Tag Archives: Workers Compensation Insurance

by | July 26, 2010 · 7:22 am

Hospitality Industry Workers’ Compensation Risks: Hotel Owners Forced To Pay Large Damage Award For “Failing To Provide A Safe Work Place And Not Procuring Workers’ Compensation Insurance” While Paying Undocumented Clerk In Cash

“…forced the owners of a large hotel chain to pay more than one million dollars in damages due to their negligence in failing to provide a safe work place and not procuring Workers’ Compensation insurance. The hotel chain had a practice of paying their employees cash and not providing Workers’ Compensation insurance…”

 In California, an employer can be sued directly by his employee, if the employer failed to obtain Workers’ Compensation insurance. This is true even if the injuries were primarily caused by the negligence or intentional conduct of third parties. McMahon’s client, a foreign citizen, was working without a visa and the owners were aware that he was an undocumented worker.

The client, working as a night clerk, was summoned to a scuffle at a room in the hotel at 2:00am. He was attacked by guests when they were asked to keep the noise to a minimum. The plaintiff was rendered unconscious and spent almost four weeks at a local county medical facility with various broken bones, teeth, and a head injury. The attackers were eventually convicted of attempted murder and are serving lengthy sentences within the California state prison system.

For more:  http://www.onlineprnews.com/news/47075-1279302038-timothy-mcmahon-robert-allard-law-firm-of-corsiglia-mcmahon-allard-selected-as-superlawyers.html

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by | May 27, 2010 · 5:19 am

Hospitality Industry Workers’ Compensation Risks: Hotel Owner Forced To Pay Large Settlement For Failing To Provide Injured Night Clerk With Workers’ Comp Insurance

“…secured a seven figure settlement against a prominent hotel chain after they failed to provide Workers’ Compensation to their night clerk who was injured in the course of employment…”

“…The hotel owner knowingly employed the clerk as an undocumented worker and was paying the clerk cash “under the table” without securing Workers’ Compensation insurance…”

The employee was injured when he went to investigate a complaint of noise coming from a hotel room and was brutally attacked by the occupants of the room.

 As part of the settlement the hotel chain was forced to take complete financial responsibility for their attempts to circumvent California labor laws. “We want our clients to be fairly compensated for injuries suffered at the hands of business owners who try to bend the rules, and we will leave no stone unturned when an employer tries to take advantage of his employees to save money and line his/her own pockets” said attorney McMahon.

For more:   http://www.onlineprnews.com/news/37680-1274803334-san-jose-law-firm-of-corsiglia-mcmahon-allard-resolves-5-personal-injuryemployer-liability-cases.html

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by | May 13, 2010 · 7:40 am

California Workers’ Compensation Insurance: Medical Provider Networks Now Account For Over 80% Of Injured Worker Medical Services

The latest data show network providers accounted for 83.1 percent of services in the first 30 days on claims for injuries from the first quarter of AY 2009, and 67.4 percent of the post-30 day services rendered on AY 2008 claims.

(From a CWCI.org release)   A new California Workers’ Compensation Institute (CWCI) study shows the percentage of medical services to injured workers delivered by network physicians jumped sharply immediately after Medical Provider Networks (MPNs) were introduced into the workers’ compensation system in 2005, and that both the network utilization rate and the percentage of workers’ compensation medical dollars paid to network providers have continued to climb over the past five years.

Using first-year medical service data from 891,918 California workers’ compensation claims with 2004-2009 injury dates, CWCI measured the percentage of injured worker outpatient medical services rendered by network providers before and after MPNs began operations in January 2005. The results show that the network utilization rate rose from less than half of first-year physician-based services for 2004 job injuries to nearly 2/3 of the services for 2005 injuries – the first claims in which treatment in the initial 12 months could have shifted to MPNs. Furthermore, the data show that the trend toward the use of networks has continued, with network providers accounting for nearly ¾ of physician-based services for 2008 injury claims.

 http://www.cwci.org/press_release.html?id=164

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by | April 24, 2010 · 5:51 am

Hospitality Industry Workplace Injuries: Over 4% Of California State Workers’ Comp Claims Filed For Hospitality Workers With Injuries Including Skin Wounds, Strains, And Other Injuries Leading To Over $1.1 Billion In Benefit Payments

The study detailed data on more than 137,000 claims filed by restaurant workers in California for work-related injuries that occurred from January 2000 through the end of 2008. Researchers said that more than 90 percent of the claims were filed by employees in restaurants and taverns. Workers employed in facilities such as wineries, country clubs and hotels were also included in the sample.

