Insurance companies and policyholders agree to a number of terms in an insurance contract. For example, a company might agree to insure a business’s manufacturing plant in the event of a disaster such as a flood, in exchange for the corporation paying monthly premiums to the insurance company. What’s more, every insurance policy in California…
DetailsInsurance companies adjust workers’ compensation premiums based on a company’s actual losses compared with the “expected” losses of all other similarly sized companies in the same industry. This adjustment, or experience modification, is expressed as a percentage. A company with an experience modification of more than 100% has had a greater-than-expected number of claims (a…
DetailsInsurance companies typically calculate workers’ compensation premiums based on the size of a company’s payroll and the type of work the company performs. Most companies’ premiums are also adjusted by applying an experience modification, which is expressed as a percentage. This modification adjusts the premium up or down depending on the company’s workers’ compensation claims…
DetailsWorkers’ compensation insurance is required of all California employers—even those who only employ one person, part-time. The policy serves as a social safety net to provide compensation for employees who become injured on the job and also limits the liability of employers if an employee sues over workplace-related injuries. Workers’ compensation insurance premiums are collected…
DetailsFor two years, RPNA’s Nick Roxborough has been leading the fight against the Division of Workers’ Compensation’s (DWC) underground rule-making, which is impacting hundreds of QMEs in California. He recently filed an amended complaint with the Los Angeles County Superior Court, adding a new allegation that the DWC used underground rules relating to time spent on medical research as a basis to deny reappointment…
DetailsIn RPNA’s case (Howard v DIR), LA County Superior Court Judge James Chelfant opined that the Division of Workers’ Compensation relied on unenforceable underground regulations when it denied applications for reappointment from two QMEs and unreasonably delayed hearings when the doctors objected. According to Nick Roxborough, the judge’s decision means the division “can’t continue to…
DetailsRPNA continues to fight against unlawful WC side agreements. Nick Roxborough recently finished hearings before a DOI administrative law judge in the case Davidson Hotel v. Travelers. Once again, another carrier is attempting to illegally enforce the terms of its unfiled workers’ compensation side agreements, subjecting employers to out-of-state arbitrations, over collateralization, and overpayment for coverage due to poor claims handling. RPNA…
DetailsWorkers’ compensation premiums, or the amount the employer pays to insurance companies to protect the employer as well as the employee in the event of a workplace accident, can be challenging to calculate. A premium is based in part on the dollars in payroll the company pays as well as the employer’s industry. Underreporting of…
DetailsWorkers’ compensation premiums, or the amount an employer pays to an insurance company in exchange for the carrier providing medical treatment and compensation to employees in the event of workplace accidents, are audited at the end of the policy term. Before the policy becomes effective, workers’ comp insurance companies prepare an initial estimate of premiums,…
DetailsWhile a predetermined formula sets workers’ compensation insurance premiums, employers often dispute the amounts of the premiums they are asked to pay and it’s no surprise as to why: Insurance premiums are one of the many challenging costs for California employers. In fact, according to a 2014 report, California is the most expensive state for…
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