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Commissioner rejects COVID claims effects on comp rate-making


California Insurance Commissioner Ricardo Lara rejected the recommendation from an agency attorney that he approve a request from the Workers’ Compensation Insurance Rating Bureau to begin incorporating COVID-19 claims in rate-making.

Mr. Lara on Tuesday adopted all classification and payroll changes the WCIRB recommended in its annual regulatory filing but declined to adopt the proposal to use COVID-19 claims filed on or after Sept. 1 when calculating employers’ experience ratings.

He did not elaborate on the evidence or arguments that influenced his decision and persuaded him to reject the recommendation of an Insurance Department attorney to adopt the experience rating changes.

WCIRB Executive Vice President and Chief Actuary Dave Bellusci said during a public hearing on the regulatory filing in April that COVID-19 claims were removed from experience rating when the pandemic started because employers at the time knew little about how to mitigate spread of the virus and there were no presumptions that could help determine whether an infection was work-related.

State lawmakers have subsequently created presumptions that COVID-19 is compensable for first responders who test positive within 14 days of going to work and for other employees who test positive within 14 days of going to work at a site experiencing an outbreak. The Legislature is currently deliberating a proposal to extend those presumptions through 2025.

Mr. Bellusci also said employers have more information about steps they can take to protect workers from the virus. Personal protective equipment that was in short supply at the start of the pandemic is now widely available. He also argued that both state and federal entities have published recommendations for mitigating workplace spread of COVID-19.

“So, our thought is, with or without the extension of the presumption, we think it makes sense to include COVID-19 claims in experience rating on a prospective nature, given that this virus is becoming endemic and it’s going to be with us for the foreseeable future,” he said.

WorkCompCentral is a sister publication of Business Insurance. More stories here.