Texas Workers’ Comp Division Assesses More Than $81K in Penalties

Administrative penalties for April and May 2008 assessed by the Texas Department of Insurance Division of Workers’ Compensation (TDI-DWC) totaled $81,667.

The disciplinary actions taken by Commissioner of Workers’ Compensation Albert Betts were for violations of the Texas Workers’ Compensation Act.

Commissioner’s orders are subject to appeal to state district court within 30 days after being issued.

The DWC’s final disciplinary orders April and May 2008:

Amerisure Mutual Insurance Company of Farmington Hills, Mich.
Order No.: DWC-08-0048
Date of Order: May 27, 2008
Action Taken: Fined $2,402
Violation(s): Failure to give sufficient explanation for a reduction of a medical bill.

American Home Assurance Company of New York, N.Y.; The Insurance Company of the State of Pennsylvania of Harrisburg, Pa.; and AIU Insurance Company of New York, N.Y.
Order No.: DWC-08-0047
Date of Order: May 27, 2008
Action Taken: Fined $49,765
Violation(s): Audits found failure to meet compliance standard for timeliness of payments of supplemental income benefits (SIBs), failure to make payment of SIBs at the proper rate, failure to pay correct interest amount when owed and failure to timely send the TWCC-52 form.

Assurance Company of America of Schaumburg, Ill.
Order No.: DWC-08-0038
Date of Order: April 15, 2008
Action Taken: Fined $25,500
Violation(s): Failure to comply with a TDI-DWC order to pay a health care provider for unpaid medical fees (three instances).

OneBeacon America Insurance Company of Boston, Mass.
Order No.: DWC-08-0039
Date of Order: April 15, 2008
Action Taken: Fined $4,000
Violation(s): Untimely payment of temporary income benefits.

Source: TDI-DWC, www.tdi.state.tx.us