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LUMP SUM PRESENT VALUE CALCULATION -Carrier's Liability


 
Name  
HPE date/Date of Death    
Date of Injury    
Compensation Rate    
Paid thru date    
Actual Benefits Pd-to-Date    
 
Calculated Pd to Date $0.00   Underpayment
Due Now
Provider's Balance of Liab $0.00   $0.00
Provider's Balance /wks 0    
 
PRESENT VALUES      
Provider's Remaining Liab      

  PV t weeks
PV $
$0.00
Balance in Weeks 0 -441.55
     
     



This sheet will calculate the Present Value of the Provider's remaining liability for PTD and Death claims using the Commission's discount table. Data entry is only required in the shaded area. If Provider's Paid to Date is different than calculated, enter the actual amount paid in that field. This should only be used when the weekly rate will not change for the remaining time period that liability would have been paid out.