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Workers Compensation Coverage Providers Fined More Than $875,000

By: Thomas M Kallman

The Department of Financial Services has issued a press release stating that workers compensation carriers & self-insured plans were fined a minimum of $875, 000 for various violations. 31 workers compensation coverage providers were fined based on the results of audits completed during the past fiscal year. The audits revealed that the providers failed to fully comply with Florida law in administering workers compensation benefits to injured workers. Florida law requires carriers to promptly pay injured workers and medical providers in 95 percent of total cases in order to avoid penalties.

Insurance companies and self-insured plans are judged under statutory standards related to:
• Timely payments to injured workers
• Timely payment of bills to medical providers
• Timely filings of notice of injury reports to the Department of Financial Services

Some of the biggest offenders were as follows:

Travelers Indemnity – $229, 000
Lumbermans Mutual – $80,000
Liberty Mutual – $64,000
Twin City – $49,000
Associated Ind – $115,000
Zurich American – $56,000
Zenith Ins Co – $21,000
Clarendon Ins Co – $28,000
First Commercial – $24,000
Ins Co Of Penn – $22,000
State Farm – $17,000
Fl Hospitality – $16,000

If you are an injured employee, your benefit check, which is paid bi-weekly, should be 66 2/3 percent of your average weekly wage. If you were injured before October 1, 2003, this amount is calculated by using wages earned during the 91-day period immediately preceding the date of your injury, not to exceed the state limit. If you worked less than 90% of the 91day period, the wages of a similar employee in the same employment who has worked the whole of the 91-day period or your full-time weekly wage may be used. If you were injured on or after October 1, 2003 your average weekly wage is calculated using wages earned 13 weeks prior to your injury, not counting the week in which you were injured.

In addition, if you worked less than 75% of the 13 week period, a similar employee in the same employment who has worked 75% of the 13-week period or your full time weekly wage shall be used. Call the insurance company and ask for the adjuster or claims representative if you still have questions or if your checks have stopped, call the EAO at (800) 342-1741 or e-mail

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