Posted by defensebaseactcomp on March 9, 2011
“Over the past six years (does not include 2010) under the WHCA,
the federal government has paid more in reimbursements to insurers for expenses
than it has paid in compensation to claimants
There is evidence that the current process, in which the federal government identifies WHCA claims after they have been paid as DBA claims and then reimburses insurers for claim and administrative costs, results in the federal government paying significant amounts that do not go directly to claimants.
Over the past six years under the WHCA, the federal government has paid more in reimbursements to insurers for expenses ($19.7 million) than it has paid in compensation
to claimants ($12.1 million).
There is also evidence, including testimony provided by DBA and WHCA claimants at a 2009 House Committee on Oversight and Government Reform hearing, that in some cases, claimants with injuries that clearly fall under the statutory requirements of the WHCA must first navigate procedural and other requirements of their contractors’ DBA insurers before their cases are eventually transferred to DOL.
In some cases, DBA insurers controvert claims or oppose specific benefits for claims that are likely to end up at the DOL under the WHCA. Under the current system, insurers have the right and responsibility to investigate all claims and controvert or oppose claims and benefits they feel are not their responsibility or that fall outside of the DBA.
However, this can cause delays for claimants, including claimants with clear WHCA cases that will eventually be paid by the DOL.