Claim Trends from ORRM

Old Republic Risk Management (ORRM) contracts with many different third party administrators (TPAs), as requested by our insureds. Because of our diverse experience with and our oversight of these TPAs, we become aware of certain issues that we believe should be of interest to our insureds.

Most recently, a few states have begun stressing the need for insureds and their TPAs and carriers to ensure that they are compliant with the claims-reporting and handling stipulations outlined in those states' Workers’ Compensation acts. Specifically:

• The Idaho Industrial Commission recently sent a memorandum to all Workers’ Compensation carriers, TPAs and Workers’ Compensation policyholders to remind them that the commission's in-state adjusting requirements include provisions stipulating that insureds:
  • Are not permitted to directly fund claims.
  • Cannot be involved in claims-adjusting process. View the Memorandum

• The Kansas Insurance Department is actively reviewing whether insureds are complying with Kansas State Act 44-557, which requires that employers report workplace accidents within 28 days. Insureds that fail to comply are subject to civil penalties set by the statute. View the Statute

Additionally, we wanted you to be aware:

• Oregon Administrative Rule 436-050-0110 requires that carriers use only TPAs with physical in-state locations. The rule also limits the approved number of TPA locations per carrier to eight.View the Rule

ORRM is committed to ensuring that our insureds and TPAs stay in regulatory compliance, and we will work with all of you to ensure that you are aware when compliance issues arise. Any questions or inquiries regarding the above issues should be directed to your ORRM claim supervisor or account executive. Of course, you should always confer with your own legal counsel when compliance matters come to your attention.