2025 Workers’ Compensation Insurance Rates to Dip Slightly
Citing higher physician reimbursement rates, the National Council on Compensation Insurance is recommending a 1 percent average premium decrease for workers’ compensation insurance policies in Florida in 2025.
Senate Bill 362 created a new workers’ compensation maximum reimbursement plan for physicians for the first time in years, allowing a big jump in pay for doctors – from 110% of Medicare’s reimbursement schedule to 175%, in many instances.
“NCCI estimates that SB 362 will result in an impact of +5.6 percent on overall workers compensation system costs,” the NCCI said in a summary of the proposed rate change. “Excluding the impact of this bill from the filing would result in a revised overall rate decrease of 6.4 percent, as opposed to the 1.0 percent change.”
“The continued focus on worker safety and technological advancements are regarded as contributing to fewer workplace injuries over time,” the summary noted. “The latest medical severity change aligns with projected medical inflation, while indemnity severity tracks with changes in average weekly wages.”
Benefits Available
Years and years of significant insurance premium decreases have drained much of the money from the system. Quite simply, insurance companies are charging such low rates that they don’t have sufficient funds to cover claims. Injured workers pay the price, but a Tampa workers’ compensation lawyer can still obtain fair compensation in these cases.
The premium decreases have affected lost wage replacement benefits. Usually, insurance companies use boilerplate actuarial charts to determine lost wage compensation. COVID is a good example. Twenty years ago, if a worker caught a serious infectious disease on the job, the case would’ve been almost uncontested. Today, if a worker contracts COVID at work, the insurance company usually disputes both liability and damages.
Almost anyone could carry the COVID virus. In many cases, the carriers have such mild symptoms that they don’t know they’re sick, or they’re not sick enough to stay home. Furthermore, coronavirus germs live on surfaces for over forty-eight hours.
To establish a work-related connection, a Tampa workers’ compensation lawyer typically points to a COVID cluster. If several employees at XYZ Company got COVID, it’s more likely than not that they got COVID at work. That’s usually the standard of proof in workers’ compensation cases.
Damages disputes are common as well. Most people recover quickly from COVID. So, the actuarial table might dictate twenty-one days off. If that’s the case, that’s what the insurance company will offer.
But many people have pre-existing conditions that transform mild COVID cases into potentially life-threatening infections. Furthermore, a significant number of people suffer from long COVID, a possibly debilitating disease that affects the mind and body.
The Workers’ Compensation Process
Because of the money drain, injured victims must scramble to secure a fair-sized piece of a shrinking financial pie. The process is longer and more frustrating, mostly because insurance companies, which dominate this process, hope victims will abandon their claims or settle them for pennies on the dollar.
This process usually begins with a Claims Examiner review. Back in the day, when the system was flush with cash, claims often settled at this point. Claims Examiners were happy to pay claims and be rid of them. Things are different today. Now, claims Examiners almost always deny job injury claims, at least in part.
Usually, depending on the jurisdiction, the matter then proceeds to a senior Claims Examiner review. Unless the original officer committed a grievous error, like looking at the wrong file, the senior examiner almost always upholds the previous results.
So, most claims settle immediately before an Administrative Law Judge appeal hearing. Insurance companies know that a Tampa workers’ compensation lawyer has free reign at this hearing to introduce evidence, make legal arguments, and challenge evidence.
Work With a Thorough Hillsborough County Lawyer
Injury victims are entitled to important financial benefits. For a confidential consultation with an experienced workers’ compensation lawyer in Tampa, contact Kobal Law. We routinely handle matters throughout the Sunshine State.
Source:
insurancejournal.com/news/southeast/2024/09/04/791283.htm
