To protect our policyholders, Pinnacol will take an aggressive approach, when necessary, to resolve claims through legal means. Our legal team — working closely with our claims representatives — assesses when litigation may be necessary. These may include situations where:
- The claim is questionable — Facts of the claim are in dispute, regarding whether the worker was truly injured or if the accident occurred on the job.
- The claim falls into a gray area legally or medically —The law may not be clear regarding wage loss, the worker’s physical impairment, or medical benefits.
We also recognize that litigation can drive up claims costs, not only in legal fees but in increased medical expenses. When a successful legal outcome is uncertain — and could cause unnecessary expense — Pinnacol will actively negotiate resolutions outside of court.
On your behalf, Pinnacol works hard to combat workers' compensation fraud.