 WVSIA.com
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 March 2011 Newsletter The West Virginia Legislature ended its 2011 regular session without passing any major workers’ compensation legislation. Several bills which had been introduced, if enacted, would have had a significant impact on the 2003 and 2005 reforms. The proposed bills would have significantly affected workers’ compensation carrier’ loss costs and increased the direct claim costs that would have been paid by authorized self-insured employers. In addition to “benefits” legislation, other workers’ compensation bills included a settlement proposal that would have required all settlements to be reviewed and approved by the Workers’ Compensation Offices of Judges. A change in the settlement authority in 2005 eliminated the prior requirement that the Offices of Judges approve all settlements. The settlement bills contained a multistep process ultimately ending before the Chief ALJ who made the settlement approval based on another Judge’s recommendation. Business had previously urged that the Legislature, if it were to restore the settlement approval authority, require a more efficient alternative practice, similar to the prior system. For now, WV’s workers’ compensation claims are not required to be filed for any approval, although the 2005 law required the Insurance Commissioner to recommend a rule implementing the changes to the settlement section of the workers’ compensation law, which was ultimately approved by the Workers’ Compensation Industrial Council. That rule contains the procedure for unrepresented claimants to file a complaint with the Insurance Commissioner to set aside a claim settlement. 85 CSR Series 12. Oddly, with the 2005 workers’ compensation reforms provided the authority for WV’s transition to a fully competitive, workers’ compensation insurance market( as of July 1, 2008) , WV is one of a minority of states allowing for claim settlements that currently requires no regulatory approval. As noted neither carriers nor self-insurers object to the concept of having claim settlements approved by the Office of judges, that practice is very common elsewhere-but they are concerned that the 2011 legislation would not create an efficient review process and would, if enacted, result in a substantial delay in the implementation of claim settlements. Another area of controversy arose with the filing of legislation for the Insurance Commissioner that granted her sole discretion in approving self-insurance pools for WV political subdivisions’ workers’ compensation and civil liabilities. As introduced, the bill excluded the WC Industrial Council from any participation in the self-insurance approval process for those political subdivisions, even though the workers ’ compensation law and self-insurance rule appears to require that body’s participation. Self-insurers were also disturbed by the requirement that the approved political subdivisions participate in the Self-Insurance Guaranty Fund, created in 2005 to fund any self-insurer’s default on claims with dates of injuries or diseases incurred on or after July 1, 2005. While the legislation was pending before the WV Senate, WVSIA was able to persuade the Senate Judiciary Chairman to assess these issues and a s a result of further discussions, the participants accepted the decision by the Insurance Commissioner to remove the mandatory provision for self-insured pooled subdivisions to participate in the Self-Insurance Guaranty Fund, which was a sensible resolution because the legislation required also that any such self-insured pools’ had to be fully secured and reinsured. The legislation passed and while the Industrial Council will play no role in approving the political subdivisions to self-insure through a pool workers ‘ compensation liabilities, any such pools will not be allowed to participate in the Self-Insurance Guaranty Fund. |
