Claim and Compensation - Insurance Industry Brief

Report: Long COVID Accounted for Three Quarters of California Comp Virus Claim Payments

Insurance Journal

JUNE 3, 2025

of the treatment payments on COVID claims and 73.7% of all COVID-19 claim payments in California’s workers’ compensation system, according to a study. The study from the California Workers’ Compensation Institute shows one-in-21 California … Long COVID cases accounted for 82.1%

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Delaware’s Workers’ Compensation Claims Cost Grew 3% a Year: WCRI

Insurance Journal

OCTOBER 1, 2024

The average cost of workers’ compensation claims in Delaware, for cases with more than seven days of lost work, went up by 3% per year between 2019 and 2022, according to a new study from the Workers Compensation Research Institute …

Workers Compensation

Workers Compensation Compensation Claim

Student-on-Employee Workers’ Compensation Assault Claims Drop: Gallagher Basset

Insurance Journal

AUGUST 8, 2024

The number of workers’ compensation claims for student-on-school-employee assault dropped significantly during the 2023-24 school year, according to data from Gallagher Basset. This change comes after two years of increasing claims following the 2020-21 school year. Citing client numbers covering …

Workers Compensation

Workers Compensation Compensation Claim Risk

Court Must Decide If Child Victims Act Revives Old Workers’ Compensation Claims

Insurance Journal

JULY 30, 2024

Did New York lawmakers intend the Child Victims Act (CVA) that revived old claims of sexual abuse to apply to claims by employees that would previously have been handled by the workers’ compensation system? It’s the responsibility of the state’s …

Workers Compensation

Workers Compensation Compensation Claim

Travelers: Costliest Claims Driven by Most Common Workplace Accidents

Insurance Journal

AUGUST 5, 2024

million workers compensation claims reveals the costliest claims are driven by the most common workplace accidents, according to Travelers 2024 Injury Impact Report. Analysis of 1.2 The data also shows first-year employees are still among those most vulnerable to injury.

Workers Compensation

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Mistake: Accepting Every Workers’ Compensation Claim

AMAXX

MARCH 18, 2025

Many companies operate under an unwritten rule: accept every workers compensation claim, no questions asked. A well-managed workers compensation program should pay 100% of legitimate claimsand 0% of the claims that arent. Employees come to believe that every claim will be accepted, regardless of the circumstances.

Workers Compensation

Workers Compensation Compensation Claim Workers Comp

How Fear Impacts Workers’ Compensation Claims (and What to Do About It)

AMAXX

MARCH 4, 2025

Research has shown that fear of being fired is one of the top predictors of negative claim outcomes, including increased litigation rates and extended time off work. By understanding the role fear plays in workers compensation claims, employers can implement strategies to foster trust, improve outcomes, and reduce costs.

Workers Compensation

Workers Compensation Compensation Claim Workers Comp

Understanding Classification Rules in Workers’ Compensation

AMAXX

FEBRUARY 18, 2025

When it comes to managing workers’ compensation, understanding classification rules is fundamental. The higher the risk, the higher the workers compensation premium for that classification. Be Proactive About Audits : Workers compensation audits are a routine part of ensuring that businesses are accurately classified.

Workers Compensation

Workers Compensation Compensation Workers Comp Premium

Demystifying Evidence-Based Medicine in Workers’ Compensation

AMAXX

APRIL 23, 2025

Evidence-Based Medicine (EBM) is increasingly recognized as a critical component in workers’ compensation, influencing treatment decisions, recovery outcomes, and cost management. Understanding EBM helps stakeholdersfrom medical professionals to claims managersmake informed decisions grounded in high-quality research and best practices.

Workers Compensation

Workers Compensation Compensation Workers Comp Injury

Long COVID Claims Still Impact California’s Workers Comp System, Report Shows

Insurance Journal

OCTOBER 6, 2024

The impact and surge of long-term COVID on the California workers’ compensation system since 2020 has been prevalent, including long-term impacts on disability and long-term patterns of medical cost and treatment on long COVID claims. That’s from a report by …

Workers Comp

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Travelers: Costliest Claims Driven by Most Common Workplace Accidents

Insurance Journal

AUGUST 18, 2024

million workers’ compensation claims reveals the costliest claims are driven by the most common workplace accidents, according to Travelers 2024 Injury Impact Report. Analysis of 1.2 The data also shows first-year employees are still among those most vulnerable to injury.

