Workers' Compensation Provided By Private Companies In California
Everyone who knows about worker's compensation will tell you that there will be problems in the system and they will always be someone's fault.
Blame is shifted from one employee and employer to another. The California Department of Insurance, for example, draws a bead on the bosses.
Employer fraud is one of the fastest growing areas of workers' compensation insurance. An employer can commit fraud by underreporting the payroll or by misclassifying employees.
The top insurance regulator has a different view toward this. An enormous amount of cash is being paid to people who are misusing the workers' compensation insurance, claims a California insurance commissioner.
This current crisis can be the fault of any group, an attorney who deals with workers' compensation issues says. His strongest defense is reserved for the workers.
Workers hardly have any cases of fraud. The Web site of the California applicants' attorneys association reveals that very few people were arrested and convicted from the millions of injuries reported between 1993 and 1998.
It is his wish that employers and employees come to the realization that they are both in the same situation. He said for five years after deregulation of the insurance industry took effect in 1995, insurance costs fell.
Investment of the premiums in the stock market led to big profits when the number of insurance claims was low.
The 9/11 events increased the problems. The terrorist marks left some heavy losses for the insurance company and also bankruptcy for several companies.
But he says there are still 235 private insurance companies offering workers' compensation coverage in California and he supports proposed legislation that would post the top 50 of them, together with their rates, on a state Website.
Another point of disagreement is that when there's a claim, prices rise, and when there's no claim, prices stay as they are. He approves the provisions of Senate Bill 191 which seeks to reward employees who have made no claims in two years.
The conditions of the patients one physical therapist serves can be described with the word compitis. According to this gentleman, there is a significant difference between how long it takes a work related injury to recover and how long it takes a non work related injury to recover.
He said a person who may get injured from playing a sport will go to work sooner than a person who got injured while at work. Doctors and other health care specialists are encouraged to remember their patients with workers' compensation because of this streamlined system of payment.
He says that once the paperwork is accomplished, the health professionals can just wait for the check to come to them. He said that is in stark contrast to an HMO which asks lots of questions, is always looking for more paperwork and fosters a system which is time consuming, expensive and difficult, and inevitably delays reimbursement of medical costs.
This one chiropractor who has been practicing for 13 years claims that only 15% of his patients are on workers' compensation. To take advantage of the system, chiropractors would usually recommend more services and therapies they would not normally recommend.
He states that he is familiar with how patients abuse the system. Patients fake injuries, but they can be detected through certain tests.
by: John Chambers
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