The New York Workers Compensation Board has voted to publish regulations for public comment that would reduce the time to resolve workers' compensation claims contested by insurers to 90 days or less.
Such cases, which arecalled “controverted” claims and at the turn of the century they took an average of 353 days to resolve, said Joe Cavalcante, a WCB spokesman.
In 2005, controverted claim resolution averaged 200 days, and though that number had dropped below 200 in 2006. Workers' compensation reform legislation in 2007 set a goal of resolving these claims in 90 days or less.
This initiative called the Indexing and Controverted Claims Process (ICCP), is also known as the “rocket docket.” The goal, according to Mr. Cavalcante, is to require more information earlier in the process. With more information, Mr. Cavalcante said, the reasons to controvert a claim diminish, and cases can proceed expeditiously.
Currently, Mr. Cavalcante explained, carriers are able to controvert claims with, for example, an employer statement, but without a medical report. The new rules would require a medical report with either an employer statement or an employee statement in order to controvert a claim.
A problem with the current system, Mr. Cavalcante said, is that carriers are bringing cases to the hearing process without doctor reports, and judges are telling the carriers to come back after obtaining the medical reports.
By the time carriers get the necessary information together for the case to proceed, the process has already gone through two hearings. This, Mr. Cavalcante said, increases costs to the system.
In order to draft the regulations, Mr. Cavalcante said that the WCB reviewed recommendations from the Insurance Department. He also said that the medical, employer, and employee forms were all revamped with significant input from all interested parties.
So far, Mr. Cavalcante said, the new regulations have been drafted, and the board voted to approve them for public comment on July 15. The public comment period will begin on July 30 and will last for 45 days.
Want to continue reading?
Become a Free PropertyCasualty360 Digital Reader
Your access to unlimited PropertyCasualty360 content isn’t changing.
Once you are an ALM digital member, you’ll receive:
- Breaking insurance news and analysis, on-site and via our newsletters and custom alerts
- Weekly Insurance Speak podcast featuring exclusive interviews with industry leaders
- Educational webcasts, white papers, and ebooks from industry thought leaders
- Critical converage of the employee benefits and financial advisory markets on our other ALM sites, BenefitsPRO and ThinkAdvisor
Already have an account? Sign In Now
© 2024 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.
