Texas Work Comp Penalties for February Reach More Than $152K

Final disciplinary actions taken by the Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC) in February 2009 include administrative penalties totaling $152,500.

Disciplinary orders are subject to appeal to state district court within 30 days after being issued.

Texas DWC’s final disciplinary orders for February 2009:

Continental Casualty Company of Chicago, IL
Order No.: DWC-09-0015
Date of Order: February 27, 2009
Action Taken: Fined $55,000
Violation(s): Inappropriate payment or denial of payment of 144 medical bills out of 517 bills reviewed; failure to meet compliance standard for data submission accuracy, timely reporting of medical bill data, or timely processing of medical bills.

Dewitt C. Fortenberry, M.D. of Texarkana
Order No.: DWC-09-0012
Date of Order: February 25, 2009
Action Taken: Fined $1,500
Violation(s): Failure to file Report of Medical Evaluation in a timely manner.

National Fire Insurance Company of Chicago, IL
Order No.: DWC-09-0016
Date of Order: February 27, 2009
Action Taken: Fined $12,000
Violation(s): Inappropriate payment or denial or payment of 41 medical bills out of 205 bills reviewed; failure to meet compliance standard for appropriate denial or reduction of a medical bill.

St. Luke’s Episcopal Health System of Houston
Order No.: DWC-09-0011
Date of Order: February 25, 2009
Action Taken: Fined $1,000
Violation(s): Improperly pursuing a private claim against a workers’ compensation claimant when the injury had not been finally adjudicated and the claimant had not been in violation of their selection of a doctor.

Transcontinental Insurance Company of Chicago, IL
Order No.: DWC-09-0014
Date of Order: February 27, 2009
Action Taken: Fined $18,000
Violation(s): Inappropriate payment or denial of payment of 90 medical bills out of 318 medical bills reviewed; failure to meet the compliance standard for appropriate denial or reduction of a medical bill.

Transportation Insurance Company of Chicago, IL
Order No.: DWC-09-0013
Date of Order: February 27, 2009
Action Taken: Fined $65,000
Violation(s): Inappropriate payment or denial of payment of 154 medical bills out of 422 medical bills reviewed; failure to meet the compliance standard for appropriate denial or reduction of a medical bill.

Source: Texas Department of Insurance Division of Workers’ Compensation

Topics Texas Workers' Compensation