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TDI Releases March 2011 Workers’ Compensation Violations

The Texas Department of Insurance on April 14, 2011, released final disciplinary decisions for violations of Division of Workers’ Compensation rules. Among these fines were the following insurer violations:

-Ace Insurance [$48,000]: Failed to comply with order or decision of Commissioner or TDI-DWC; Failed to timely pay income benefits to injured employee; Failed to pay for preauthorized medical services; Failed to timely act on request for reconsideration of a medical bill.

– American Home Assurance (AIG/Chartis) [$11,000]: Failed to pay for preauthorized medical services; Failed to timely respond to an injured employee’s request for reimbursement of travel expenses.

– Arch Insurance [$4,500]: Failed to timely pay income benefits to injured employee; Failed to timely pay medical bill; Failed to timely act on request for reconsideration of a medical bill.

– Dallas National Insurance [$9,000]: Failed to pay for preauthorized medical services; Failed to timely pay income benefits to injured employee.

– Hartford [$5,000]: Failed to reasonably and prudently process claims ; Failed to provide written notification of claims experience; Failed to provide written notification of loss analysis; Failed to provide mandatory on-site visit to policyholders.

– Hartford [$4,500]: Failed to timely pay income benefits to injured employee; Failed to provide written notification of claims experience.

– TASB Risk Management Fund [$5,000]: Failed to timely pay income benefits to injured employee.

– Transportation Insurance [$10,000]: Retrospectively reviewed medical necessity of preauthorized medical service or treatment; Failed to pay for preauthorized medical services.

These are fines paid to the state for violations of DWC rules and the Texas Insurance Code. Doyle is committed to helping individuals who have been harmed by such violations when they amount to bad faith activity by an insurance carrier. Click here for more information about the wrongful handling of workers compensation cases.

The complete list of fines is available here.