Workers Compensation Insurance Overview of WCI claims/expenses at UTPA WCI Procedure for filing a claim. Overview of UTPA insurance programs

Transcription

1

2 Workers Compensation Insurance Overview of WCI claims/expenses at UTPA WCI Procedure for filing a claim Mexico Claims Return to work program Overview of UTPA insurance programs

3 The purpose of Workers' Compensation Insurance (WCI) is to provide medical benefits, and, in some cases, financial payments to employees on the payroll of UT Pan American if they sustain a compensable injury or occupational disease while carrying out their job duties.

4 Employees of the University of Texas System are provided Workers Compensation coverage under a self-insuring, self-managed program as authorized by the Texas Labor Code, Chapter 503. UTPA s WCI expenses are directly affected by other components WCI injury rates. The Resource Allocation Program (RAP) reimburses the UTPA if WCI expenses are minimized.

5 UT Pan American has spent $96, in 2010 for work related injuries. An average of $1, per claim

6 Academic Services Business Affairs Enrollment/ Student Services Information Technology University Advancement President's Office

7 $60, $50, $40, $30, $20, $10, $0.00 Academic Services Business Affairs Enrollment/ Student Services Information Technology University Advancement President's Office

8 Although Business Affairs employs the high risk groups (i.e. Custodians, Groundskeepers) with a denial rate is 23%, the cost per claim is lower than those in other divisions. * Information Technology - $3, * Enrollment/SS - $2, * Business Affairs - $1, * Academic Affairs - $1,681.37

9 $3, $3, $2, $2, $1, $1, $ $0.00 Academic Affairs Business Affairs Information Technology University Advancement Enrollment and Student Services Presidents Office

10 The Supervisor as the ultimate responsibility to insure that the appropriate filing is conducted in the event of a work place injury. Submit a report immediately to DEHS y/progs_workcomp Talk to your injured worker - keep in contact Report anything suspect to DEHS offices Report all work place injuries no matter how small Participate in Return to Work Program Delays or failure to meet deadlines Can result in denial of the claim for the employee Fine to the University

11 Does your injury require Medical Attention or is it an Incident Only? Be detailed in your description and make sure injury correlates with the incident i.e. I fell on my right knee and injured my left? Please Denote Injured Body Part & Which Side of the Body was Injured

12 Please be sure to fill out this pertinent information

13 Preferred providers list (Worker s Compensation Link) Preferred providers result in lower costs and more expeditious return to work. Preferred providers have a relationship with the University for more efficient processing of claims.

14 Workers Compensation Insurance DOES NOT cover treatment or medication obtained in Mexico. If an injured worker does seek treatment in Mexico, that will be considered an election of remedies and cause for denied.

15 Injured employees are required by State law to participate in the RTW program Supervisors of injured employees are required by State law to participate in the RTW program Modified duties UTPA has the option to hire own doctor in disputes

16 Workers Compensation Auto Policies Equipment Policy Fine Arts Policy Camp Policy General Liability for Specific Locations/Events Tenant User Liability Insurance Policy (TULIP) Special Event

17 General Liability It is the stated policy of the State of Texas not to acquire commercial general liability insurance for torts committed by employees of the state who are acting within the scope of their employment. Rather, Chapter 101 of the Civil Practice and Remedies Code states that a governmental unit in the state is liable for property damage, personal injury and death proximately caused by the wrongful act or omission or negligence of an employee acting within his scope of employment... Liability of the state government under this chapter is limited to money damages in a maximum amount of $250,000 for each person and $500,000 for each single occurrence for bodily injury or death and $100,000 for each single occurrence for injury to or destruction of property.

18 DEHS provides training to help offer advice and techniques to maintain a safe work place. We welcome comments and suggestions as Safety is in everyone s job description! Celia M. Saenz Claims Analyst Environmental Health and Safety LAMR 1101 Dept Fax cmsaenz@utpa.edu