Florida Workers Compensation Rate Increase Update
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Florida Workers Compensation Rate Increase Update

By John Conrad, Aug 29 2016 09:14PM

NCCI has proposed workers compensation rate increases to the Florida Department of Insurance Regulation based on two recent Florida Supreme Court rulings. Increases are requested to offset expected workers compensation benefits and legal expense increases as a result of the Supreme Court rulings. Current NCCI requested increases total 19.6%. Requested NCCI increases, once approved, to be effective 10.1.2016.

A public hearing was conducted in Tallahassee on August 16, 2016. Currently awaiting decision from the FLDOIR regarding both the amount and effective date of the proposed increase.

Key Points Derived from the Court Decisions:

Temporary indemnity benefits will be increased from 104 to 260 weeks. Claimant attorney fee caps to be adjusted upward to “reasonable” hourly fees. If carrier is deemed to be wrong in denying a claim the carrier is obligated to pay the claimant’s attorney’s fees.

Claimant Attorney Target Areas:

Average weekly wage determination is a high value target for claimant attorneys. Average weekly

wage has to be settled within 30 days of claim. At day 31, claimant attorney can recoup all attorney

fees. Something as simple as a gift card can trigger an adjustment to the average weekly wage. The claim is medically reasonable and necessary.

Potential Client Impact:

Increase in claims expenses due to longer temporary disability benefits period allowing for the chance in deterioration of medical condition; more requests for expense medical testing and treatment in order to prove permanent total disability; Higher reserves based on possibility of 260 weeks of temporary benefits; higher impairment ratings based on prolonged medical treatment. The ultimate impact on Medicare set aside amounts is undetermined. Increased attorney fees will be allocated to the indemnity column increasing client EMR.

Mitigation Strategies (Claims):

Increase the focus on accident prevention to eliminate claims. Open clear lines of communication between employer and carrier. Ensure a clear understanding of and focus on accurate reporting of average weekly wage. Agree on average weekly wage prior to 30 day cutoff to avoid litigation and attorney fees. Close carrier scrutiny of temporary benefits.

Mitigation Strategies (Premiums):

Conduct claims review of open claims six months prior to renewal date. Audit experience modification rate worksheets for accuracy. Explore program structures to include risk sharing options.

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