AA Election and liens (California)

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AA Election and liens (California)

Postby lacompfun on Sun Jan 06, 2019 9:46 am

Scenario:

1. Two insurance companies A and B on one CT.

2. AA elects agains insurance company A while underlying case is going.

Question:

1. Does AA election require carrier A to resolve the liens?


Any authority in answers provided would be greatly appreciated.
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Re: AA Election and liens (California)

Postby mytwocents on Sun Jan 06, 2019 3:13 pm

It may not be possible to answer your question because 1) it depends on what you mean by “resolve” the liens and 2) there are many potential scenarios that might take place after an election. If, after a trial, the WCAB finds a previously denied case to be compensable, the elected defendant may have to conduct UR and pay accordingly if it has no other defenses. Or, if the case was accepted but the liens weren’t paid because the providers weren’t in the elected defendant’s MPN, only the elected defendant can litigate that question. If by “resolve” you mean settle the liens after a C & R, no party is obligated to compromise a claim. Once a final order has issued, the lien claimants have the right to file a DOR and seek to prosecute their liens at the WCAB. Of course, if the non-elected defendant thinks the elected defendant did a bad job in defending AOE/COE at trial, it has the right to litigate that question all over again in contribution proceedings. So, that would be a good argument for the election to continue with respect to the liens. In general, though, it’s probably the better course of action for the defendants to coordinate their efforts with the liens.
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Re: AA Election and liens (California)

Postby lacompfun on Sun Jan 06, 2019 5:02 pm

C&R denied case two defendants in one CT
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Re: AA Election and liens (California)

Postby steve appell on Mon Jan 07, 2019 10:06 am

Insurance Company A (the elected IC) is required to administer the entire claim which includes the liens. The only exceptions I know if would be if it is a CIGA claim or if the parties enter into a subsequent agreement.

LATE
Steve

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Re: AA Election and liens

Postby lacompfun on Tue Jan 08, 2019 4:55 pm

AA elected against a carrier and the Judge signed off on it per Minutes of Hearing a court order. I was not sure how far it goes if applied to liens.

Thanks.
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Re: AA Election and liens (California) (California)

Postby lacompfun on Sun Jan 13, 2019 10:17 pm

Interesting...Steve do you recall labor code or case that supports elected defendant has to handle liens then go after other defendants?
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Re: AA Election and liens (California)

Postby steve appell on Mon Jan 14, 2019 3:01 pm

LC5500.5(c) In any case involving a claim of occupational disease or cumulative injury occurring as a result of more than one employment within the appropriate time period set forth in subdivision (a), the employee making the claim, or his or her dependents, may elect to proceed against any one or more of the employers. Where such an election is made, the employee must successfully prove his or her claim against any one of the employers named, and any award which the appeals board shall issue awarding compensation benefits shall be a joint and several award as against any two or more employers who may be held liable for compensation benefits. If, during the pendency of any claim wherein the employee or his or her dependents has made an election to proceed against one or more employers, it should appear that there is another proper party not yet joined, the additional party shall be joined as a defendant by the appeals board on the motion of any party in interest, but the liability of the employer shall not be determined until supplemental proceedings are instituted. Any employer joined as a defendant subsequent to the first hearing or subsequent to the election provided herein shall not be entitled to participate in any of the proceedings prior to the appeal board’s final decision, nor to any continuance or further proceedings, but may be permitted to ascertain from the employee or his or her dependents such information as will enable the employer to determine the time, place, and duration of the alleged employment. On supplemental proceedings, however, the right of the employer to full and complete examination or cross-examination shall not be restricted.
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Re: AA Election and liens (California) (California) (California)

Postby beach7 on Tue Apr 02, 2019 4:42 pm

say Ciga was the administrator the entire time but another carrier had been joined under joint and several liability. D2 paid the remaining amount of C&R with thomas finding. Ciga reimbursement and several medical liens remained pending. Ciga says D2 must handle all the medical liens basically by operation of law. D2 is not so sure about that for probably multiple reasons: A) the practical problem of not being able to fully defend without having direct access to the CIGA/TPA adjuster to assess merits of the liens. How can D2 ascertain all possible defenses without speaking to the CIGA TPA? A second question is what if the CIGA TPA made errors in administration of claim causing liens (or any extra reimbursement expenses for that matter)? There are numerous examples but say lien provider was outside MPN and CIGA TPA didn't object and paid some services, and not others. Questions are: 1) Is Ciga responsible for handling liens pending final perfection of its reimbursement claim? 2) is joint and several carrier responsible for CIGA TPA errors in administration? 3) would lien claimant be forced to deal solely with D2 including D2s thomas finding and AOE/COE defense on the joint and several issue?
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