Employers, Insurers Slow To Report Claims Says Missouri Audit Report

September 30, 2002

A report from Missouri State Auditor Claire McCaskill has found that a “vast majority of injuries” are reported late or not at all.

The audit evaluated the management of the state’s workers’ compensation program, which mandates that employers/insurers report injuries to the state Workers’ Compensation Division within 10 days of learning of an accident in order to ensure the timely payment of benefits to employees with work-related injuries and illnesses.

“During the 4-year period reviewed, auditors found employers/insurers failed to report 93 percent of employees’ injuries within the prescribed 10 day period, which delayed employee benefit payouts and increased case costs by nearly $300 million. In addition, 249,238 of the 428,495 delayed cases were not reported within 30 days and 14,660 were never reported,” said the bulletin.

McCaskill’s report also faulted state officials for not sending warning letters to “persistent violators” and for not referring cases to the State’s Attorney General’s office for prosecution. The report indicated, however that, “Division officials said they could be more effective if they had the authority to penalize entities without going through the Attorney General’s office, as is done in other states. Current law only allows the Attorney General to prosecute and assess penalties.”

According to a report from the Associated Press, some of the problem may be caused by differing interpretations of the 10-day requirement. The Workers Compensation Division calculates the time from the date the employer learns of the injury, but according to Missouri Employers Mutual, which writes around 20 percent of the state’s workers comp coverage, the 10 day requirement starts when the insurer learns of the injury from the employer.

Topics Carriers Claims Workers' Compensation Commercial Lines Business Insurance Missouri

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