Precision Castparts Corp. - PCC Structurals v. Cramer

“An insurer’s conduct is not unreasonable if the insurer had a legitimate doubt about its liability.” Liberty Northwest Ins. Corp. v. Olvera-Chavez, 267 Or App 55 (2014).

Claimant sustained a compensable workplace injury and changed physicians in the course of treatment, resulting in a dispute with employer over whether her initial physician was her attending physician and therefore able to provide sufficient information for employer to close her claim. Employer assigns error to the assessment of a penalty based on the determination that the claim was unreasonably closed. “An insurer’s conduct is not unreasonable if the insurer had a legitimate doubt about its liability.” Liberty Northwest Ins. Corp. v. Olvera-Chavez, 267 Or App 55 (2014). The board’s conclusion was supported by substantial evidence because the employer did not have a legitimate doubt that the initial physician was not the attending physician. The board appropriately applied the legitimate-doubt standard in making its decision while considering all relevant evidence. Because it was unreasonable for employer to believe the initial physician was claimant’s attending physician in light of the evidence, the board was correct in determining the claim was unreasonably closed and therefore did not err in assessing a penalty. Affirmed.