As of January 2017, insurers are now required to report all claims to the California Workers’ Compensation Insurance Rating Bureau (WCIRB). These include claims for which any medical care is provided and medical costs are incurred, including those involving first aid treatment, even if the insurer did not make the payment. 

Businesses in California who previously made arrangements with their medical clinic to directly pay for medical treatment bills for “first aid” claims will no longer receive the benefit of their workers’ compensation experience modification rating being unaffected. 

In the past, many insurance carriers allowed employers to make direct payments to medical providers for treatment specifically related to first aid claims. Insurers rarely, if ever, tracked the actual costs paid by employers for first aid claims.

Now, since all claim financial data must be reported, even first aid workers’ compensation claims that are paid directly to medical clinics will affect an employer’s experience modification. Employers are highly encouraged to report all claims to their insurance provider.

Western Growers Insurance Services can assist members with training their managers, supervisors and employees on the process for handling workers compensation claims and assist the business in finding the best workers compensation provider for its business. 

For questions, contact Ken Cooper at [email protected] or (949) 379-3858.