21-Day Compliance for 2013
Preliminary Report of Insurer/Self-Insured Employer Performance
The Pennsylvania Workers' Compensation Act, Section 406.1(a)(c), requires insurers and self-insured employers to either make first payment or deny a claim no later than 21 days after the employer has notice or knowledge of the claimant's disability. Additionally, the Rules and Regulations require a form to accept or deny a claim be sent to the claimant, or the claimant's dependent, and the bureau no later than 21 days after the employer has notice or knowledge of the claimant's disability.
Since 1999, the Bureau of Workers' Compensation has been monitoring the 21-day compliance rate of insurers and self-insured employers. The bureau's formula for calculating 21-day compliance is to compare the file date of the Notice of Compensation Payable, Agreement for Compensation, Denial or Temporary Notice of Compensation Payable against the Employer Notified Date or the Date Disability Began from the First Report of Injury, using the later of the two (to account for delayed disability situations). The bureau then selects one random quarter per year, as a sampling, to complete this comparison and determine an insurer/self-insurer's compliance rating.
The 2013 report was drawn from the reporting period of April 1, 2013 - June 30, 2013. It identifies each insurer and self-insured employer by name, bureau code, number of claims filed in the reporting period and the percentage of compliance. The report lists the statewide industry average of 72 percent
and is offered alphabetically
for comparative purposes.
The bureau's goal is to provide ongoing information to the public regarding individual and industry-wide success in meeting the filing requirements under the Act. To strengthen this effort, you should begin seeing individual insurer 21-Day Compliance Reports quarterly on the Insurer Profile Page of the Workers' Compensation Automation and Integration System, or WCAIS, under the 21-Day Compliance Tab. The overall alphabetical listing will continue to be published on this page for comparison purposes, on a quarterly basis. As always, Bureau of Workers' Compensation staff are available to offer guidance to insurers with regard to 21-Day compliance requirements. For questions or more information, email the bureau at RA-CMDRegAd&EdOutrch@pa.gov