Yasmin Duenas — ADJ8375307

Applicant Yasmin Duenas claimed an April 4, 2012 industrial injury while employed as a Production Scanner by a general employer (Workforce Solutions) and special employer (Komar Distributions). The insurer for the insolvent carrier's claim was covered by CIGA, while Pacific Indemnity was a solvent insurer found jointly and severally liable. The WCJ found Pacific was 'other insurance' under Insurance Code section 1063.1 and awarded CIGA reimbursement of $10,907.47, of which $2,739.07 represented UR and bill review expenses Pacific characterized as non-reimbursable loss adjustment expenses. The WCAB affirmed, holding that medical cost containment expenses (UR and bill review) are required to provide medical treatment under the Labor Code and are therefore reimbursable as 'covered claims,' regardless of WCIRB reclassification of those expenses as allocated loss adjustment expenses.