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Workers’ Compensation Insurance: Claim Costs, Prices, and Regulation

Workers’ Compensation Insurance: Claim Costs, Prices, and Regulation
Author: David Durbin
Publisher: Springer Science & Business Media
Total Pages: 362
Release: 2007-08-27
Genre: Business & Economics
ISBN: 0585325308

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The articles in this volume were first presented at the Seventh and Eighth Conferences on Economic Issues in Workers' Compensation sponsored by the National Council on Compensation Insurance. A principal objective of the Conference series has been for workers' compensation insurance researchers to apply state-of-the-art research methodologies to policy questions of interest to the workers' compensation insurance community. This community is a rather diverse group--it includes employers, insurers, injured workers, regulators, and legislators, as well as those who service or represent these groups (e.g., physicians, rehabilitation specialists, labor unions). Despite this diversity and the variety of agendas, the Conference series continues to address many important policy questions. Readers familiar with the Conference series and the four previously published volumes should notice an evolution in terms of the topics addressed in this volume. In the earlier conferences, the topics were more often concerned with the underlying causes of the tremendous increase in workers' compensation benefit payments. In the present volume, h- ever, only four of the fourteen chapters directly concern workers' c- pensation insurance benefits, while the other ten concern the pricing of workers compensation insurance. This is not to suggest that workers' compensation cost increases have abated. In 1989, workers' compensation incurred losses exceeded $45 billion to continue the annual double-digit cost increases. Two explanations can be offered for the somewhat altered focus of this volume. First, despite the continued increase in prices, the financial results for the workers' compensation insurance line continue to be poor.


Workers' Compensation Insurance

Workers' Compensation Insurance
Author: David Durbin
Publisher:
Total Pages: 372
Release: 2014-01-15
Genre:
ISBN: 9789401741231

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Rate Regulation of Workers' Compensation Insurance

Rate Regulation of Workers' Compensation Insurance
Author: Patricia Munch Danzon
Publisher: American Enterprise Institute
Total Pages: 196
Release: 1998
Genre: Business & Economics
ISBN: 9780844739335

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In the 1980s and the early 1990s, America's system of workers' compensation insurance was in trouble. As medical costs grew and benefits and compensable injuries expanded, costs of this insurance skyrocketed. In response, the states imposed price controls, but those controls caused unforeseen--and negative--consequences. The authors define the problems, trace the regulatory responses, and analyze the effects of rate regulation.


Workers' Compensation

Workers' Compensation
Author: Terry Thomason
Publisher: W.E. Upjohn Institute
Total Pages: 474
Release: 2001
Genre: Business & Economics
ISBN: 0880992182

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Traces trends in workers compensation since 1960, with particular reference to the State of Rhode Island. Addresses effects of deregulation and other changes in insurance pricing arrangements, assesses benefit adequacy vs. affordability, measuring employers' cost, etc.


Medical Fee Schedule

Medical Fee Schedule
Author:
Publisher:
Total Pages: 262
Release: 1995
Genre: Employers' liability
ISBN:

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Louisiana Workers' Compensation

Louisiana Workers' Compensation
Author: Denis Paul Juge
Publisher:
Total Pages:
Release: 1993
Genre: Workers' compensation
ISBN:

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Workers' Compensation Law

Workers' Compensation Law
Author: Bevans
Publisher: Cengage Learning
Total Pages: 317
Release: 2009
Genre: Workers' compensation
ISBN: 9781418018290

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Workersa Compensation Law provides an in-depth look at the day-to-day practice of this field while addressing theoretical aspects that form a critical foundation for this branch of law. Reviews how a worker's compensation case begins and explains activities involved in those cases, such as drafting petitions, presenting cases to an administrative law judge, and bringing an appeal. The theoretical basis of the material is laid out in easy to understand and enjoyable format reinforced with practical real-life examples. Although written with paralegal-specific information, the content includes information vital to anyone dealing with Workersa Compensation issues.


Benefits, Costs, and Cycles in Workers’ Compensation

Benefits, Costs, and Cycles in Workers’ Compensation
Author: Philip S. Borba
Publisher: Springer Science & Business Media
Total Pages: 197
Release: 2012-12-06
Genre: Business & Economics
ISBN: 9400921799

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Workers' compensation insurance presents a set of institutional charac teristics that are unique. For every other form of insurance, both the insurer and the coverage provided under the policy are completely controlled either by the federal or a state government, or by an arrangement between the insured and a property-casualty insurer. Unemployment insurance, Social Security, and bank-deposit insurance are examples for which a legis lative body sets the benefits. and a government agency prescribes the in surance premium. By contrast, the coverage and premiums for automobile, homeowners, and fire insurance are individual contractual arrangements between a policyholder and one of the more than 1800 U. S. property casualty insurance companies. Workers' compensation insurance, however, is a hybrid in which state legislatures stipulate the terms of coverage, while regulated competition is the major determinant of prices. State legislatures enact statutes that prescribe the replacement rate and duration of indemnity benefits, as well as full reimbursement of medical expenses. And although the manual rates for workers' compensation insurance continue to be administered by a prior approval process in most states, the competitive-market price for coverage is achieved through a variety of price-modification plans (Appel and Borba, 1988).


