed a DIR claims audit. For its part, Keenan agreed to fix the problems identified in the audit and drop its appeal. The settlement leaves the failing grade intact. The deal was revealed as …
The Division of Workers’ Compensation is reviewing comments and feedback it received from a recent outreach to workers’ comp industry stakeholders to gather thoughts about what needs to be fixed in California’s audit regulations for claims adjusters and third-party administrators (TPAs). Division officials did not provide a timeline for when or if formal changes to …
Five years into its ownership of York Risk Services, private equity firm Onex found its exit with a deal to sell the third-party administrator (TPA) to competitor Sedgwick for an undisclosed amount. Onex reportedly paid $1.3 billion to acquire York in 2014. The deal reinforces Sedgwick’s position as the nation’s largest TPA. Sedgwick itself is …
A third-party administrator that failed to timely respond to a settlement offer for $30,000 is now on the hook for the full $18.5 million an arbitration panel awarded the carrier on the case for the TPA’s malfeasance. The underlying case had settled for $15 million after a trial court returned an award for the plaintiff …
Why is it a good thing to be a Member of a SIG? How does this work? Clay Jackson explains.
Workers’ comp carriers in California are taking heat from both employers and regulators over the dollars they spend to administer and defend workers’ comp claims. Loss adjustment expenses (LAE) ballooned following the reforms, but a case now pending before the California Supreme Court could have a moderating effect on one component in that cost driver …
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 …