What Happens When a Workers’ Compensation Insurance Company Acts in Bad Faith?

When it comes to suing a workers’ compensation insurance company, we often think of the standard things that workers’ compensation insurers do to people to try to deny them benefits. These can include a failure to pay medical expenses, cutting people off from needed medical care, or disputes about the nature, extent and severity of people’s injuries.

When you sue a workers’ compensation insurer for these reasons, you are suing them for their improper decision, such as a decision to deny you needed surgery. You are not suing them for mishandling your claim, or for the way they handled it.

Suing for Bad Faith

However, there is one time when you can sue a workers’ compensation insurer for failing to properly handle your claim: When the insurance company acts in what is known as “bad faith.”

Bad faith is not unique to workers’ compensation; insurance companies that handle personal injury cases, or homeowner’s insurance cases also can be sued for bad faith. However, bad faith is unique in workers’ compensation, which is supposed to be the sole remedy for injured workers. This is why suing your employer is not allowed in most workers’ compensation situations.

Examples of Bad Faith

A bad faith claim is where the insured (the worker or employee) sues the insurance company for failing to handle or evaluate a claim in a reasonable manner, or for failure to deal with the worker in a way that is reasonable and fair.

Bad faith claims are not easy to make. They cannot be brought just because the worker disagrees with the insurance company. Insurance company decisions that are arbitrary, done to frustrate the worker, or which are against or contrary to medical advice or common medical knowledge can constitute bad faith.

One way to look at bad faith is to ask whether the insurance company’s decision defies all logic. For example, if you were in a serious injury where you suffered a fractured skull and a concussion, but the insurance company denied you the right to see a neurologist, this would be bad faith: any doctor alive would agree that someone in this situation needs at least a consultation with a neurologist.

If an insurance company denied you a medical test that was plainly recommended by a workers’ compensation physician, that would be bad faith. Insurance companies that make workers go for duplicate testing, or have workers take multiple diagnostic tests just to discover what was already obvious from the day of the accident, could be liable for bad faith.

Suing for Bad Faith

Florida law requires that to sue any insurance company for bad faith, including in workers’ compensation claims, notice on specified Department of Insurance forms must be given to the insurance company, notifying them of the potential claim, and giving them the chance to correct their error. This is why a good workers’ compensation attorney who can help you navigate the bad faith process is so important.

Don’t be taken advantage of by insurance companies. The Tampa workers’ compensation attorneys at Barbas, Nuñez, Sanders, Butler & Hovsepian can help you deal with your workers’ compensation problems. Call us today to discuss obtaining damages for your injuries. Schedule a consultation today.

Resource:

leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0600-0699/0624/Sections/0624.155.html

https://www.barbaslaw.com/workers-compensation-and-the-coronavirus/