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You are here: www.tdi.texas.gov . wc . pbo . index

System Monitoring and Oversight

System Monitoring and Oversight consist of three different program areas (Performance Based Oversight (PBO) and Monitoring & Analysis, Complaint Resolution and Audit & Investigations) which encourage fair treatment of system participants and the prompt delivery of benefits payments.

Program Areas

Performance Based Oversight System (PBO) and Monitoring & Analysis

Performance Based Oversight (PBO) monitors system participants' compliance with the Texas Labor Code and Rules. PBO objectives are achieved through monitoring electronic and paper data, complaint handling, entity audits, and enforcement actions. PBO encourages and rewards excellence and continuous improvement; fosters improved and timely communications; establishes performance objectives, measures and expectations and focuses on results rather than prescriptive requirements.

Monitoring and Analysis (M&A) monitors complaints, disputes, the quality and quantity of system participants' data submissions. M&A's objectives are achieved through monitoring of electronic data submitted to the Texas Department of Insurance, Division of Workers' Compensation.

Insurance Carrier Quarterly Meetings
Texas Department of Insurance, Division of Workers' Compensation (TDI-DWC) holds quarterly insurance carrier meetings to discuss complaints and other compliance issues in the workers' compensation system.

The purpose of these meeting are to provide insurance carriers with early notice of complaint issues currently impacting the system and to solicit feedback that will assist the TDI-DWC in resolving these issues. Our goal will be to provide system complaint information and to problem-solve through focused, open communication in an informal atmosphere.

Complaint Resolution

Complaint Resolution seeks to encourage communications and assists Texas workers' compensation system participants in resolving complaints. In this process, the staff examines complaints for compliance with the Texas Labor Code and DWC Rules and makes referrals to the Audit and Investigation section of System Monitoring and Oversight when appropriate. The complaint resolution process routinely results in additional claims payments to system participants.

Audits & Investigations

Audits & Investigations conducts compliance and performance audits of workers' compensation system participants and prepares justified complaints for enforcement action within the Texas Labor Code and DWC Rules.

For more information contact:

Last updated: 02/08/2016

Contact Information and Other Helpful Links

Translation by WorldLingo

Translation by WorldLingo