DWC Administrative Director Tours Southern California Insurer

On the heels of a seven-city Public Forum tour, California’s Department of Industrial Relations’ Division of Workers’ Compensation (DWC) Administrative Director, Rosa Moran, continued her fact-finding mission on the workers’ compensation process.

On May 23, Moran visited the Pleasanton office of ICW Group Insurance Companies, a multi-line carrier based in southern California. She met with numerous examiners as they processed workers’ compensation claims.

Moran was invited by ICW Group to get an up-close look at processing workers’ compensation benefits to injured workers from the claims side. She sat with claims examiners, listening to their telephone discussions with injured workers, medical providers and lien claimants while learning how the paperwork is processed.

“Spending time with a claims operation was extremely interesting and educational,” stated Moran. “How a carrier handles a work comp claim is vital to ensuring the system is working properly.”

“We thought it important that the AD experience the actual claims process including new claims set-up, daily work flow, medical authorizations, bill payments, lien issues, litigation referrals and the appeals process,” said Amanda Granger, ICW Group’s assistant vice president who oversees the carrier’s national claims operation.

ICW Group’s senior legal counsel Kent Ball, who arranged the visit, supported Granger’s observations. “I believe the AD increased her industry knowledge by witnessing first-hand, what claims examiners do day in and day out. I think she would agree that it was a day very well spent.”

Source: ICW Group