2000 Audit Report

2000 AUDITSA Report to the California Legislatureon Claims Handling Practices ofWorkers' Compensation AdministratorsDepartment of Industrial RelationsDivision of Workers' CompensationAudit UnitApril 1, 2001California Department of Industrial RelationsDivision of Workers' Compensation2000 Audits of Workers' Compensation Insurers, Self-Insured Employers,and Third-Party AdministratorsApril 1, 20012000 Audit ResultsThis eleventh annual workers' compensation audit report summarizes the accomplishments of theAudit Unit of the Division of Workers' Compensation during calendar year 2000.ScopeThe Audit Unit of the Division of Workers' Compensation completed a total of 54 audits in 2000,an increase of 24 audits from the 30 audits conducted in 1999. Of these, 45 were randomlyselected and the remaining 9 were non-random, or "targeted" audits. Non-random audits wereselected either based upon results from prior audits or following investigations resulting fromcomplaints received by the Division of Workers' Compensation. The total number of auditsubjects included 18 insurance companies, 13 self-administered, self-insured employers, and 23third-party administrators (TPAs).In addition to these 54 audits, the Audit Unit conducted 10 investigations, in which 37 claim fileswere reviewed based on complaints received by the Division of Workers' Compensation allegingclaims administrators' failure to comply with workers' compensation obligations. Theinvestigations ...