It is the position of most insurance companies that they do not have a duty to pay medical benefits, that the only duty they have is to reimburse the Employee for medical expenses 30 days after the Insurer received notice of the Employee’s expenditures, and that, just to be nice, the Insurer’s arrange to pay some of the medical benefits directly to the providers.
That’s not what the law says. The law says the insurance companies have a duty to pay medical benefits immediately on demand. In other words, “now” means “now”. The case which said interpreted the law to hold that the benefits are due immediately is Harris v. M-K Rivers, 325 P.3d 510 ( Alaska, 2014) decided in March of 2014 by the Alaska Supreme Court. “To determine when an employer's payments for medical care are due under the Workers' Compensation Act, for purposes of determining whether the employer is subject to a penalty for failing to timely pay amount due, payments due are more appropriately characterized as payable immediately or on claimant's demand, rather than owed as a debt.” Id, 519. Harris v MK
So if the insurance company is dragging its feet in pre-authorizing surgery, some other medical benefit, it will owe penalties and interests and is flirting with the possibility of being referred to the Division of Insurance for an investigation.
Keenan Powell has practiced Workers Compensation law in the State of Alaska for more than 30 years and has dedicated her practice to Workers Compensation representing injured Alaskans. A sample of verdicts she has obtained for Employees is found at http://www.keenanpowell.com/settlements_wc.html.
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