Santa Claus Contends with Workers Compensation Claim

Elf claims physical injury and mental stress due to heavy workload.

North Pole — (December 20, 2021) — Saint Nicholas, sometimes known as Kris Kringle but most popularly known as Santa Claus, has had a workers compensation claim filed by one of his elves. It appears the elf suffered from Pre-Holiday Burnout (PHB), caused by the effort required to make gifts for everyone in the world. He also suffered a broken toe when he dropped a toy anvil on his foot. Mr. Claus consented to sit for an interview with a reporter from WILBUR (World Insurance-Leading Business Underwriting Report). The elf, identified only as Ernie, declined to be interviewed. What follows is a transcript of the interview with Mr. Claus, edited for brevity and clarity.

WILBUR: How are you feeling about Ernie’s claim, Mr. Claus?

Santa: Look. I know this is supposed to be the season of giving. But all this claim is giving me is grief and agita.

WILBUR: You have the proper insurance coverage, don’t you?

Santa: Well, yeah. But managing two different claims is a nightmare.

WILBUR: What do you mean?

Santa: Ernie filed one claim for physical injury for the broken toe. That caused him to file another claim for the PHB. Now I have to manage both of them.

WILBUR: What if your claims system tracked claims by incident, recording every claim resulting from that one incident?

Santa: Right. And what if reindeer could fly?

WILBUR: Uh … they can.

Santa: Okay. I forgot. But where do I find an incident-based claims system?

WILBUR: In the cloud.

Santa: You mean with the reindeer?

WILBUR: Not exactly. It’s called Cloud Claims. I’ll get you the information.

Santa: Thank you. But I have to get back to work now. I’m short one elf. Ho, Ho, Ho!


WILBUR is the world’s foremost insurance authority. If it’s insurance, it’s WILBUR. For more information, please visit, email, or call 1-800-WILBUR1.

About Santa Claus

Santa Claus is a fat guy in a red suit who flies around the world in a red sleigh on Christmas Eve and brings everybody everything they want. For more information, please write a letter to the North Pole.

Media Contact:
JoAnna Bennett

Last June, we published a post called, Clean Up Your PAID Act. It laid out the reasons that entities required to comply with the Medicare, Medicaid, and SCHIP Extension Act (MMSEA) of the Centers for Medicare and Medicaid Services (CMS) and its Section 111 reporting requirements would soon be facing new mandates. Those mandates would be coming under the new compliance guidelines of the Provide Accurate Information Directly (PAID) Act. The PAID act was signed into law on December 11, 2020. As promised by CMS, the new law goes into effect on December 11, 2021. That’s Saturday of this week.

The PAID Act enable insurers to better identify claimants’ Medicare plans and to avoid unnecessary litigation. And it prevents the lawsuits that were being filed by Medicare Advantage Plans against insurers for double recovery and for failure to provide primary payment or reimbursement for qualifying charges. But it will require all responsible reporting entities (RREs) to manage additional data from CMS — data they they weren’t required to manage before the PAID Act. More specifically, the PAID Act requires CMS to deliver Medicare Part C (Medicare Advantage Plans) & Part D information to help RREs resolve liens with Medicare. That, however, requires significant changes to Section 111 reporting systems.

That means, beyond your present system’s inability to access the new fields, without changes, many systems won’t be able to process the new CMS query responses at all. That may render your current Section 111 reporting process obsolete. And it will put your CMS compliance at very real risk.

Depending on when your CMS reports are due, you don’t have much time. But with MIR Express™, we do. MIR Express is our secure system for managing your Non-Group Health Plan (NGHP) Medicare reporting. It’ll ensure you’re ready to handle CMS’s changes and to access all the valuable new information you’ll be getting from CMS right away. And we’ll make the transition painless.

If you’re already using MIR Express, you don’t have anything to worry about. And if you’re not already using MIR Express, you still don’t have anything to worry about because you can get it and be using it before your actual reporting deadlines.

We’re ready right now. Please let us know when you are.

December 11 is five days away.