The Texas Department of Insurance-Division of Workers’ Compensation (DWC) announced that through performance audits of several insurance carriers on the accuracy of payments of lifetime income benefits (LIBs) and death benefits (DBs) it discovered underpayments on 64 claims totaling more than $511,000.
Commissioner of Workers’ Compensation Ryan Brannan said in a statement that he is “pleased to see that claimants received monies owed to them.” However, he also expressed concern that “there may be other deserving claimants in the same situation. These results indicate that we need to continue these types of performance audits.”
The primary focus of these performance audits was to ensure compliance with Labor Code §408.081 which provides that an insurance carrier must pay income benefits accurately.
Common compliance errors discovered in these performance audits that contributed to the underpayment of benefits included:
- Failure to pay 75 percent of average weekly wage
- Failure to obtain a complete wage statement
- Failure to properly calculate average weekly wage
- Failure to include non-pecuniary wages in average weekly wage
Source: TDI-DWC
Topics Texas Workers' Compensation
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