Applied Risk: Featured News

3 Garber Hill Road, Blauvelt, NY 10913 --- 845-365-2444

Thank you for reviewing company and industry highlights. If you would like additional information on the topics discussed, please feel free to contact us.

January 2004

State: New York

Area of Interest: OSHA Fines Bronx Rite Aid Drugstore $134,500
for Locked Exits, Other Safety Hazards

Safety infractions, including locking an exit door, have resulted in $134,500 in proposed penalties against Rite Aid of New York, Inc., located at 650 Castle Hill Ave., Bronx, N.Y.
The U.S. Labor Department's Occupational Safety and Health Administration (OSHA) has cited the company, which operates a pharmacy, for alleged willful, serious and repeat violations of the Occupational Safety and Health Act. The action results from an investigation initiated on June 12 in response to a complaint about blocked exit doors.

Source Occupational Safety and Health Administration

State: California

Area of Interest: Commissioner Announces Substantial Reduction in Workers’ Compensation Rate Filings of 95 Insurers, Highlighting “Significant Impact” of Reform Legislation

Insurance Commissioner John Garamendi announced Wednesday that workers' compensation base premium rates filed by insurers to date are below current rates by an average 3.6 percent, a "clear sign" that the historic reforms signed into law in September will result in much needed savings for many employers.

Commissioner Garamendi said that 95 carriers, about one-third of the market, have filed rates with the Department of Insurance that will take effect on Jan. 1, 2004. Those carriers represent more than 75 percent of total premiums in the market.

Of those filings, 69 companies will reduce rates, 16 will keep rates at current levels, and 10 will increase rates. The list includes the State Compensation Insurance Fund (State Fund), which writes policies for more than half of the California market. It plans to reduce rates by an average of 2.9 percent.

Since 1999, private carriers have increased their base premium rate filings every year. The increases by private carriers over that period ranged from 9 percent to 22 percent annually. State Fund filed for increases during that same period ranging from 9 percent to 23 percent annually.

Prior to the passage of the reform legislation, the Workers' Compensation Insurance Rating Bureau (WCIRB) had recommended to the Commissioner that the advisory rate he sets for insurers be increased by 12 percent beginning in January.

Source: State of California

State: New York

Area of Interest: Multiple Individuals in the Albany Area Arrested for Various Insurance Fraud Schemes.

These arrests are part of a larger sweep of 15 fraud arrests in cases representing more than $1.1 million announced earlier today by the Albany County District Attorney's Office.

The following are summaries of the arrests made:

Two brothers were arrested and are facing charges of defrauding the State Insurance Fund (NYSIF) for allegedly concealing hazardous roofing work in applying for insurance for their general carpentry business. As a result, the company escaped paying NYSIF more than $49,000 in premiums. In other State Insurance Fund (NYSIF) related cases, the defendants allegedly obtained through fraud more than $143,000 in workers’ compensation benefits by claiming they could not return to work when all of them were working in other jobs while collecting disability.
An individual sustained injury as a construction worker, but was allegedly found working as a home building contractor in Saratoga County. His arrest resulted in future savings of more than $325,000 in benefit payments.
An injured sheet metal worker, opened and operated a Kingston delicatessen while still collecting full disability benefits. His arrest resulted in more than $241,000 in estimated savings.
A nurse’s aide in Wassaic, NY was indicted on a four-count indictment and arrested. The individual was allegedly working in Fishkill, NY, while collecting full disability. Her arrest resulted in more than $109,000 in future savings.
A one-time developmental aide allegedly worked as a heavy equipment operator, earning almost fifty thousand dollars a year in salary, while collecting disability benefits. His arrest resulted in $225,000 in estimated future savings.
An individual was arrested on workman’s compensation fraud charges. The individual then admitted to Insurance Fraud in the Fourth Degree and Workman’s Compensation Fraudulent Practices, two Class E Felonies. She acknowledged she collected disability payments totaling $28,844.00 while working one employer, and as a private duty nurse at the same time. She was sentenced on December 8, 2003, was Ordered to pay full restitution, received a five year felony probation period, credit for time served in jail, and was Ordered to forfeit all future medical, wage and related disability benefits.
A beverage company employee was purportedly injured told American International Group Insurers that he was not working. He was arrested and charged with various counts of insurance fraud and larceny. He admitted to working for three months at another employer while collecting his full disability. The individual entered a plea of guilty to a reduced larceny charge. He paid $1,560 in restitution and was fined.

Source: State of New York

State: Florida

Area of Interest: Florida Outpaces Nation in Insurance Fraud Convictions

Florida once again leads the nation in the number of insurance fraud convictions and cases presented for prosecution, according to a study released today by the Coalition Against Insurance Fraud, a national alliance of consumer organizations, insurance companies and government agencies working to combat insurance fraud.

It is estimated that insurance fraud costs the average Florida family as much as $1,400 a year in increased premiums and higher costs for goods and services. Gallagher said insurance fraud schemes not only are getting costlier and more complex, but also more dangerous.

Source: State of Florida

State: Ohio

Area of Interest: Director Womer Benjamin Seeks to Protect $12 Million in a State Insurance Fund for Medical Malpractice Initiatives
Testifies Before Ohio House Insurance Committee

Ohio Insurance Director Ann Womer Benjamin testified today before the Ohio House of Representatives Insurance Committee to advocate for amendments to HB 282, sponsored by Representative Larry Flowers (R – Canal Winchester). The changes would protect $12 million for medical malpractice initiatives and provide the Department greater flexibility while working to stabilize the medical malpractice insurance market.

Medical malpractice insurance premiums have risen by an average of 30% among the five major insurers over the past year and three of the five insurers have experienced financial reversals recently.

Source: State of Ohio

State: Washington

Area of Interest: State safety inspectors told to get owners' permission before entering property

State safety inspectors must now "be polite" and make a point of asking an employer's permission before entering a work site.

In a little-noticed directive published last summer, the state's chief of workplace safety told inspectors to explicitly ask for and confirm consent before proceeding onto private property to look for safety violations or interview workers.

Previously, inspectors could flash their identification and enter the property without explicitly asking for permission, a practice the Washington Farm Bureau called illegal.

Source: Yakima Herald Republic

Older News...

A good idea that is not shared with others will gradually fade away and bear no fruit, but when it is shared it lives forever because it is passed on from one person to another and grows as it goes.
- Lowell Fillmore