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New Workers’ Comp Rules Coming

Insurance Commissioner Steve Poizner rejected the Workers’ Compensation Insurance Rating Bureau of California (WCIRB) proposal for an increase in the workers’ comp claims cost benchmark (aka the pure premium rate), but he approved staff recommendations in financial reporting rules and other changes to the Unit Statistical Reporting Plan that will impact employers. Among the changes … Read More »

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Utilization Review and Cost Containment Reporting Changes

Employers with claims may get a break on their workers’ comp experience modifications (X-Mods) next year if a planned change by the Workers’ Compensation Insurance Rating Bureau (WCIRB) is adopted by the California Department of Insurance. And it seems likely that a unit statistical reporting change will be adopted. After all, it was Insurance Commissioner … Read More »

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Roundup (19)

AIG Lawsuit Dismissed, Others Pending A federal judge in Chicago last week dismissed a $1 billion lawsuit that the National Council on Compensation Insurance (NCCI) had filed against AIG (NYSE: AIG), but the troubled insurer still faces a potential class-action lawsuit that several individual carriers are pursuing. The brouhaha is over allegations that AIG systematically … Read More »

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Contractor Nabbed for Premium Fraud

Investigators from the California Department of Insurance celebrated the arrest of three individuals associated with NBC General Contractors, a general contracting firm that CDI alleges cheated its workers’ comp carrier out of $1.45 million in premiums by falsifying payroll records. The premium fraud allegations, according to CDI, are that Monica Mui Ung, 49, of Alamo, … Read More »

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Former SCIF General Counsel Calls It Quits

Charles W. Savage, assistant chief counsel for large litigation at State Compensation Insurance Fund (SCIF), is retiring this month after 31 years at SCIF. Savage was a former vice president and general counsel at SCIF until he was demoted after a well-publicized scandal involving former SCIF president Jim Tudor and other management. Savage was Tudor’s … Read More »

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FLASH: Couple Busted In $38 Million Premium Fraud Case

The owners of three Orange County roofing companies are under arrest and being held on a combined $20 million in bail. They allegedly masterminded a premium fraud scheme that cheated the State Compensation Insurance Fund out of an estimated $38 million over an eight year period. The case is the largest premium fraud scam ever … Read More »

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First Aid: New Treatment from Employers and Providers on the Way?

When is a paper cut just a paper cut? The question of what constitutes a first-aid claim baffles employers and injured workers alike. The confusion stems from the two definitions: one in the Labor Code that applies to workers’ comp and another in Title 8 under Cal/OSHA. These vagaries not only create what could be … Read More »

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X-Mod Inflation

Medical containment costs — dollars that go to bill review, utilization review and other services to keep the actual medical expenses in check — are inflating (read: increasing) your and/or your clients’ X-Mods. But is the process unfair to employers? One prominent attorney says it is and is pushing the California Department of Insurance and the … Read More »

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