Workers' Compensation Subrogation In All 50 States - Fifth Edition

Workers' Compensation Subrogation In All 50 States - Fifth Edition
Author: Gary L. Wickert
Publisher: Juris Publishing, Inc.
Total Pages: 1616
Release: 2012-04-01
Genre: Law
ISBN: 1578233631

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Workers' compensation subrogation continues to change and adapt, as trial lawyers prod its weak points and capitalize on confusing areas of the law. There have been numerous changes in workers' compensation statutes and case law in many states since the last edition. This edition includes an exhausting survey and detailed explanation of the crazy status of employer contribution in Illinois, which includes a step-by-step exposition of how contractual indemnity and the "Kotecki cap" play a role in expanded employer liability in Illinois workers' compensation subrogation cases. It covers the many nuances of Naig and Reverse-Naig settlements under Minnesota law, including an analysis of who has what burdens of proof and the effect such a settlement has on the remaining third-party case tried to a jury. In light of the landmark Missouri Court of Appeals decision in Robinson v. Hooker, the liability of co-employees in Missouri and surrounding states have been covered in greater detail. The concept of co-employee liability for acts which are intentional or committed outside of the course and scope of employment has been added in several states. New case law and explanations were added to the Texas chapter with regard to subrogating against UM/UIM policies, including arguments with regard to the efficacy of UM/UIM exclusionary policy language and the ability to subrogate against a UM/UIM policy actually issued by the same carrier insuring for workers' compensation coverage. West Virginia completely revised their subrogation statute and created a new statute relating to the "statutory employer" status of primary contractors and subcontractors on construction sites, limiting when and how primary contractors can become legitimate third parties for purposes of subrogation. Chapter 7, "Contractual Limitations to Subrogation" has been completely overhauled to include new statutes and case law for every state to assist practitioners in determining the law applicable when there is an alleged applicable waiver of subrogation which might otherwise destroy subrogation. A new Chapter 12 has been added, which focuses on jurisdiction of workers' compensation third-party actions taking a broad look at 28 U.S.C. § 1441, which prohibits removal of cases "arising under" state workers' compensation laws. A carrier now has the ability to prevent cases from being removed from favorable venues in state court to less favorable federal court venues - an attractive option for plaintiffs' attorneys with whom subrogated carriers can negotiate with for stipulations and concessions on their subrogation interests in exchange for maintaining a case in state court. This edition also expands on which states do and do not hold workers' compensation to be primary. Combined with more than 100 new case decisions, this Fifth Edition is the most complete and up-to-date edition yet. Workers' Compensation Subrogation is the most complete and thorough treatise covering workers' compensation subrogation ever published. There are very few areas in which the laws of each state vary more and are applied as differently, then in the area of workers' compensation subrogation. This book is intended to introduce the workers' compensation claims handler, in-house counsel, and subrogation professionals to some of the more esoteric and complex subrogation issues encountered in today's workers' compensation insurance subrogation marketplace. It covers the following issues in all 50 states: • Allocating Third Party Recoveries • Attorney's Fees • Borrowed Servant Doctrine • Conversion of Workers' Compensation Liens • Costs and Expenses • Dual Capacity Doctrine • Equitable Subrogation/Contribution • Exclusivity Rule Barring Action Against Employer • How To Calculate Your Credit/Advance and How It Is Applied In Each State • Intentional Acts • Joint Ventures • Made Whole Doctrine As Applied To Workers' Compensation Subrogation • Necessity of Intervention • Lien Reduction Statutes • Staff Leasing Services and Temporary Employment Agencies • Statutory Subrogation Rights • Subrogating Against UM/UIM Benefits • Subrogating In Medical Malpractice Cases • Subrogating In Legal Malpractice Cases • Waivers of Subrogation • Who Qualifies As A Third Party • Other Workers' Compensation Subrogation-Related Issues In addition to being an excellent primer on workers' compensation subrogation, suitable for both the new subrogation professional and the seasoned veteran, the book also contains a detailed synopsis of the workers' compensation subrogation laws in each of the 50 states. It is a must for anyone with multi-state subrogation responsibilities. Complete with diagrams, references and thousands of footnotes, this is the most ambitious workers' compensation subrogation project ever undertaken. The following issues and topics are covered in detail for each of the 50 states: Statutory Subrogation Rights • Identifies the statutory authority for workers' compensation subrogation in that state. • Discusses the purpose/legislative intent of the statute. • Is an election necessary by the worker? • Who can