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It’s All About Control

Why is it a good thing to be a Member of a SIG? How does this work? Clay Jackson explains.

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California Supreme Court Considers Overtime Pay for Claims Adjusters

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 … Read More »

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E-Billing Is on Its Way

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 … Read More »

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Commissioner’s Report Urges CIGA Reforms

Echoing the concerns of an independent auditor and a termed out board member, Insurance Commissioner Steve Poizner released a report yesterday that calls on the California Insurance Guarantee Association to improve its internal controls and to better manage its costs. And while the report includes dozens of potential improvements, this same report also clears CIGA … Read More »

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School JPA Wins Major Claims Case

The Marin School Insurance Authority is rolling in a $4.66 million verdict after a Napa County Superior Court jury found that the Authority’s third-party administrator (TPA) was negligent in handling at least 230 workers’ comp claims. Attorneys for MSIA say the case underscores the importance of payors and TPAs paying attention to proper claims handling … Read More »

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TPA Fraud A Growing Concern

Industry regulators have yet to determine the best way to handle fraud among third-party administrators (TPAs), an issue that insiders say is worth tackling. It is difficult because there is no specific watchdog group for the industry. Although California’s Division of Workers’ Compensation audits all workers’ compensation claims-adjusting locations as part of its audit program, … Read More »

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