Code of Maine Rules
02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
031 - BUREAU OF INSURANCE
Chapter 440 - MAINE WORKERS' COMPENSATION RESIDUAL MECHANISM
Subchapter IV - SERVICING CARRIER PERFORMANCE STANDARDS
Section 031-440-IV-3 - Litigation Management

Universal Citation: 02 ME Code Rules ยง 031-440-IV-3

Current through 2024-38, September 18, 2024

A. Servicing carriers shall properly prepare all controverted cases, and cases petitioned for additional or subsequent ruling, before conference, hearing, or trial. Preparation shall include but not be limited to the following:

(1) The carrier shall make a pre-litigation offer for the purpose of establishing the "prevail standard" baseline for the payment of legal fees, or explain in the file why it has chosen not to do so;

(2) Complete pretrial preparation in the areas at issue, such as coverage, liability, medical;

(3) Have available all necessary lay and professional witnesses or their depositions before formal hearing or trial;

(4) Have medical reports and opinions and witnesses available and ready for testimony or deposition if trial encompasses issues of extent of disability and/or permanency, depending on statutory requirements;

(5) Servicing carriers shall expeditiously pursue the case through the mediation and hearing process, as appropriate. Where appropriate, servicing carriers shall pursue settlement negotiations at any point during the dispute resolution process;

(6) Servicing carriers shall base all settlements of permanency or compromise on sound claims judgment consistent with liability and medical evidence developed, in accordance with the law and benefit structure;

(7) Servicing carriers shall deliver sufficient file material on a timely basis to the attorney or other person handling the case to allow for adequate preparation for conference, hearing, or trial;

(8) After settlement, the servicing carrier shall file a settlement report which adequately and accurately explains the amount paid.

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