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Insurers denying nearly half of COVID-19 claims: Texas report

Posted On: Mar. 5, 2021 11:07 AM CST


The total number of claims reported to Texas Department of Workers’ Compensation in 2020 was 24% higher than in 2019 and as of Feb. 14, insurers reported 44, 873 COVID-19 claims and 200 related fatalities.


Of the claims, 52% came from first responders and correctional officers and 16% came from health care/social workers, according to a report of data compiled from 74 insurers issued Thursday.


Overall, insurers disputed 49% of COVID-19 positive test claims. Of the 10,985 denials of COVID-19 claims with positive tests or diagnoses, there were only 45 counter disputes filed with the department as of Feb. 14, according to the report.


For COVID-19 claims, indemnity, or income replacement costs soared past that of medical, $21.2 million compared to $13.4 million. Of the medical costs paid, insurers covered $11.1 million in hospital/facility services, 90% of which was for inpatient care, $2.2 million in professional services, 65% of which was for evaluation and management services, and $104,910 in pharmacy services, 46% of which covered respiratory medicines.


More insurance and workers compensation news on the coronavirus crisis here