By Peter Marcus, DENVER DAILY NEWS
Lawmakers are pushing legislation that would limit the ability of workers’ compensation providers from spying on employees who have made a claim.
The bill stems from discussions by the Pinnacol Interim Committee, after lawmakers looked to tighten control over the state’s workers’ compensation provider of last resort. Concerns were raised about the company spying on injured workers to validate claims.
House Bill 1012, sponsored by Rep. Sal Pace, D-Pueblo, would only allow surveillance with reasonable cause.
The bill would prohibit an insurer or employer from spying on workers who have submitted claims unless the insurer or employer has a “reasonable basis” to suspect the employee has committed fraud. Employees would be allowed to request an expedited hearing before a administrative law judge to challenge the surveillance.
Insurers and employers would also be required to destroy all material collected unless the materials are “reasonably necessary” to resolve an ongoing claim of fraud. Violations would result in a $1,000 per day penalty.
Pace points out that of the $4.7 million spent last year to spy on 2,500 workers, only 11 were found to have actually committed fraud. He said workers are complaining that the surveillance is used to intimidate workers into accepting lesser payments.
“The insurance companies are abusing it, it’s evasive, and it’s our responsibility as legislators to stand up for average Coloradans, and not for the special interest and insurance companies,” said Pace.
Pinnacol, however, sees flaws with the bill. A spokeswoman for the insurer said Pace’s bill would slow down investigations that often require a quick response. She added that the challenges would clog up the court system and constrain investigators, which would lead to more fraud and higher costs to individuals.
“Our surveillance efforts are about finding out the facts in a case,” said Suzi Stolte, spokeswoman for Pinnacol Assurance. “What we want to do is shut down cases as soon as we know that they’re fraudulent. When we find out that information, the sooner we can shut down a case, then that is saving money and time for the policy holder.”
Distributed by Colorado Capitol Reporters