Brian Clymer, Attorney at Law

ICA Vows to Hold Carriers Accountable But Will It Make Good on the Promise?

Attorney Laura Clymer joined hundreds of workers' compensation claims adjusters, nurse case managers, HR representatives, and attorneys representing both sides at the Industrial Commission's Annual two-day seminar at Camelback Inn last week.

The first day featured five, one-hour sessions for attendees on topics ranging from claims adjusting to compensability issues to the hearing process to determining average monthly wage and permanent awards. Day Two was showcased a guest presenter lecturing on return to work issues and panel discussion on key cases in workers' compensation law.

Of interest to our firm were presentations by the Claims Division to claims adjusters regarding appropriate claims adjusting. We heard the ICA Claims Manager rightly explain to claims adjusters that they have to issue lost-wage indemnity checks timely because those checks replace a person's paycheck, in essence. We also appreciate the emphasis the Claims Division placed on the importance of being fair to the injured worker and properly issuing notices because it puts the injured worker on notice regarding their benefits.

What remains to be seen, however, is whether the Industrial Commission will make good on its statutory duty outlined in the general powers and found in Ariz. Rev. Stat. 23-107(A)(6): "The commission has full power, jurisdiction and authority to: Act as the regulatory agency insuring that workers' compensation carriers are processing claims in accordance with" our workers' compensation statutes

The Industrial Commission has a statutory duty to regulate insurance carriers, and we hope over the next year the ICA makes good on its promise not only to train adjusters and to facilitate the claims process, but also regulate the carriers when they unfairly administer claims or unreasonably deny or delay benefits owed injured workers. As the adage goes, "The proof of the pudding is in the eating."

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