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Pinnacol Opposes New Colorado Bills

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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.

Picture of Cash Dollars Pinnacol Opposes Bills
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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.

Two Files Folder Pinnacol Opposes White Background
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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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Table of Contents

James Moore

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Mgmt Consultants, Inc. in 1996. J&L’s mission is to reduce our clients’ Workers Compensation premiums by using time-tested techniques. J&L’s claims, premium, reserve and Experience Mod reviews have saved employers over $9.8 million in earned premiums over the last three years. J&L has saved numerous companies from bankruptcy proceedings as a result of insurance overpayments.

James has over 27 years of experience in insurance claims, audit, and underwriting, specializing in Workers’ Compensation. He has supervised, and managed the administration of Workers’ Compensation claims, and underwriting in over 45 states. His professional experience includes being the Director of Risk Management for the North Carolina School Boards Association. He created a very successful Workers’ Compensation Injury Rehabilitation Unit for school personnel.

James’s educational background, which centered on computer technology, culminated in earning a Masters of Business Administration (MBA); an Associate in Claims designation (AIC); and an Associate in Risk Management designation (ARM). He is a Chartered Financial Consultant (ChFC) and a licensed financial advisor. The NC Department of Insurance has certified him as an insurance instructor. He also possesses a Bachelors’ Degree in Actuarial Science.

LexisNexis has twice recognized his blog as one of the Top 25 Blogs on Workers’ Compensation. J&L has been listed in AM Best’s Preferred Providers Directory for Insurance Experts – Workers Compensation for over eight years. He recently won the prestigious Baucom Shine Lifetime Achievement Award for his volunteer contributions to the area of risk management and safety. James was recently named as an instructor for the prestigious Insurance Academy.

James is on the Board of Directors and Treasurer of the North Carolina Mid-State Safety Council. He has published two manuals on Workers’ Compensation and three different claims processing manuals. He has also written and has been quoted in numerous articles on reducing Workers’ Compensation costs for public and private employers. James publishes a weekly newsletter with 7,000 readers.

He currently possess press credentials and am invited to various national Workers Compensation conferences as a reporter.

James’s articles or interviews on Workers’ Compensation have appeared in the following publications or websites:

  • Risk and Insurance Management Society (RIMS)
  • Entrepreneur Magazine
  • Bloomberg Business News
  • WorkCompCentral.com
  • Claims Magazine
  • Risk & Insurance Magazine
  • Insurance Journal
  • Workers Compensation.com
  • LinkedIn, Twitter, Facebook and other social media sites
  • Various trade publications

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