Bad Faith: Workers Compensation Lawsuits

Many that are injured in the workplace are able to find solace in knowing they will be able to cope with their medical expenses and loss of income through the benefits provided by workers' compensation. However, some injured workers are denied their benefits due to the bad faith of the workers' compensation insurer. If the workers' compensation insurer is intentionally neglecting to provide benefits for meritorious claims, the insurer is breaking the law. Workers' compensation insurers are required to provide benefits to those that are rightfully covered under their employers' workers' compensation coverage, and in the event the insurer breaks the law by acting in bad faith, the injured work may be entitled to seeking punitive damages by pursuing a liability lawsuit.

The Injured Workers' Compensation Benefits

Each state has laws regarding the handling of the workers' compensation process. As such, an injured worker needs to find out about their available rights from their states workers' compensation statutes. Some states include provisions in their workers' compensation law detailing the amount of time or statute of limitations for injured workers to file an act of bad faith on part of the workers' compensation insurer. Moreover, employers are required to provide workers' compensation benefits in a timely manner as set forth in the state which the injury occurred. For instance, many states workers' compensation laws have provisions determining the length of time an insurer has to act throughout each process of the workers' compensation claim. The insurer must act in accordance with the workers' compensation statutes and make payments and or provide benefits in a timely manner.State workers' compensation statues for the provisioning of payments and benefits may include the following guidelines:

  • Requirements for the timely processing of injured workers' claim by the insurer
  • Amount of time allowed for the insurer to provide payment to the injured
  • The time allotted for notifying the employee, the employer, and the department of workers' compensation regarding the suspension or cessation of workers' compensation payments

Guidelines for the Provisioning of Benefits

Furthermore, most states provide guidelines setting forth the amount of allowable time for the workers' compensation insurer to investigate an injured parties' claim for benefits. Insurers' are not allowed to 'stall' or 'delay' workers' compensation benefits based on their ineffectiveness in determining culpability of the claim. State statutes also provide penalties for the late payment of workers' compensation benefits. In some cases the department of workers' compensations' judge of compensation claims may need to pass judgment to determine whether a penalty shall incur for the untimely payment of workers' compensation benefits.In the event a determination of fault for the act of an untimely payment of benefits is required, the department of workers' compensation may have the judge of compensation claims determine, without hearing, the penalty that shall be assessed by the responsible party.Further guidelines may set down provisions for the release of liability to the employer or the insurer for future liability upon the acceptance of a lump-sum payment to the claimant. Other conditions which may also come into consideration are as to whether the claimant shall receive compensation for legal fees the injured worker incurred for legal representation.  Workers' compensation law requires the insurer to provide the injured work benefits without prejudice. However, determining the viability of a bad faith workers' compensation lawsuit is based in the interpretation by the state division of workers' compensation. Denied claims are required to be handled with regards to the injured worker. Yet, a bad faith claim, which requires the assessment of whom is a fault, can be subject to a states' workers' compensation statutes. Bad faith lawsuit claimants should seek the knowledge and advice of qualified workers' compensation representation.

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