City and County of San Francisco's Misleading Response in PPO Discount Dispute
Apr 5, 2021
Recently, a DaisyBill provider disputed a reduction in reimbursement from the City and County of San Francisco (CCSF) for treating an injured employee. In the Explanation of ...
Zurich Denies Liability After Accepting Liability
Mar 30, 2021
Zurich recently denied liability for an injured workers’ treatment, claiming the 2003 injury was not work-related — despite the fact that Zurich already authorized the treatm...
IBR Hall of Shame: Employers
Mar 24, 2021
Employers Holdings set a shameful new standard of indifference with regard to promptly and correctly reimbursing providers. The insurer incorrectly denied payment, disregarde...
When Zurich Speaks, Garbled Noncompliance Comes Out
Oct 20, 2020
We are writing about Zurich again, as the claims administrator’s conduct continues to be a symptom of the deep unfairness that permeates California’s workers’ comp system. Th...
Gallagher Bassett Sinks Second Review Appeals
Sep 21, 2020
For California workers’ comp providers, we encourage submitting Second Review appeals when the claims administrator incorrectly adjusts or denies payment. Below we sho...
AmTrust - IBR Hall of Shame
Sep 15, 2020
Below, we document the flouting of workers’ compensation law by AmTrust North America (AmTrust), and its continued refusal to reimburse a provider despite being ordered to do...
Benihana AND Broadspire Join IBR Hall of Shame
Feb 26, 2020
In this entry in the IBR Hall of Shame, we surface still another example of a workers’ comp claims administrator clearly not understanding, or not complying with, and/or just...
Sedgwick – IBR Hall of Shame
Jan 17, 2020
All too often, insurance companies and claims administrators find unfair ways to deny, delay, and otherwise wiggle out of paying the workers’ compensation reimbursements that...
Maximus & DWC Drop Ball on IBR Eligibility
Oct 22, 2019
California workers’ comp billing and payment regulations are a minefield of complications. That said, some rules are fairly simple, and should be immutable. For exampl...