Insurers and Self-Insurers

Insurance carriers and self-insured employers are key stakeholders in the worker’s compensation program. They have the primary responsibility for the administration of worker’s compensation claims for injured workers. This includes the responsibility to make payments that are due to workers promptly and accurately.

Further, the responsibilities include interfacing with the Worker’s Compensation Division by sending required reports and by replying promptly to all correspondence. The information contained on these web pages is intended to assist insurers, employers and claims administrators to properly insure workers and administer the worker’s compensation claims.

Worker's Compensation actively participates in the EDI Project sponsored by the International Association of Industrial Accident Boards & Commissions (IAIABC). Insurance Letters #453 and #455 provide instructions on information and forms that are now required to be electronically transmitted via EDI or the Internet Pending Report Application.

There has been an amendment to Wis. Stats. §102.13 (2) (c). A filing of a final medical report in cases with eye injuries where the employee received treatment on three or more occasions off the employer's premises, even if there is no lost time from work, is now required. As part of its claims monitoring process the Worker's Compensation Division will follow-up with all reported eye injuries as necessary. In cases where there is no lost time it is not necessary for insurance carriers or self-insured employers to report the claim to the Worker’s Compensation Division unless the three or more offsite visits threshold is met.

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