California’s Insurance Commissioner recommended Tuesday that insurers slash the rates they charge businesses for workers’ compensation coverage by 14.2%, topping the 8% cut proposed by the largest insurer.

The Commissioner also warned insurance companies that he would send in auditors to make sure they don’t delay or deny needed medical care for injured workers, citing complaints from advocates for injured workers.

In calling for the rate reduction, the Commissioner cited "historic, record-low" insurance company payouts. Although it’s only a recommendation, insurers have generally gone along with the rate cuts proposed by the insurance commissioner.

Things could be different this time, however.

The government-controlled State Compensation Insurance Fund, the California market leader, has filed for a much smaller reduction of 8% for its 230,000 customers. A fund spokesman declined to discuss the filing.

The Insurance Commissioner credited the 2003-04 workers’ compensation changes with helping employers cut their insurance payments by as much as 65%. But he voiced concern that insurers could be improperly using review procedures to block needed care.

At issue is a change in treatment protocols for injured workers known as utilization reviews.

The workers’ comp overhaul gave employers the right to send workers to company-contracted clinics for immediate care and longer-term treatment, including surgeries. Those treatment plans, however, can be second-guessed by specialized doctors.

Employers argue that the reviews, often by out-of-state doctors who never see the patient, use objective standards that lead to lower treatment costs. But advocates for injured workers — and some of Gov. Arnold Schwarzenegger’s own regulators — counter that the reviews have sometimes been used to deny needed care.

Indeed, a survey released by the California Division of Workers’ Compensation in March showed that 22% of injured workers said they were dissatisfied or highly dissatisfied with their care. In the same survey, 65% of medical providers said they believed that care for injured workers had declined since 2004.