The Claims Services Division provides oversight and support of multiple workers’ compensation programs. The Old Fund is the legacy claims liability that existed upon the privatization of workers’ compensation, which is administered by the Third Party Administrators (TPAs); Sedgwick CMS and HealthSmart. In addition, this Division provides claims oversight of the Uninsured Employer Fund (UEF), the Federal Black Lung program with dates of last exposure prior to January 1, 2006, and the State Agency Workers’ Compensation (SAWC) program. A primary focus is to ensure the claims are properly reserved and administered to the Best Claims Practice standards, and that the claims are in compliance with statutory and regulatory provisions.
The West Virginia Offices of the Insurance Commissioner (WVOIC) contracts with two TPA’s to administer claims. The two TPAs are:
- Sedgwick CMS, which administers the largest portion of the Old Fund Trauma and UEF claims
- HealthSmart Disability Management, which administers the majority of State Occupational Pneumoconiosis (OP) and Federal Black Lung (FBL) claims, Security, and Guaranteed funds
The West Virginia Office of the Insurance Commissioner and the International Workers' Compensation Foundation are jointly sponsoring a Workers' Compensation Educational Conference which is unique in West Virginia. The goal of this conference is to educate all those who participate in the West Virginia workers' compensation system regarding current rules, procedures, policies and forms, and to provide an opportunity for dialogue among these participants. The conference includes an exhibit hall, and participants may earn continuing education credits.
Registration is now open!
Registration is now open for the 2017 West Virginia Workers' Compensation Educational Conference at the Marriott Charleston Town Center Hotel on May 4-5, 2017.
There are two ways to sign up.
For a copy of the conference brochure or to pay by check, click on the button below to download the conference registration form, or you may visit http://www.iwcf.us
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To pay by credit card, please visit https://www.compevent.com/west_virginia.
We hope to see you at the conference this spring. For more information, you may contact us via email at iwcf@bellsouth.net.
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The West Virginia Offices of the Insurance Commissioner (WVOIC) contracts with two TPAs and a carrier to administer claims on its behalf. The two TPAs and carrier currently under contract are:
- Sedgwick CMS, which administers the largest portion of the Old Fund Trauma and UEF claims
- HealthSmart Disability Management, which administers the majority of State Occupational Pneumoconiosis (OP) and Federal Black Lung (FBL) claims, Security, and Guaranteed funds
If you have an issue accessing any of the information or forms via the links on the Claims Services Division webpages, please contact:
Paul D. Dixon II, MBA
Insurance Program Specialist
Phone: (304)-558-1966, ext. 3114
Email:
Paul.D.Dixon@wv.gov