Moreci v. Scaffold Solutions, Inc., 2021 WL 4397397 (Calif. App. 2021). A valiant effort by a California workers’ compensation carrier to make it more difficult for an employee to argue employer fault and settle around a workers’ compensation carrier’s statutory lien and right of reimbursement fell on deaf ears recently, when the California Court of…
Secura Sup. Ins. Co. v. Est. of Huck, 2021 WL 4449249 (Wis. App. 2021). A new Wisconsin Court of Appeals decision has ruled that an uninsured/underinsured (UM/UIM) automobile insurance carrier cannot reduce UM/UIM payments to its insured by the amount of workers’ compensation benefits the insured received, if the insured had to reimburse those benefits…
Recovery of Case Management Costs, Medical Bill Audit fees, Rehabilitation Benefits, Utilization Review Costs, IME’s, Nurse Case Worker Fees, Attorneys’ Fees, and Other “Allocated” Loss Adjustment Expenses. It’s the question every claims professional and trial attorney claims to know but few fully understand. In addition to paying for medical expenses, death benefits, funeral costs and/or…
Moranz v. Harbor Mall, LLC, 477 P.3d 179 (Haw. App. 2020), cert. granted, SCWC-17-0000006, 2021 WL 1924134 (Haw. May 13, 2021). We are at the precipice of a potential upheaval in workers’ compensation recovery rights in the Aloha State. The Hawaii Supreme Court is about to decide whether equitable considerations and defenses to subrogation—such as…
A tragic, but all-too-frequent claims handling mistake in Oregon is the inadvertent waiver of a large workers’ compensation lien when the underlying claim is settled through a Claim Disposition Agreement (CDA). On an accepted workers’ compensation claim, the employee and carrier can enter into a CDA through which, in return for an agreed amount paid…
A new ruling from the Florida Supreme Court may shed some light into ability of a workers’ compensation carrier to seek reimbursement from an employee’s legal malpractice claim against his or her personal injury attorney. In a case that had been pending for almost two years, the Florida Supreme Court has ruled that a professional…
Understanding the nuances of the somewhat complicated and confusing subrogation law in California is instrumental in formulating the right decision when it comes to protecting your workers’ compensation subrogation interests. California workers’ compensation subrogation requires both an in-depth knowledge of the law and the ability to play poker. California is perhaps the most confusing state…
Employers Fight Losing Battle Against Tortfeasors Who Cause Premium Increases Workers’ compensation insurance premiums seem to know only one direction – up. On average, premiums rise approximately 5% annually; more, if an insured has experienced significant losses. For many corporate risk managers and claims professionals, the concepts of underwriting and experience ratings remain a clouded…
Katherine A. Sandoval will be presenting a MWL webinar on Advanced Concepts of California Workers’ Compensation Subrogation on May 11, 2021 from 11:00 to 12:00 p.m. (CDT). There are very few areas in which the law of each individual state vary more and are applied as differently, than in the area of workers’ compensation subrogation. While…
Health insurance subrogation involves much more than simply making demands on negligent tortfeasors. Coordination of Benefits (COB) is a subset of health Plan subrogation. It primarily concerns itself with situations where two different health Plans, or a health Plan and a no-fault automobile carrier, cover the same person or loss. Obviously, with two sources of…