Can I Force The Workers Comp Insurance Company To Settle?

Settlements of workers compensation claims are quite different than settlements of other types of claims.  In a workers compensation claim, a judge or jury will never determine the amount you should receive from the workers compensation carrier as a settlement.   Settlements of workers compensation claims are voluntary.  Meaning, you cannot force the insurance company to settle.  Likewise, they cannot force you to settle.  Settlements are reached in nearly every workers compensation claim, but the settlements occur as a result of negotiation on your behalf and your decision to accept the amount offered.  The significance of the difference between recovering a settlement in a workers compensation claim in comparison with recovering a settlement in a civil suit could be explained through comparing a workers compensation settlement to a settlement reached in a personal injury claim.  Dolman Law Group has extensive experience in handling many types of injury claims and workers compensation claims.   If you are considering a settlement of your workers compensation claim and wish to discuss your options, a consultation with our office is free.  Workers compensation insurance companies are aware of the fact that when an injured employee is represented by an attorney, they pay 3 times the amount in the claim than if the person does not have representation.  We are committed to ensuring our clients receive every benefit they are entitled to, and doing everything within our power to make that happen.

In a personal injury case, a demand for settlement is sent to the insurance company.   The demand is an amount of money you’ve discussed with your attorney in regard to negotiating towards a resolution (settlement).   If the insurance company does not consent to pay an agreeable amount to settle, the option to take your case to trial and have a jury determine your damages exists.   Meaning, forcing the insurance company to settle is possible through obtaining a successful result in a lawsuit.  The main elements you will be working to establish are negligence on behalf of the defendant, causation with respect to the defendant’s negligence and its connection to the event or occurrence or resulting in your damages, and the amount you’re entitled to receive as compensation for your damages.  Some examples of damages in a civil personal injury claim include: payment of medical bills generated as a result of the treatment received, lost wages if the accident prevented you from working, pain and suffering, loss of consortium if married, loss of future earning capacity, loss of enjoyment of life, etc.  The specific facts of your case will determine what specific types of damages you can claim.  Prevailing in a civil personal injury suit means that a judgment is entered by the court in your favor.  The judgment would reflect an amount of money determined by the jury to be fair with respect to the facts of your case.   The insurance company would have the obligation to pay the amount of the judgment.  However, the defendant’s insurance carrier can appeal the decision.  Most appeals are not successful in having the decision reached by the lower court overturned.   A successful appeal requires a finding by the appellate court that the lower court made a mistake in fact or error in conclusion of law.   Because most trial courts do not make such decisions, most appeals are met with a decision referred to as “per curiam affirmed.”   Meaning, the lower court’s decision is correct and will not be overturned.

It is not common, but another option for the defendant in the fact of a judgment in your favor is to request a reduction of the amount awarded.  A reduction is accomplished through filing a motion requesting what is called a remittitur.  A remittitur is seeking a ruling by the judge to reduce or essentially disregard the jury verdict for the purpose of lowering the amount of damages granted by a jury in a civil case. Usually, a remittitur is requested because the amount awarded exceeded the amount demanded., or appeal the decision.  There is no guarantee that a request for a remittitur will be granted by the judge.  Regardless of the options through which a defendant could seek to avoid having to pay damages, the bottom line is that the option to take your case to trial over the amount damages (money) paid in the form of a settlement exists in such civil suits but DOES NOT exist in a workers compensation claim.

Does this mean you can never take any aspect of your workers compensation claim to trial?  Certainly not.   You absolutely have the right to take certain claims for workers compensation benefits to trial before a Judge of Compensation Claims.  The benefits you’re entitled to proceed to trial over are governed by Florida’s Worker’s Compensation Laws that were in effect on your date of accident.  For example, if you sustain an injury on the job and the workers compensation insurance company denies your claim benefits, you can have a Judge of Compensation Claims determine whether your accident was in the course and scope of your employment and whether you are indeed entitled to lost wage and medical benefits.  If the workers compensation carrier has been late in making lost wage payments to you, but does so 30 days after a Petition for Benefits is filed, or after a Judge of Compensation Claims issues an Order finding that you are entitled to lost wage benefits, the insurance company has to pay an additional 20% as a penalty for the late payment wage benefits.  One case we handled proceeded to trial wherein one of the issues was our client’s entitlement to wage benefits.   We prevailed, resulting in our client receiving all the benefits requested; including lost wages.  The workers compensation carrier sent our client a check for $86,000.00 in lost wages, penalties, and interest1.  This amount was not a settlement of his claim.   Rather, the $86,000.00 was payment for wage benefits he was entitled to pursuant to the Order by the Judge of Compensation Claims.

So, you can go to trial in a worker’s compensation claim and you can receive a monetary award if you’re entitled to lost wages.  However, you cannot go trial in a workers compensation claim for the sole purpose of compelling a work comp carrier to pay an amount to settle your claim.   You can go to trial over the issue of whether you are entitled to benefits provided pursuant to Florida’s Worker’s Compensation Law.  Examples of issues for which you could proceed to trial over in a workers compensation claim include such things as a denial of your claim entirely, a denial of authorization for a specific type of treatment, if they deny lost wage payments, if they fail to pay you the correct amount of lost wages, and if they otherwise fail to provide you with any number of benefits you are entitled to receive under Florida Worker’s Compensation Law2.

Regardless of whether your question is about a workers compensation claim, you are encouraged to contact the lawyers at Dolman Law Group regarding any legal issue or concern you have. Call us today at (727) 853-6275.

Dolman Law Group
5435 Main Street
New Port Richey, FL 34652
(727) 853-6275