|Date Requested:March 22, 2013
Time Requested:11:57 AM
| FUND(S) |
7162, 7163, 7164, 7165, 7173
Sources of Revenue
Legislation creates:Neither Program nor Fund
Effect this measure will have on costs and revenues of state government.
| If enacted, HB 3069 would amend §23-5-16 of the Code of WV to provide that attorney’s fees may be awarded in workers compensation cases if a claimant successfully prevails at any appellate level for medical benefits that were denied by the Insurance Commissioner, a private carrier or a self-insured employer.
If enacted, HB 3069 will impact the Offices of the Insurance Commissioner (OIC) by increasing costs to the Old Fund, the Uninsured Employers Fund, the Self-insured Guaranty and Security Funds administered by the OIC an estimated minimum of $326,666 per year.
|Effect of Proposal||Fiscal Year|
|1. Estmated Total Cost||326,666||343,000||359,333|
|Repairs and Alterations||0||0||0|
|2. Estimated Total Revenues||0||0||0|
3. Explanation of above estimates (including long-range effect):
The OIC handles an average of 13,367 medical payment claims each year. From those medical claims processed, an average 481.33 protests were filed with the Office of Judges. Of the 481 protest filed, the OIC’s Order was reversed or modified an average of 130.66 times, which is less than 1% (.978%) of the total claims handled.
The above estimate was calculated by using the 3 year average (2010, 2011 & 2012)of 130.666 X $2,500 = $326,666.
The above estimate assumes that litigation in medical cases can vary and could increase by approximately 5% to 10% after the enactment of HB 3069. Accordingly, the OIC has attempted to provide a range of the estimated increased costs.
The estimate is solely limted to the cost increases to the Old Fund, Uninsured Employer's Fund, and Self-insured Guaranty & Security Funds administered by the State.
| HB 3069 provides that attorney’s fees may be awarded in workers compensation medical treatment claims if a medical denial is overturned during litigation at any appellate level or during a mediation process.
HB 3069 will increase costs to the Old Fund, the Uninsured Employers Fund and the Self-insured funds.
The above estimate does not include any projection for a potential increase in medical benefits paid, as it is not possible to quantify exactly what type and cost of medical benefits might be awarded through litigation. It also does not include any estimate for any increased loss adjustment expenses incurred as the result of increased litigation activities.
The above cost estimate solely reflects the cost to the workers compensation related funds administered by the Offices of the Insurance Commissioner and does not include any projected costs that will be paid by carriers or self-insured employers.