Insurers Contest 25% Of WTC Comp Claims

By Daniel Hays

NU Online News Service, July 29, 4:26 p.m. EST?About 25 percent of workers' compensation injury cases arising from the Sept. 11 terrorist attack on New York's World Trade Center are being contested by insurers, according to an industry study.

The study, announced last week by the American Society of Workers' Comp Professionals, Inc. in Mount Vernon, N.Y., looked at stress claims related to the event.

According to AMCOMP, out of 3,438 cases that were reviewed by the Workers' Compensation Mental Stress Council 1,594 involved evidence of stress. Of the 1,594 stress cases, 665 also had evidence of a physical injury, leaving 929 stress-only cases, AMCOMP said.

AMCOMP gave examples of stress cases and how they were treated. One woman who fled her building before its collapse was unable to leave her home for five days when doctor gave her a prescription for mental trauma and depression. Her claim was paid and she returned to work.

Another woman was preparing a business presentation when she saw the planes hit the twin towers and saw people jump from the buildings. She produced no medical evidence to back her claim of stress and depression and has lost no time from work. The carrier is contesting the claim.

"Since the opportunity for fraud is so great and psychic trauma is relatively easy to feign, prudent carriers will put such [stress] claimants to their medical proofs," AMCOMP advised.

John Sullivan, a representative for the New York Workers' Compensation Board, said that so far there have been 6,503 claims submitted, including death claims.

He said that looking at the overall claims picture, the top five insurers with the most claims were Pacific Indemnity Company (13 percent), State Insurance Fund (10 percent), Travelers (8 percent), Electrical Employers, a self-insured entity (7 percent), and New York City (6 percent).

Without death claims, the top five insurers with the most claims were the State Insurance Fund, Transcontinental Insurance Company, Travelers Group, American Casualty Company, and Marriott Educational Service.

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Insurers Contest 25% Of WTC Comp Claims

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