tag:blogger.com,1999:blog-8489363879633129568.post2003862905168262720..comments2023-11-13T11:54:56.769-08:00Comments on DePaolo's World: Not The Average CaseAnonymoushttp://www.blogger.com/profile/02446191842560064784noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-8489363879633129568.post-63167067648286921552013-08-27T09:20:20.265-07:002013-08-27T09:20:20.265-07:00Great comments Sam. Thanks for sharing your though...Great comments Sam. Thanks for sharing your thoughts.Anonymoushttps://www.blogger.com/profile/02446191842560064784noreply@blogger.comtag:blogger.com,1999:blog-8489363879633129568.post-59291420528956037052013-08-27T09:08:26.324-07:002013-08-27T09:08:26.324-07:00David,
This blog is a great illustration of one o...David,<br /><br />This blog is a great illustration of one of the reasons employers who can, self-insure. It is true in Texas and I expect to some extent in other jurisdictions that the employer may not direct the actions of the carrier or TPA. On the whole this is probably a good thing. Self-Insured employers have more flexibility to extend coverage to cases that are clearly compensable, but may have a technical defect. Granted employers are people and make mistakes. Sometimes an employer may want to have a claim denied for less than admirable reasons. Regulatory agencies and dispute resolution processes are in place to provide safeguards for that. They aren't perfect either, but that is their job. I have yet to see them tell a self-insured employer who wanted a claim covered that they couldn't do it. I admit to being prejudiced, but my experience with certified self-insureds in Texas is that they are responsible employers who care about their employees. They want them to receive quality medical care and to be treated with dignity and respect.<br />I have worked with small to large companies over the years and while it is easier to have an impact with the carrier or TPA if you are in the Fortune 100, smaller companies can, and should, be prepared to move their business if their service provider doesn't reflect their values. To the extent employers put price as the only differentiator in selecting a provider they are as much a part of the problem as the carrier or TPA.<br />Workers' compensation is a complex and convoluted legal construct built on basic concept of the employer/employee compromise. As someone recently pointed out, more rules make more opportunities to play the game. The more game players we have, the more the we need rules to keep them in check. Every so often things get so out of balance we have to have "Reform". When cases like the ones you describe get to be too common (and one is really too many) people will push for reform. The best we can hope for is to reform for balance rather than retribution.<br />Thanks again for something for us to get our teeth into.Anonymoushttps://www.blogger.com/profile/08496401822532555239noreply@blogger.com