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Flash: Jane Kim Insurance Commissioner
- California has a new Insurance Commissioner-elect.
- While the election won’t be certified until the state finishes counting votes, the outcome is clear.
- Activist Commissioner-elect Jane Kim brings a progressive agenda to the Department.
Court Bars Insurer From Using Workers’ Comp Payments to Cut Uninsured Motorist Coverage
- The Missouri Court of Appeals, Eastern District, ruled Oct. 27 that American Family Insurance Co. could not reduce a couple’s uninsured motorist coverage because of workers’ compensation payments, holding that Missouri insurance regulations prohibit such setoffs, including for coverage above the $25,000 statutory minimum. The court reversed a lower court’s judgment on the first vehicle and entitled Zachary and his wife to $275,000 in total coverage, $225,000 more than the $50,000 American Family had paid.
- Zachary Beaver was struck and injured by an uninsured motorist on Nov. 6, 2023, while doing asphalt work in a closed roadway in a construction zone. His employer’s workers’ compensation insurer had paid more than $500,000 for medical treatment by the date of summary judgment. American Family cut the first vehicle’s $250,000 limit to the $25,000 statutory minimum because of those payments, and paid another $25,000 on the second vehicle.
- The court found the policy language clear but unenforceable, relying on Missouri regulation 20 CSR 500-2.100(2)(G)(1), which it said prohibits workers’ compensation setoffs “without any qualification.” It noted uninsured motorist coverage can compensate for pain and suffering and loss of consortium, which workers’ compensation does not cover. It acknowledged a Western District decision, Coffin, upholding such an exclusion, but said no prior court had considered the regulation.
- The court upheld the separate provision limiting stacked coverage on the second vehicle to the statutory minimum, so the couple could not collect the full $250,000 on it. The trial court had granted summary judgment to American Family.
Employers’ Group Urges Limits on Long-Term Workers’ Comp Medical Care
- The Korea Enterprises Federation said in a Nov. 5 report that workers receiving workers’ compensation medical care for a year or longer still account for a considerable share of cases, and called for more proactive management of care. In the first half of 2026, the share was close to 30% in the tire (29.7%) and shipbuilding (27.7%) industries, and 14.9% in automobile manufacturing, where it is gradually rising.
- KEF surveyed workplaces in high-claim industries, focusing on musculoskeletal disorders, because detailed statistics on workers’ compensation medical care are not publicly available. It documented cases in which workers received care for more than five years by repeatedly filing claims for additional conditions, requesting transfers to other medical institutions and submitting treatment plans to extend care.
- In one case, a worker approved for a shoulder condition later filed claims for the cervical spine, elbow and ankle, received care for about three and a half years, requested more than 10 transfers and submitted more than 40 treatment plans, without working or any further workplace exposure. In another, a worker approved for an elbow condition frequently went golfing and fishing while receiving outpatient treatment.
- KEF proposed guidelines for standard care periods by condition, stronger procedures for filing and adjudicating claims for additional conditions, limits on transfer requests and treatment plans, and tighter screening and management of workers receiving outpatient care independently.
California has a new Insurance Commissioner-elect. While the election won’t be certified until the state finishes counting votes, the outcome is clear. Activist Commissioner-elect Jane Kim brings a progressive agenda to the Department.