California Rating Bureau Announces Changes in Reporting of Small Medical Only or First Aid Claims

The Insurance Commissioner recently approved amendments to the California Workers’ Compensation Uniform Statistical Reporting Plan—1995 (USRP) effective January 1, 2017, to clarify the reporting requirements for small medical only or “first aid” claims. The Insurance Commissioner’s Decision (CDI File No. REG-2016-00018), dated October 14, 2016, approved amendments that specifically reference first aid as defined in California Labor Code Section 5401(a), to clarify that insurers must report the cost of all claims for which any medical care is provided and medical costs are incurred, including those involving first aid treatment, even if the insurer did not make the payment.

ALL injuries for which medical care is provided and medical costs are incurred MUST be reported to your insurance carrier – including reporting any and all amounts paid directly by the employer for medical expenses – so that your insurance carrier can (a) reimburse the employer for any covered medical expenses that the employer has paid directly and (b) fulfill their statutory reporting obligations.

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About Genia Ruckman

Genia Ruckman, Vice President, Claims Management Services, assists the commercial lines department at J.W. Terrill in the retention of existing business and growth of new business by providing advocacy and consulting services for client companies to assist in the management of workers’ compensation claims and incurred costs.

View all posts by Genia Ruckman

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