If the employer or the carrier unreasonably fails to make payments of benefits due you, you may be entitled to a bad-faith penalty award. Generally you must show that:
- The employer or carrier had no reasonable basis to deny your claim for benefits or for payment of medical expenses, or both; and
- The employer or carrier knew it had no reasonable basis to deny your claim, or it acted “in reckless disregard” of the fact that it had no reasonable basis to deny your claim.
Also, if the employer or the carrier fails to report an injury, you may be entitled to a bad-faith penalty award.
The judge determines the amount of the penalty. The judge may order any amount up to 200% of the benefits due, or $30,000, whichever is less. ($30,000 is the maximum penalty.) The judge will consider the seriousness of the behavior of the carrier (or the employer) and its effect on the injured employee.
Under certain circumstances, you might receive more than one penalty award if the judge finds more than one act of bad faith.
Important: If you believe your employer unreasonably refused to make WC payments due you (or due your medical providers), please contact us to discuss the circumstances of your case.
We obtained a $15,000 bad-faith penalty for a client in a case in which the Sedgwick Claims Management Services failed to pay benefits ordered by the Worker’s Compensation Department by the deadline the Department set.
In another case we brought against Sedgwick Claims Management Services on behalf of a client, Sedgwick paid a $17,000 bad-faith penalty.
In a case involving a construction worker with a serious back injury, we have received multiple bad-faith settlements from Acuity Insurance.
In Gloria Graham’s case, discussed elsewhere in this website, we obtained a penalty settlement of $23,500 for our client.