bring a third party action (plaintiff, carrier, employer, or all of the above)? • When and must a third party action be brought? • What are the rights of a carrier to intervene in an existing third party action filed by a worker? • Will a worker's compensation carrier's subrogation interest be barred if not brought timely? Third Parties • Who can be sued as third parties in a third party action? • Can a co-employee be sued and under what circumstances? • Can an uninsured/underinsured carrier be a "third party" under the laws of that state? • Is there a dual capacity or borrowed servant doctrine which somehow affects the ability of a worker's compensation carrier to effectively subrogate? • What is the state's workers' compensation bar? • Are there any specific restrictions regarding subrogation against a subcontractor or an employee of a subcontractor in a construction situation? • Under what circumstances can the employer be sued? • Can a carrier subrogate to the benefits of a recovery in a legal or medical malpractice action? Allocation of Third Party Recovery • How and when does the carrier recover its subrogated interest? • Does the carrier recover past benefits only or also the present value of future benefits which it owes under the Workers' Compensation Act of that state? • Is there a formula used to determine how a third party recovery is allocated? • What happens to the total recovery and how is it applied? • Can a carrier recover benefits paid by a third party or recovered in a third party action which relate to loss of consortium, or non-economic damages such as pain and suffering, mental anguish, or punitive damages? • Does the employer's negligence reduce the recovery by the worker or carrier? Attorneys' Fees/Costs • Can the plaintiff's attorney recover attorneys' fees and/or costs out of the carrier's subrogated recovery and under what circumstances? • How are attorneys' fees and costs handled if the carrier is also represented by subrogation counsel, intervenes into the third party action and actively represents its interest? • What if the carrier isn't represented? • Can a plaintiff's attorney recover attorneys' fees based on the value of past benefits only or will he be able to recover attorneys' fees based on the future benefits/credit recovered by the carrier? • Must a carrier bear its proportionate share of expenses as many states require, and what does that really mean? Credit/Advance • Can a carrier take a vacation from paying workers' compensation benefits once a worker makes a third party recovery? • How is the credit calculated under state law? • Does the carrier have to do anything special to obtain the credit, such as filing with the Workers' Compensation Commission? • Does the carrier get a credit toward future compensation benefits it owes or does it actually get to collect the present value of the future benefits it owes and still be obligated to pay the scheduled benefits in the future? Statutes of Limitation • What are the applicable statutes of limitation or statutes of repose that may be applicable to third party subrogation actions? Related Subrogation Issues • Are there any other issues or statutes which affect a worker's compensation carrier's right of subrogation, such as the made whole doctrine, common fund doctrine, or anti-subrogation statutes? • Are there any lien reduction statutes, such as those existing in Indiana, which affect a worker's compensation carrier's right of recovery? • Does the state have any no-fault laws which complicate workers' compensation subrogation involving an automobile accident, such as exist in Michigan and Colorado? • What are the carrier's options if the worker and his attorney simply refuse to repay a worker's compensation carrier's lien after settling a third party action? • If the worker fails to repay the carrier, is there a cause of action for conversion of a carrier's subrogation interest or may the carrier still proceed against the third party tortfeasor to recover its subrogation interest?


California's Volatile Workers' Compensation Insurance Market

California's Volatile Workers' Compensation Insurance Market
Author: Lloyd S. Dixon
Publisher:
Total Pages: 0
Release: 2009
Genre: Workers' compensation
ISBN:

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Since partial deregulation of insurance rates in 1995, the California workers' compensation insurance market has been very volatile. For reasons that go beyond price deregulation, there have been dramatic swings in insurers' underwriting profits and the share of coverage written by private insurance carriers, and a substantial number of insurers, including some of the largest market participants, have failed. The price that California employers have paid for workers' compensation insurance has been volatile since 1995 as well, continuing the considerable variation that occurred in earlier years. This book identifies and examines factors that contributed to the market volatility and the large number of insolvencies following price deregulation. It also examines the regulatory system that oversees the workers' compensation market and how the California Department of Insurance responded to the market turmoil that followed the move to open rating. It makes recommendations that aim to reduce market volatility and the frequency of insolvencies while realizing the benefits of a competitive market.