House Bill No. 6916
Special Act No. 19-10
AN ACT ESTABLISHING A TASK FORCE TO STUD Y REMEDIES
AND POTENTIAL LIABILITY FOR UNREASONABLY CONTESTED
OR DELAYED WORKERS' COMPENSATION CLAIMS.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. (Effective from passage) (a) There is established a task force
to (1) identify the extent of unreasonably contested or delayed
workers' compensation claims, (2) study methods to expand remedies
regarding potential liability for unreasonably contested or delayed
workers' compensation claims, and (3) clarify the law regarding bad
faith handling of workers' compensation claims. Such study shall
include, but need not be limited to, an examination of: (A) How such
claims are handled when an injured worker is covered by employee
benefit health insurance, (B) whether an employee benefit plan should
make payments during the time period the Workers' Compensation
Commission takes to determine whether the worker's injury is work
related, (C) how claims are handled when an injured worker's
employer does not provide an employee benefit health insurance plan,
(D) the Workers' Compensation Commissioner's authority to fine an
insurance company for unreasonably contested claims or undue delay,
particularly when such undue delay may cause permanent injury to an
employee, (E) delays caused by the failure of medical professionals to
follow the Professional Guide for Attorneys, Physicians and Other House Bill No. 6916
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Health Care Practitioners Guidelines for Cooperation, or to provide
respondents with a complete and accurate medical history, including,
but not limited to, all relevant medical records requested, (F) whether
benefits are paid to injured workers or on behalf of injured workers
without prejudice during a period of contest, and the frequency with
which (i) said benefits are reimbursed in cases in which the underlying
injury is deemed not compensable, (ii) the treatment paid for without
prejudice is deemed unreasonable or unnecessary, or (iii) indemnity
was paid during a period of time in which the injured worker is
deemed to have been capable of working and work was available, (G)
remedies when an undue delay in payment causes unnecessarily long
delays in medical treatment, resulting in loss of employment, (H) types
of systems that may be created to obtain data regarding reasonable
treatment and recovery timeframes, and (I) best methods to prevent
unfair claim-handling practices that violate the Connecticut Unfair
Insurance Practices Act, as amended from time to time, including, but
not limited to, the following: (i) Misrepresenting pertinent facts or
insurance policy provisions relating to coverages at issue; (ii) failing to
acknowledge and act with reasonable promptness upon
communications with respect to claims arising out of and in the course
of employment under insurance policies and third -party
administration contracts; (iii) failing to adopt and implement
reasonable standards for the prompt investigation of claims arising out
of and in the course of employment to which such insurance policies
and third-party administration contracts shall respond; (iv) refusing to
pay benefits without conducting a reasonable and timely investigation
based upon all available information; (v) failing to affirm or deny
coverage of benefits within a reasonable time after submission of a
request for such benefits has been submitted; (vi) not attempting in
good faith to effectuate prompt, fair and equitable provision of benefits
for claims in which liability has become reasonably clear; (vii)
attempting to settle claims on the basis of an application that was
altered without notice to or knowledge or consent of the insured; (viii) House Bill No. 6916
Special Act No. 19-10 3 of 5
making known to beneficiaries of such insurance policies or third-
party contracts of administration pursuant to this section a policy of
appealing from decisions of a workers' compensation commissioner or
administrative law judge in favor of such beneficiaries for the purpose
of compelling the acceptance of settlements or compromises in an
amount less than the amount awarded in decisions; (ix) delaying the
investigation or payment of claims by requiring a beneficiary or health
care provider to submit a preliminary claim report and then requiring
the subsequent submission of formal proof-of-loss forms, both of
which submissions contain substantially the same information; or (x)
failing to promptly provide a reasonable written explanation for the
denial of a claim or for an offer of a compromise and settlement in
relation to the facts or applicable law.
(b) The task force shall consist of the following members:
(1) Two appointed by the speaker of the House of Representatives,
one of whom is an attorney and a member of the Connecticut Trial
Lawyers Association who has experience in workers' compensation
cases and one of whom is an attorney and a member of the
Connecticut Defense Lawyers Association who primarily represents
respondents in workers' compensation cases;
(2) Two appointed by the president pro tempore of the Senate, one
of whom is a representative of physicians who treat workers'
compensation claims patients and one of whom is a physician who
performs respondents' medical examinations in workers'
compensation cases;
(3) Two appointed by the majority leader of the House of
Representatives, one of whom shall be a member of the General
Assembly and one of whom is an injured worker;
(4) Two appointed by the majority leader of the Senate, one of House Bill No. 6916
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whom shall be a member of the Workers' C ompensation Legal
Advisory Panel or the Workers' Compensation Medical Advisory
Panel, whomever of which is available for any scheduled meeting, and
one of whom is a member of the Connecticut State Medical Society;
(5) Two appointed by the minority leader of the House of
Representatives, one of whom shall be a representative of the business
community and one of whom is an injured worker;
(6) Two appointed by the minority leader of the Senate, one of
whom shall represent a workers' compensation insurance carrier and
one of whom shall be a representative of industry;
(7) The chairperson of the Workers' Compensation Commission, or
the chairperson's designee;
(8) The Insurance Commissioner, or the commissioner's designee;
(9) The Commissioner of Social Services, or the commissioner's
designee; and
(10) The Commissioner of Administrative Services, or the
commissioner's designee.
(c) Any member of the task force appointed under subdivision (1),
(2), (5) or (6) of subsection (b) of this section may be a member of the
General Assembly.
(d) All appointments to the task force shall be made not later than
August 1, 2019. Any vacancy shall be filled by the appointing
authority.
(e) The speaker of the House of Representatives and the president
pro tempore of the Senate shall select the chairpersons of the task force
from among the members of the task force. Such chairpersons shall
schedule the first meeting of the task force, which shall be held not House Bill No. 6916
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later than sixty days after the effective date of this section.
(f) The administrative staff of the joint standing committee of the
General Assembly having cognizance of matters relating to labor shall
serve as administrative staff of the task force.
(g) Not later than January 1, 2020, the task force shall submit a
report on its findings and recommendations to the joint standing
committee of the General Assembly having cognizance of matters
relating to labor, in accordance with the provisions of section 11-4a of
the general statutes. The task force shall terminate on the date that it
submits such report or January 1, 2020, whichever is later.