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County Trash Collector’s Workers’ Compensation Claim Thrown Out

Insurance Journal

FEBRUARY 20, 2025

When the garbage truck stopped, the worker stepped down from the metal step on the back of the truck to run and retrieve a trash can. When his feet hit the ground, he heard a pop in his leg, felt …

Workers Compensation

Workers Compensation Compensation Claim Liability

Claim Frequency in California Workers’ Comp Higher in L.A. Area, Study Shows

Insurance Journal

DECEMBER 4, 2024

Claim frequency in California workers’ compensation remains significantly higher in the Los Angeles Basin than in the northern part of the state, a new study shows. The Workers’ Compensation Insurance Rating Bureau of California released its WCIRB Geo Study 2024, …

Workers Comp

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Minnesota Adds Stricter Guidelines for Rehabilitation Services in Work Comp Claims

Insurance Journal

JULY 30, 2024

Injured Minnesota employees who seek services from the Department of Labor and Industry’s Vocational Rehabilitation unit (VRU) while their disputed workers’ compensation claim goes through the litigation process will soon face new eligibility rules. Effective Aug. 1, 2024, if the …

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Workers’ Comp Premiums Fall 3% in 2024; Combined Ratio Holds at 86: NCCI

Insurance Journal

JUNE 1, 2025

By Andrea Wells Workers’ compensation remained a healthy and profitable line in 2024, but claims severity grew with an increase of 6% for medical claim severity and 6% for indemnity claim severity. That’s according to the National Council on Compensation …

Workers Comp

Workers Comp Premium Compensation Claim

Employee Whiffs on Workers Compensation Claim for TopGolf Injury

Insurance Journal

MARCH 18, 2025

An employee who claims he injured his knee while swinging a club during an employer-sponsored TopGolf event has failed to qualify for workers’ compensation benefits. The Virginia Workers’ Compensation Commission (VWCC) recently upheld the denial of benefits for the injured …

Workers Compensation

Workers Compensation Compensation Injury Claim

Connecticut Approves 6% Workers’ Compensation Rate Decrease for 2025

Insurance Journal

NOVEMBER 21, 2024

The trend of decreasing rates in Connecticut workers’ compensation insurance will continue as the state’s insurance regulator has approved an industry proposed 6% rate decrease beginning January 1, 2025. The now-approved rate filing submitted by the industry’s National Council on …

Workers Compensation

Workers Compensation Compensation Insurance Insured

Workers’ Comp Mega Claims Total $1B-Plus Yearly, Multiagency Study Shows

Insurance Journal

DECEMBER 12, 2024

Mega claims in workers’ compensation represent far less than 1% of total workers’ comp claims yet account for more than 2% of total loss dollars, and total in excess of $1 billion each year, a new study from 10 state …

Workers Comp

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How to Tell If You Need a Nurse Case Manager for Your Workers’ Compensation Claim

AMAXX

FEBRUARY 24, 2025

However, there are times when the NCM doesn’t serve a specific purpose and is assigned to the claim to get it moving. Ask your third-party administrator or adjuster to work with you to determine when nurses are needed to resolve claims quickly and ensure good-quality medical care for employees.

Workers Compensation

Workers Compensation Compensation Workers Comp Claim

Report: Oregon Worker’s Comp Claims Fell in 2023 from Previous Two Years

Insurance Journal

MAY 7, 2025

Oregon worker’s compensation claims fell in 2023 from the previous two years, a report from the Oregon Department of Consumer and Business Services shows. The department received notification of 22,994 accepted disabling claims for occupational injuries and diseases in 2023, …

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Insurer, Contractors Allege Staged Injury Claims Scheme Under New York Scaffold Law

Insurance Journal

NOVEMBER 18, 2024

A construction industry captive insurer along with three construction contractors have filed a lawsuit alleging a massive New York fraud scheme involving staged workplace accidents and bogus workers’ compensation and personal injury lawsuits backed by complicit lawyers and medical providers.