(From a RiskandInsurance.com article)   Total medical and indemnity benefit payments on these claims amounted to just under $1.1 billion. In addition to accounting for 4.1 percent of the state’s workers’ comp benefit payments, restaurant workers filed 6.1 percent of all California job injury claims.

Leading claims. The study found that the number one injury diagnosis for restaurant workers was minor wound/injury to the skin. Researchers said these injuries represented nearly one out of three restaurant claims, but only 4.4 percent of the loss payments because workers were treated quickly and returned to work with no lost time. On the other hand, medical back problems without spinal cord involvement — typically sprains and strains — made up less than one in five restaurant claims but carried a much higher average cost and consumed almost one-third of paid losses in this sector.

Rounding out the top five injury categories were shoulder, arm, knee and lower leg sprains (10.4 percent of the claims and 8.8 percent of paid losses); other injuries, poisonings and toxic effects (8.1 percent of the claims and 9.4 percent of the payments); and ruptured tendons, tendonitis, myositis and bursitis (3.8 percent of the claims and 6 percent of the payments). Researchers found that second- or third-degree burns represented 3.6 percent of the restaurant claims. However, burn injuries accounted for only 1.4 percent of the total dollars paid on restaurant claims (about five times the proportion found for all industries).

http://www.riskandinsurance.com/story.jsp?storyId=398239449

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by | April 21, 2010 · 7:08 am

Hospitality Industry Insurance: Health, Workers Comp And Liability Insurance Represent Fastest-Growing Expense For Hotel Operators

“….insurance is the fastest-growing expense for hotel operators in the country, according to an August report from PKF Hospitality Research, part of Los Angeles-based PKF Consulting…”

(From an InsuranceNewsNet.org article)   Though workers’ compensation insurance rates in California have fallen in the past year and a half, healthcare premiums continue to climb, the future of the Terrorism Risk Insurance Act is in question and property insurance is almost sure to increase after this year’s unprecedented hurricane season.

Last week, the California Medical Association released a report alleging workers’ comp insurers are interfering with and denying treatment to injured workers.

The group, which represents about 90,000 California doctors, suggested its members might have to cut back or discontinue treating injured workers because of reimbursement issues, raising the specter of a renewed battle over workers’ compensation.

http://www.insurancenewsnet.org/html/HealthInsurance/2010/0409/Property–Health-Insurance-Top-Hotel-Chain-Worries.html

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by | March 26, 2010 · 6:06 am

Workers’ Comp Fraud Prevention: State Of Colorado Amends Bill That Would Restrict Video Surveillance That Is Deemed “Intrusive Or Harassing”

The original intent of the bill was to restrict workers’ comp insurers’ use of video surveillance to only cases where the insurer has a reasonable basis to suspect fraud. It also would have imposed a significant fine on insurers that violated the rule. However, the legislation was amended after lawmakers raised concerns that it would seriously hinder insurers’ efforts to prevent fraud.

The amended version prohibits evidence from being introduced at workers’ comp administrative hearings if it is deemed that the surveillance was intrusive, intimidating or harassing. In addition, the evidence would not be permitted if the administrative law judge finds that the investigator, if questioned, misrepresented himself to the claimant and did not disclose on whose behalf he was conducting the surveillance. The legislation would also require insurers to present the surveillance videos to the claimant’s treating physician for review.

http://www.riskandinsurance.com/story.jsp?storyId=375682191

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by | March 4, 2010 · 4:38 am

Hospitality Industry Risk: Workers’ Compensation Insurance Premiums May Rise Due To Higher Medical Costs, Even As On-The-Job Injuries Decline

“…on-the-job injuries are down, but claims are heftier because of higher medical costs.”

(From a BostonHerald.com article)   The Workers’ Compensation Rating and Inspection Bureau of Massachusetts is seeking a 4.5 percent average increase in policy premiums, effective Sept. 1.

Attorney General Martha Coakley yesterday announced her opposition to the proposed increase, saying the hike would cost small businesses and other employers more than $40 million in extra premiums.

The workers compensation bureau – a nonprofit group of insurers licensed as a rating organization by the state Division of Insurance – says on-the-job injuries are down, but claims are heftier because of higher medical costs. Rates have not risen since 2001.

The group’s request for a 2.3 percent rate increase in 2008 was hit with a lawsuit by the attorney general’s office. The legal move led to a settlement in which insurers agreed to a 1 percent rate reduction – saving businesses some $30 million, Coakley said.

http://www.bostonherald.com/business/general/view/20100303ag_hits_plan_to_hike_workers_comp/

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