Most Calif. comp claims handlers meet or exceed performance

An annual report to the California legislature on claims-handling practices of worker compensation administrators found that 67.5% met or exceeded the performance standards set by the states.

The state, as part of a routine audit to lawmakers, examined case management for 40 claims organizations for 2019. While 27 of them passed muster, 13, or 32.5%, failed to meet or exceed the standard. Seven of those audits expanded into a full compliance audit of indemnity claims, according to the report released by the state Department of Industrial Relations, Division of Workers’ Compensation.

A sample of denied claims to be audited was also added, according to the report.

As a result of the audits, the state Audit & Enforcement Unit found and cited 5,261 violations against claims administrators, with administrative penalties totaling $1,462,876, according to the report.