Pinnacol Opposes New Colorado Bills In State Legislature
Colorado’s Pinnacol opposes quite a few Workers Comp Bills this week. I have seen articles over the last week that Pinnacol has opposed a number of bills that are now in the Colorado legislature. Most of opposition from Pinnacol is justified in my opinion. However, there is one area that I do not agree with overall. I have seen this often in Workers Compensation claims adjusting units. I also see it in our file reviews for self-insureds and larger employers.
Providing adjusters with incentives on the number of denied claims is somehow fertile ground for conflicts of interest. An incentive for very low settlements is also one that I have seen over the years. I do not agree whatsoever that adjusters’ denial performance should be rewarded. In one carrier where I used to be employed, there were actually trophies and plaques given out for denial rates and low settlements.
Adjusters are supposed to give unbiased opinions and decisions on Workers Compensation files. In our file reviews, we notice that most denials are either won by the injured employees or settled.
I think the reserving efforts by adjusters should be monitored more than anything else they do in their job. Please feel free to use the search box on the right side of the screen using reserves as a search term to see my opinion on inaccurate reserving. I have posted many articles on the over-reserving of files and the harmful effect to employers. Under-reserving can also be harmful if not monitored properly.
Do adjusters need to perfectly estimate the reserves on the file at the outset of the claim? No – but they do need to monitor the reserves closely for changes in the file that would affect the reserves.
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