Dealing with Bad Faith in a Workers’ Comp Claim

All insurance carriers, including workers’ compensation insurance carriers, are required to operate in good faith and fair dealing with claimants. What this means is that they are required to investigate every claim and pay entitled benefits to the claimant if the claim is legitimate. However, there are times when insurance carriers do not operate in good faith, and sometimes their actions lead to bad faith insurance practices.

What is “Bad Faith” in a Workers’ Comp Claim

It is important to point out that not every case of a denied or delayed claim will necessarily be bad faith on the part of the workers’ compensation insurance carrier. However, there are some situations that could arise that may indeed indicate that the insurance carriers are operating in bad faith. Some bad faith examples include:

• Denying benefits explicitly listed in the policy 
• Offering less compensation than what the claimant should actually receive
• Delaying payment to the claimant without giving a proper reason
• Failing to adequately investigate the claim in a timely manner 
• Poor management of claims, including failing to review the claim properly
• Hiding evidence that supports the worker’s claim or benefit request 
• Disregarding timelines in place under law or through the policy

What You Can do to Help Your Claim

There are various steps that you can take after sustaining workplace injury that can help prevent bad faith claims, though if an insurance carrier is going to act in bad faith, there may be very little you can do about it without assistance from an attorney.

• Know the deadlines in place regarding your workers’ compensation claim. Work injury claims must be made within 30 days from when the incident occurs. However, the overall statute of limitations after reporting the injury for filing a claim is one year from the date the injury occurred.
• Attempt to maintain a good working relationship with the insurance carrier and the employer. This does not mean you have to be friends with anyone, but you need to be polite and respect inquiries. Often, this means letting your attorney handle this process.
• Keep meticulous documentation about everything that happens. This includes writing down every doctor visit, keeping every bill or receipt that comes in, and maintaining how much lost income you have incurred. Also, keep a journal about how the injury has affected your day-to-day life.

If you begin to experience issues with the insurance carrier or your employer after sustaining a workplace injury, you need to reach out to a skilled bad faith workers’ compensation attorney as soon as possible. A lawyer will investigate every aspect of your claim and help ensure that you recover maximum compensation for your losses. 

Your lawyer may ask you to undergo a medical examination by a doctor outside of the workers’ compensation system to verify any findings that other doctors have made. However, regardless of whether or not you think your insurance carrier is acting in bad faith, you need to ensure that you go to all follow-up medical visits recommended by the treating physician, even if you do not think you need to. Discontinuing medical care could give the insurance carrier or the employer a reason to delay or deny the claim.