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| | Central Valley Claims Adjuster Not Taking Any Lip
By Robert Warne - June 5, 2003
The Central Valley is heating up early this year and it has nothing to do with summer. Nope, this early June warm-up can be attributed to letters to the editor at the Modesto Bee on the hot topic of workers’ compensation.
It all started when a Modesto man’s letter titled, “Workers comp problems,” was published, June 2.
In it, Bill McCarthy said, “…the biggest fraud is committed by the compensation insurance companies themselves.
“The claims adjuster is a paid stooge who must keep costs down by lying to or avoiding telling injured workers the truth about the benefits due them.
“The insurance companies delay settlements with honest injured workers long enough to force the worker into bankruptcy. Twenty percent of all bankruptcies are compensation insurance related, two to six years delayed.
“In Stanislaus County if you become injured and need retraining, there are only 10 jobs that you can get training for under compensation. None of the training is adequate to provide entry level jobs above minimum wage in any of the fields. Also, the employment rehab counselor must be approved by the compensation insurance company. None of the successful rehab counselors are strong advocates for the workers. They follow the insurance company rules or they don't get approved for clients.”
Then on June 5, Nanci Zapien, a claims adjuster with a decade behind a work comp desk to back her up, pounced on McCarthy’s opinion like a Serengeti feline—chewed it to shreds—and left the carcass for the rest of the adjusting pride to gnaw on.
In her letter she said, “As a workers compensation insurance adjuster with more than 10 years' experience in the business, I resent the comment in ‘Workers comp problems’ (Letters, June 2) that ‘the claims adjuster is a paid stooge who must keep costs down by lying to or avoid telling injured workers the truth about benefits due them.’
“Being a workers compensation insurance adjuster these days is not an easy job, as we must adhere to many stringent regulations on a daily basis. We are required to adjust claims strictly in accordance with the workers compensation laws of California. I have never lied or purposely avoided providing information to any claimant, nor have I ever been told to. I think anyone who has ever dealt with workers compensation knows how complicated the system can be, but to assume that all claims adjusters lie or purposely withhold information is just completely unfair.”
With readings like this on the editorial thermometer, it looks like we could be in for a work comp heat wave this year.
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