Injury

Injury Compensation Claim Insured

The Role of Evidence-Based Medicine in Transforming Workers’ Compensation

AMAXX

JANUARY 20, 2025

In the intricate landscape of workers’ compensation, the pursuit of optimal outcomes for injured workers is paramount. In the context of workers’ compensation, EBM seeks to streamline care pathways and promote recovery by basing treatment plans on standardized guidelines and peer-reviewed evidence.

Workers Compensation

Workers Compensation Compensation Workers Comp Injury

Worker Injured While Drunk on the Job Wins Claim Approval

Insurance Journal

OCTOBER 17, 2024

A worker injured when he fell from a ladder is entitled to workers’ compensation benefits despite the fact he was intoxicated at the time of the accident. An appellate court in New York has upheld a decision of the Workers’ …

Compensation

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Minnesota Workers’ Comp System Stable Despite COVID-19 Impact

Insurance Journal

JULY 17, 2024

Workers’ compensation claim rates and benefits paid in Minnesota continue to be stable or follow their long-term downward trajectories, a new Department of Labor and Industry (DLI) report shows. The 2024 Minnesota Workers’ Compensation System Report presents trend data regarding …

Workers Comp

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Morgan & Morgan Vows to Fight Proposed Class Action on ‘Botched’ Injury Claims

Insurance Journal

JULY 23, 2024

But perhaps the Orlando-founded firm has grown too big, too quickly, suggests a proposed class-action lawsuit that claims the firm has botched hundreds of … Morgan & Morgan calls itself the nation’s largest injury law firm, with offices in most states.

Injury

Injury Claim Workers Compensation Insurance Claim

How Lag Time Sabotages Claims—And What You Can Do About It

AMAXX

MAY 27, 2025

In the world of workers compensation, few factors have a more immediate and measurable impact on claim outcomes than lag time the delay between when an injury occurs and when it is reported to the carrier or third-party administrator (TPA). Beyond four weeks , claim costs jumped 31%. Here’s what you need to know.

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What is Evidence-Based Medicine in Workers’ Compensation

AMAXX

FEBRUARY 24, 2025

Evidence-Based Medicine (EBM) plays a critical role in workers compensation, guiding both medical professionals and non-medical stakeholders in making informed decisions about injury treatment, recovery time, and return-to-work strategies. States mandate different sets of guidelines, which stakeholders must adhere to when managing claims.

Workers Compensation

Workers Compensation Compensation Workers Comp Injury

Court, Not Board, Must Decide If Insurer’s Conduct After Canceling Policy Was Negligent

Insurance Journal

AUGUST 12, 2024

Claims that a workers’ compensation insurer’s conduct after it canceled a policy were negligent are for a court, not the state’s workers’ compensation board, to decide, the Connecticut Appellate Court has ruled. Liberty Mutual Insurance Co. had succeeded before both …

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Why Empathy is the Secret Weapon in Workers’ Compensation Programs

AMAXX

APRIL 28, 2025

In workers’ compensation programs, the conversation often revolves around costs, compliance, and claims management systems. Empathy isnt just a nice to have in workers comp management it’s a proven strategy for reducing claim costs, preventing litigation, and helping injured employees return to work faster.

Workers Compensation

Workers Compensation Compensation Workers Comp Injury

Cyber Risk: West Virginia OIC Plans to Dispose of Older Workers’ Comp Files

Insurance Journal

AUGUST 22, 2024

The West Virginia insurance commissioner’s office has adopted a new policy: It will soon begin destroying workers’ compensation claim files that are 10 years old or older. “Given increasing cybersecurity concerns and the type of information contained in the closed …

Workers Comp

Workers Comp Cyber Compensation Risk

How to Prevent Workplace Injuries and Reduce Workers’ Compensation Claims

Mark Jackson Insurance Agency

APRIL 21, 2025

For business owners, preventing injuries is key to protecting employees, maintaining productivity, and minimizing workers compensation claims. Responding quickly and documenting everything helps limit the impact of workplace injuries and supports the workers compensation claims process.

Workers Compensation

Workers Compensation Injury Compensation Claim

Chased by Golf Cart at Work: Horseplay or Assault? For Workers’ Comp, It Matters.

