During the course of a Workers’ Compensation claim, it is quite common for the insurance carrier to allege an overpayment.
Most claimants will contest the claimed overpayment. However, it is important to understand that in order to determine whether or not an actual overpayment or underpayment exist a complete indemnity audit needs to be performed.
An indemnity audit involves comparing formal awards made by the Workers’ Compensation Board to actual payments made by the insurance carrier. In order to make this comparison, formal notices of decision from the Workers’ Compensation Board need to be secured. Also cancelled checks or a verified computer printout documenting all indemnity payments made by the insurance carrier must be obtained. Securing cancelled checks or an indemnity printout can take several weeks or even months.
The results of the indemnity audit will determine whether or not the claim has been overpaid or whether there is additional money owed to the claimant. This process is time consuming and labor intensive.
If a true overpayment exists, it can only be recouped from future payments. It is up to the Law Judge to set a weekly amount that will be deducted from future indemnity payments and credited toward the overpayment. An insurance carrier should not ask a claimant to reimburse monies by personal check. Reimbursement should only come in the form of future deductions.
For help with allegations of overpayment contact Paul Giannetti today!