Between 23% and 24% of workers with approved COVID-19 workers’ compensation claims who received medical or hospital/facility services received those services one month after the injury, according to a report released Monday by the Texas Department of Insurance, Division of Workers’ Compensation.
Using data collected from 74 insurance companies in the state, the division also reported that as of Aug. 7, insurance companies saw more than 90,000 COVID-19 claims and 459 deaths. Slightly more than half of these claims (51%) and deaths (55%) involve first responders and correctional officers.
Sixty-eight percent of claims involved employees who tested positive or were diagnosed with covid-19, and insurance companies reportedly accepted 59% of such claims. Insurance companies denied 39% of covid-19 positive test claims; and despite more than 22,000 denials of covid-19 claims with positive tests or diagnoses, there were only 207 disputes submitted to the DWC on August 7.
Overall, during the covid-19 pandemic, 65% of covid-19 claims submitted had only indemnity payments attached to them, according to the report.
Of the 35% of medical and indemnity claims, 89% of hospital/facility payments were made for inpatient services, followed by outpatient services (8%) and other (3%). Nearly a quarter (23-24%) of claimants received these services after one month post-injury, while only a small percentage (8-9%) of claimants received these services for more than six months post-injury, according to the Report.