Insurance Journal

JUNE 4, 2025

Workers’ compensation benefits are not available to a worker injured when he was chased and hit by a golf cart driven by a co-worker who claimed he was just horsing around. The Virginia Court of Appeals ruled that Dennis Ocasio’s …

Workers Comp

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Florida Appeals Court Upsets Applecart on Workers’ Comp Statute of Limitations

Insurance Journal

JANUARY 15, 2025

A recent decision and concurring opinion by a Florida appeals court may have upset years of practice and could raise costs for workers’ compensation insurers. Some claims that carriers were once ready to close out of due to the statute …

Workers Comp

Workers Comp Compensation Claim Workers Compensation

Washington Metal Fabricator Faces Felony in $340K Workers’ Comp Scam

Insurance Journal

SEPTEMBER 19, 2024

A Washington man who claimed he was too injured to work while operating a metal fabrication shop faces a felony charge in an alleged $340,000 workers’ compensation scam. Travis Lee Johnson, 52, of Spokane Valley, pleaded not guilty recently to …

Workers Comp

Workers Comp Compensation Claim Workers Compensation

Georgia Appeals Court Questions Insolvency Pool’s Subrogation in Comp Cases

Insurance Journal

JULY 17, 2024

Georgia employers and their workers’ compensation insurers can rest a little easier after an appeals court this week narrowed the circumstances in which a state guaranty association can seek reimbursement on claims paid after staffing firms’ insurance carriers become insolvent.

Insurance Carrier

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California Vocational School Owner Charged With Fraud in Workers’ Comp Scheme

Insurance Journal

OCTOBER 24, 2024

The owner of a Fresno, California-based for-profit vocational school was charged with engaging in fraudulent billing practices related to workers’ compensation. The fraudulent insurance claims could reach … Paul Steve Ramirez, 59, was charged with 11 felony counts, including insurance fraud.

Workers Comp

Workers Comp Compensation Insurance Claim Claim

4 Step Process to Successfully Settle More Workers’ Compensation Claims

AMAXX

NOVEMBER 5, 2024

Successfully settling workers’ compensation (WC) claims can significantly reduce costs and streamline processes for employers and insurers. By adhering to a proven four-step process, organizations can consistently achieve better claim outcomes. One key trigger is the injured worker reaching medical stability.

Workers Compensation

Workers Compensation Compensation Claim Workers Comp

Collateral Agreement Didn’t Mention Tort Claims, Cutting SUNZ Out of BP Funds

Insurance Journal

JANUARY 9, 2025

If insurance carriers want to have dibs on a company’s assets as premium security or collateral, they had better specify that those assets include potential tort-claim settlements, a federal appeals court said Wednesday. In a case that involved a Florida …

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With Unrevealed Previous Injury, Later Claim Cannot be Denied, Georgia Court Says

Insurance Journal

MARCH 3, 2025

Defending workers’ compensation claims from employees who have not disclosed previous injuries may have just become a little more complicated for employers and insurance carriers in Georgia. The Georgia Court of Appeals last week found that a long-standing defense against …

Injury

Injury Claim Insurance Carrier Compensation

Washington Adult Family Home Operator Facing Felony Charge in Alleged Workers’ Comp Scam

Insurance Journal

JULY 16, 2024

A Spokane, Washington woman who ran an adult family home while claiming she was too injured to work faces a felony charge in a $60,000 workers’ compensation fraud case. Serah Kamau, 52, reportedly operated her business, Brookhouse Adult Family Home, …

Workers Comp

Workers Comp Compensation Claim Workers Compensation

Avoid Litigation and Improve Workers’ Comp Claim Outcomes

AMAXX

FEBRUARY 17, 2025

When a worker is injured, their experience in the workers’ compensation system can have a profound impact on their recovery, return to work, and overall job satisfaction. However, implementing strong communication strategies can significantly improve claim outcomes and reduce unnecessary legal battles.

Workers Comp

Workers Comp Claim Workers Compensation Injury

Birth Injury Compensation Fund Executive Gets 9 Years for Embezzling $6.7 Million

Insurance Journal

MARCH 6, 2025

A Providence Forge, Virginia man has been sentenced to nine years in prison for embezzling funds from his former employer, the Virginia Birth-Related Neurological Injury Compensation Program. According to court documents, John Hunter Raines was the chief financial officer and …

Injury

Injury Compensation Claim Insurance

Part 1: Layoff Planning to Control Workers’ Comp Claims

AMAXX

MARCH 10, 2025

Mass layoffs or company closures can trigger a significant increase in workers’ compensation claimssome legitimate, others potentially unsubstantiated. Enhance Claims Handling Capacity Prepare for an uptick in claims by adding staff who can handle the additional workload effectively.

