Whitt & Del Bueno, Attorneys at Law

Leaders in defending workers' compensation claims.

Articles

No More Mr. Nice Guy

By Mike Del Bueno

Most or all of you out there in Virginia workers’ comp land are likely familiar with the Commission’s show cause Orders and hearings. For those of you who don’t know about those, here’s how it (used to) work: after sending to an insurance company a request (sometimes more than one request) for information on a case, such as how much compensation had been paid to a claimant, and not receiving any response to that request, the Commission would issue what is (was) called a show cause Order that forced the insurance company to come to the Commission and explain to it why it didn’t respond to the Commission’s request for information. Many times, the Commission accepted the explanation (which usually came from counsel in written form prior to the show cause hearing), cancelled the show cause hearing, and did not penalize the insurance company.

Well, folks, it appears those days are over. The Commission is no longer issuing show cause Orders and having hearings on them. Instead, if an insurance company does not respond to a request by the Commission for information on a case, the Commission will now simply send a letter to the insurance company allowing seven days to tell the Commission why it did not respond to the request and why a penalty or fine should not be assessed. While we may have to wait and see how this plays out, don’t be surprised if the Commission is more likely now to assess a fine where it was not before. It may be the situation that only a reasonable or valid excuse (like never receiving the Commission’s request for information) will now allow an insurance company to avoid a fine.

From this information, one thing is clear (if it wasn’t clear before): be vigilant and timely in responding to a request by the Commission for information on a case. Remember that the Commission has a job to do, and it doesn’t just send out these requests for the heck of it. The Commission needs the requested information for a reason, and not giving it to the Commission simply makes the process of claims administration that much more difficult.

If you have concerns or questions about this new undertaking by the Commission, please give us a call. We will help you try to avoid incurring penalties or fines, and keep you on the right side of the Commission.