Yearly Open Claim Validation Report
DATE: February 24, 2017
TO: All Insurers and Self-Insurers
FROM: Mark Long, WCA Director
SUBJECT: YEARLY COMPENSATION PAYMENT VALIDATION report
In alignment with the agency’s mission to efficiently administer the Act and provide prompt, courteous and impartial service to all customers, we have begun to implement a series of changes with how we collect and examine weekly benefit payment(s). Some of these changes impact only our internal operations while others will impact how we interact with our external customers.
One such change relates to the YEARLY COMPENSATION PAYMENT VALIDATION report. Effective immediately with the 2016 annual report we now require a response from all insurers and self-insurers or their respective third party claims handler. Upon receipt please review the annual report and certify compliance with its requirements. Select for a sample letter that will acompany the validation reports. This change will assist in ensuring that our records accurately portray the status of indemnity benefit payments by the industry.
Where available the service company or third party claims handler will receive the report. However, it remains the responsibility of the self-insurer or the insurer of record writing the policy covering the date of injury to see that all items related to the claim are resolved timely and appropriately reported to the agency in accordance with the Michigan Workers’ Disability Compensation Act.
Another change is the requirement to file form WC-701 to terminate benefits that have been reduced to zero after applying adjustments “A” thru “G” (coordination of benefits) for more than 14 consecutive calendar days. Form WC-701 must be submitted to terminate benefits for each claim in Category 4 (All Others) of the Validation report for Year Ending 2016 where COMPENSATION RATE of zero was started during 2016. The WC-701 form should be submitted with filing reason “C” (Terminating Benefits), Through date should be 15th day after From date, Termination Reason “H” (Other) and “Coordination reduced to 0 more than 14 days” on the comment line provided below Part D of the form.
The Form WC-701 instructions have been updated to reflect these changes.
If you have open claims where indemnity payments are being made and they do not appear on this report please immediately report them to our agency by completing the appropriate forms.
Questions regarding this procedure may be directed to Agency staff at 517-284-8914.