More than half of the complaints filed with the Texas Division of Workers’ Compensation stem from alleged failures of insurance companies, according to an agency official who commented on compliance efforts regulated by law.
During a recent DWC quarterly insurer meeting, Nikki Karr, director of DWC enforcement, reported that as of Aug. 31, the agency had received 1,322 complaints this year.
Of the complaints, 840 concerned insurance company actions or failures to act. Another 264 related to health care providers, while 131 were filed against employers. The remaining complaints were filed against attorneys and injured workers.
Ms. Karr said top complaints against insurers included failure to timely respond to an injured employee’s request under a claim, failure to notify the DWC or employee within 10 days of taking action on a claim, failure to contact an employer within seven days of receiving notice of a claim, and failure to timely pay temporary income benefits.
Failure to pay medical bills in a timely manner was another top complaint, accounting for about a quarter of the complaints against insurers, she said.
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