Claims and Costs News

Study Looks at Polypharmacy Claims in California Workers’ Comp

A study from the California Workers’ Compensation Institute shows the likelihood that indemnity was paid on a workers’ comp claim increased with the number of concurrent prescriptions the injured worker was on. Concurrent use of multiple medications to treat one …

3 Types of Workers’ Comp Insurance Fraud and How to Prevent Them

Workers’ compensation insurance is a safety net for employees who are injured on the job, as well as for their employers. It pays for lost wages, medical expenses and other expenses and benefits incurred by an injured worker. Sometimes, however, …

Investigation and Claims Handling Strategies for Willful Misconduct Defense

Many, if not most, states have a no-fault workers’ compensation system that intends to provide employees with benefits regardless of who is to blame. This blame includes not only the employee’s own carelessness, but also the negligence of the employer. …

Cancer-Stricken Texas Firefighters Often Denied Workers’ Comp

Many Texas cities are denying workers’ compensation to firefighters with cancer, according to union leaders and state lawmakers. Over the past six years, more than 90 percent of the 117 workers compensation claims filed by Texas firefighters with cancer have …

Workers’ Comp Study Reveals Top Ways to Close Claims Performance Gap

A five-year analysis of more than 1,700 claims executives benchmarking data by Rising Medical Solutions identifies the top three practices claims organizations should adopt to join their more successful peers, or risk falling further behind. Just 24 percent of claims …

Survey: Workers’ Comp Drug Spend Declined by $1B in Past 8 Years

Pharmacy costs in workers’ compensation have decreased by $1.1 billion during the past eight years, according to CompPharma’s 15th Annual Survey of Prescription Drug Management in Workers’ Compensation. “Pharmacy is no longer the fastest-growing segment of work comp medical expenses,” …

Vehicle Complexity Driving Increases in Repair Time Cycle

Repair cycle time and length of rental have seen steady increases over the last several years. Within the industry the primary explanation used to explain these increases is growth in vehicle and repair complexity; which preliminary comparison of vehicle repair …

White Paper Reveals Impact of Attorney Involvement on Workers’ Comp Claim Costs

Injured workers who hire attorneys to handle their workers’ comp claims tend to stay on temporary disability longer, according to a newly released white paper by CLARA Analytics, an artificial intelligence and data science company that specializes in machine learning …

Cost Control and the Role of Precertification and Utilization Review in Workers’ Comp

Medical expenses, now averaging well over 60 percent of average claims costs, according to a 2014 Lockton whitepaper, represent a significant impact on an employer’s workers’ compensation total cost of risk. This trend isn’t going away soon, as this average …

Montana Regulators Propose Fines Against Pharmacy Benefits Managers

State regulators are proposing fines against two companies that manage pharmacy benefits for health insurers, saying they operated in Montana without a license. The alleged violations were discovered while the office of the Commissioner of Securities and Insurance was gathering …