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TPA Liability

Thursday, December 26, 2019

Self-insured employers rely on third party administrators to manage their workers’ compensation claims, however when TPA mistakes are made who is liable?  Mistakes which are violations of the self-insured rules, i.e. untimely payment of compensation, result in a Self-Insured employer being penalized with a self-insured complaint.  Multiple self-insured complaints put the very privilege of self-insurance at risk. While some mistakes result in self-insured complaints, there are some mistakes such as the unauthorized certification of a claim, the authorization of treatment for non-allowed conditions which directly result in the increase of a self-insured employer’s claim costs. 

TPAs are professional organizations, and can be held to a standard of care. TPAs carry errors and omissions insurance coverage, in the same way as other professionals, such as insurance agents, architects, engineers, doctors, lawyers, and dentists.  Although TPA standard of care is very fact dependent, it requires a TPA to exercise the skill and knowledge normally possessed by members of the profession in good standing in similar communities.

When a TPA actions fall below the standard of care, it may seem like the only result is that employer pays, with no accountability for a mistake by the TPA. However, a covered occurrence may have been triggered under the TPA errors and omissions policy.   A professional malpractice claim is like any other negligence claim in that it requires proof of a breach of standard of care resulting in damages.

If you believe that you are paying for claim costs due to TPA negligence, please call us for a free consultation. 

LL Patterson LLC sponsors and volunteers at Community Meal at One Bistro 12/11/19

Thursday, December 12, 2019

Lisa Patterson and her staff spread some Christmas spirit by volunteering at the Community Meal at One Bistro in Xenia on December 11, 2019, serving over 85 meals.

Lisa Patterson sponsored the Community Meal, and supports One Bistro’s mission to “provide a place where our neighbors eat and come together as one community.”

Check out the photos of great volunteers working and making our community a better place!

Not every workers’ compensation claim requires the help of an attorney. But if you need one, choose experience, reputation, and most importantly, someone who understands how you do business.

LL Patterson LLC is founded on the principle of providing clients with exceptional and results oriented service. The singular mission of LLP is to aggressively and exclusively protect Ohio Employers’ rights in workers’ compensation, OSHA, VSSR, and employment related issues. Whether you’re in the medical or healthcare industry, the construction field, education, the corporate world, or small business, the goal remains the same: to reach final closure of your workers’ compensation claim in as little time as possible while minimizing cost.

Lisa L. Patterson understands the complex intricacies of the Ohio workers’ comp system and has sixteen years experience working with this very specific and sensitive form of law. A seasoned Ohio employers’ advocate, she will work to ensure that all parties’ claims are fairly and efficiently executed to protect your interests and assets.