Workers Comp

Workers Comp Claim Workers Compensation Injury

‘Old School’ Job Search Benefits Injured Worker in Lost Wages Claim

Insurance Journal

FEBRUARY 6, 2025

A manufacturer and its workers compensation insurer thought an injured 60-year old service technician employee did not work hard enough to find a suitable replacement job as required to qualify for wage loss benefits. Among other things, he did not …

Workers Compensation

Workers Compensation Workers Compensation Insurance Compensation Claim

Report: Long COVID Accounted for Three Quarters of California Comp Virus Claim Payments

Delaware’s Workers’ Compensation Claims Cost Grew 3% a Year: WCRI

Trending Sources

Student-on-Employee Workers’ Compensation Assault Claims Drop: Gallagher Basset

Court Must Decide If Child Victims Act Revives Old Workers’ Compensation Claims

Travelers: Costliest Claims Driven by Most Common Workplace Accidents

Mistake: Accepting Every Workers’ Compensation Claim

How Fear Impacts Workers’ Compensation Claims (and What to Do About It)

Understanding Classification Rules in Workers’ Compensation

Demystifying Evidence-Based Medicine in Workers’ Compensation

Long COVID Claims Still Impact California’s Workers Comp System, Report Shows

Travelers: Costliest Claims Driven by Most Common Workplace Accidents

County Trash Collector’s Workers’ Compensation Claim Thrown Out

Claim Frequency in California Workers’ Comp Higher in L.A. Area, Study Shows

Minnesota Adds Stricter Guidelines for Rehabilitation Services in Work Comp Claims

Workers’ Comp Premiums Fall 3% in 2024; Combined Ratio Holds at 86: NCCI

Employee Whiffs on Workers Compensation Claim for TopGolf Injury

Connecticut Approves 6% Workers’ Compensation Rate Decrease for 2025

Workers’ Comp Mega Claims Total $1B-Plus Yearly, Multiagency Study Shows

How to Tell If You Need a Nurse Case Manager for Your Workers’ Compensation Claim

Report: Oregon Worker’s Comp Claims Fell in 2023 from Previous Two Years

Insurer, Contractors Allege Staged Injury Claims Scheme Under New York Scaffold Law

The Role of Evidence-Based Medicine in Transforming Workers’ Compensation

Worker Injured While Drunk on the Job Wins Claim Approval

Minnesota Workers’ Comp System Stable Despite COVID-19 Impact

Morgan & Morgan Vows to Fight Proposed Class Action on ‘Botched’ Injury Claims

How Lag Time Sabotages Claims—And What You Can Do About It

What is Evidence-Based Medicine in Workers’ Compensation

Court, Not Board, Must Decide If Insurer’s Conduct After Canceling Policy Was Negligent

Why Empathy is the Secret Weapon in Workers’ Compensation Programs

Cyber Risk: West Virginia OIC Plans to Dispose of Older Workers’ Comp Files

How to Prevent Workplace Injuries and Reduce Workers’ Compensation Claims

Chased by Golf Cart at Work: Horseplay or Assault? For Workers’ Comp, It Matters.

Florida Appeals Court Upsets Applecart on Workers’ Comp Statute of Limitations

Washington Metal Fabricator Faces Felony in $340K Workers’ Comp Scam

Georgia Appeals Court Questions Insolvency Pool’s Subrogation in Comp Cases

California Vocational School Owner Charged With Fraud in Workers’ Comp Scheme

4 Step Process to Successfully Settle More Workers’ Compensation Claims

Collateral Agreement Didn’t Mention Tort Claims, Cutting SUNZ Out of BP Funds

With Unrevealed Previous Injury, Later Claim Cannot be Denied, Georgia Court Says

Washington Adult Family Home Operator Facing Felony Charge in Alleged Workers’ Comp Scam

Avoid Litigation and Improve Workers’ Comp Claim Outcomes

Birth Injury Compensation Fund Executive Gets 9 Years for Embezzling $6.7 Million

Part 1: Layoff Planning to Control Workers’ Comp Claims

‘Old School’ Job Search Benefits Injured Worker in Lost Wages Claim

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