The Tuesday, May 26, decision in Nancy R. Summers v. Zurich American Insurance Co. overturned trial court and appellate court findings that barred Summers from suing Zurich American for the insurer’s alleged refusal to authorize medical treatment ordered by the state Workers’ Compensation Court.
The Workers’ Compensation Court had awarded medical and wage benefits to Summers for a 2004 work-related injury, court records show. Summers later sued the insurer for failing to comply with the court-ordered medical treatment.
But Zurich won a summary judgment by arguing that Summers did not follow a post-judgment certification procedure that allows insurers to show why benefits remain unpaid.
The Oklahoma Supreme Court found that the lower courts erred and that there was confusion about the role of the certification process in cases involving both medical and indemnity benefits. A lawsuit is a claimant’s prerogative for an insurer’s alleged failure to authorize ordered medical treatment, the high court ruled.