Indicator 6: Accuracy of Weekly Rates & Total Payments

Indicator Description:  

This indicator measures both the accuracy of setting wages for computing TTD rates under ss. 102.11 and 102.43 of the Wisconsin statutes, and accuracy of total payments of temporary and permanent disability benefits.

Compliance Requirement:  

Insurers are required to comply with ss.102.11 and 102.43 and make accurate payments in accordance with these statutes.

Standard or Benchmark:  

There is no standard set by statute or rule for this indicator. The benchmark used for training purposes is to have a ratio of no more than 10% of claims requiring letters to correct rate calculation or payment accuracy.

Source of Indicator Data:  

The source of the data is from wage and rate computations shown on the Supplemental Report, form WKC-13, and the Wage Information Supplement, form WKC-13A. The program selects "balance due" (form letters WC77 and WC77P) and "wage correction" request letters (form letter WC119) sent during the quarter. Click here (Standard Letters)  to view specific letter language.

Computation Methodology:  

Accuracy is computed by dividing the number of balance due and wage correction letters by the number of first and final supplemental reports received during the quarter and establishing a ratio of these letters sent during the quarter to the number of first and final supplemental reports received during the quarter. Counts and ratios will be made for these two categories combined on the report:

    1) The accuracy of the wages used and TTD rate computation, and
    2) The accuracy of the total temporary and total permanent disability payments

State of Wisconsin Averages:

 

What This Indicator Measures:

This indicator measures the accuracy of insurers in determining the rate at which to pay worker's compensation temporary benefits and the accuracy of actual total payments. It has a 90% benchmark which is minimal for the importance of this indicator.

Explanatory Comments for Current Indicator:

Industry performance for the past 12 quarters is 92%. 2nd quarter 2014 performance is  91%. Continued monitoring, education and feedback by the WC Division, as well as insurance carrier and self-insured employer diligence, have enabled insurers and self-insured employers to meet or exceed the 90% benchmark for this very important aspect of claims adjusting.

Indicator 6: Accuracy of Weekly Rates & Total Payments
Group A - Large Insurers (400 claims or more per year)
Group B - Medium Size Insurers (65-399 claims per year)
Group C - Small Size Insurers (equal to or greater than 65 claims every 3 years)

PLEASE NOTE: Quarterly summary reports are static, a snapshot of performance reflected by our database the day prior to the reports being run.  As such, actual performance may be different due to changes to the claims for the given quarter after the reports are run than performance captured in the PDF.

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