Santa Ana, CA – A Beverly Hills surgeon has been sentenced to 10 years in state prison for stealing nearly $38 million in an elaborate insurance fraud scheme that involved hiring body brokers to pay patients at Southern California sober living homes to undergo medically unnecessary surgeries, medical testing, and other medical procedures. This is… [Read more]
Claims, Legal, & Compliance News
Origami Risk and CLARA Analytics Team to Offer AI-Driven Claims Solutions
Chicago, IL & Santa Clara, CA – Origami Risk LLC and CLARA Analytics recently announced they have formed a strategic partnership to make CLARA’s claims solutions available to insurers, managing general agents (MGAs), and self-insured pools using Origami’s industry-leading multitenant SaaS property and casualty platform. CLARA’s AI-driven tools and resources for insurance companies, MGAs and… [Read more]
NCCI Releases Countrywide Court Case Update Report
Boca Raton, FL – The National Council on Compensation Insurance (NCCI) recently released its Countrywide Court Case Update providing a look at some of the key cases and decisions monitored by NCCI’s Legal Division that may impact workers compensation across the US. The July 2020 edition contains updated information on cases previously introduced, and presents… [Read more]
CWCI Offers On-Demand Webinar On Impact of 2021 Med-Legal Fee Schedule Changes
Oakland, CA – The California Workers’ Compensation Institute (CWCI) recently released an 18-page Research Update report that examined the effects of the 2021 revisions to the Medical-Legal Fee Schedule (MLFS) on med-legal utilization and costs. CWCI Senior Research Associate Stacy Jones, who authored the study, and CWCI General Counsel Sara Widener-Brightwell also recently conducted a… [Read more]
Brown & Brown, Inc. Subsidiary PGCS Selects SpearClaims
Corte Madera, CA – Spear Technologies recently announced that Preferred Governmental Claim Solutions, Inc. (PGCS) has selected SpearClaims as its new claims solution. PGCS is a wholly-owned subsidiary of Brown & Brown, Inc. and a premier governmental third-party administrator (TPA) in Florida. SpearClaims will support claims management for all lines of business, including workers’ compensation,… [Read more]
CWCI: CA Private Self-Insured Claim Frequency Hit a 14-Year High in 2021
Oakland, CA – Workers’ compensation claim frequency among California’s private self-insured employers hit the highest level since 2007 last year as both medical-only and indemnity claim volume rose according to a California Workers’ Compensation Institute (CWCI) review of initial data from the state Office of Self-Insurance Plans (OSIP). OSIP’s annual summary of private self-insured data,… [Read more]
SF City Attorney Announces $54 Million Opioid Settlement with Allergan and Teva
San Francisco, CA – San Francisco City Attorney David Chiu recently announced that he has reached a $54 million settlement agreement with two opioid defendants that will go towards addressing the opioid crisis in San Francisco. Under the agreement in principle, opioid manufacturers Allergan and Teva, will pay San Francisco $34 million in cash payments… [Read more]
Tower MSA Webinar to Share “Tricks of the Trade” for MSAs
Delray Beach, FL – Not all Medicare Set-Asides are created the same. Tower MSA Partners recently announced that it will share insights into some of the specialized areas during “Tricks of the Trades for Successful MSA Outcomes.” Tower’s Chief Compliance Officer Dan Anders will discuss $0 MSA approvals, whether to include the results of an… [Read more]
CWCI Finds Sharp Increase in CA Workers’ Comp Med-Legal Costs Under New Fee Schedule
Oakland, CA – Payments for medical-legal services used to resolve medical disputes over compensability issues in California work injury claims have risen sharply under the new Medical-Legal Fee Schedule (MLFS) that took effect last year according to a new CWCI study, with the increase in aggregate med-legal fees in the first seven months after the… [Read more]
Brentwood Services Announces Acquisition by Acrisure
Brentwood, TN – Brentwood Services, Inc., a provider of insurance-related claims services specializing in alternative-market solutions, recently announced it has entered into an agreement to become an Acrisure Partner. Acrisure is a fintech leader that operates one of the ten largest insurance brokers in the world. Richard (Dick) Hammer started Brentwood Services in 1990 and… [Read more]