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Dawson and Rosenthal
Dawson and Rosenthal

How to Prove Bad Faith Insurance in Workers’ Compensation 

Workers’ compensation insurance is meant to provide fast, reliable support for hurt workers so they can obtain the medical care they need. It is the insurance company’s obligation to fulfill such claims and not to delay in doing so, which can lead to a bad faith claim.

If you believe that it has occurred, proving bad faith insurance in a workers’ compensation case can be complex. We encourage you to reach out to Dawson & Rosenthal, P.C. for an immediate consultation to discuss your specific case.

What It Takes to Prove Bad Faith

The most common type of workers’ compensation claim is a medical bill. Most of the time, this should be easily covered by the employer’s workers’ compensation claims. If, for some reason, this does not automatically and quickly occur, it may be time to consider a bad faith claim.

Keep in mind that, as an injured worker, you must still follow the specific submission guidelines of the insurance company, including filing your claim within 45 days of the incident and notifying your employer of the incident.

What Is Bad Faith?

If the insurance company is not working closely with you or any of the following occurs, it could be seen as a bad faith claim. You can use these examples as ways to prove that bad faith occurred:

  • Paying less to you than the amount of claim approved initially.
  • Denying a claim without conducting an investigation.
  • Forcing you to obtain multiple tests for a needed type of care that could be considered obvious.
  • Telling a victim to go to numerous doctors only to find that they all provide the same diagnosis.
  • Denying some or all of the benefits that the policy should include.
  • Lying or otherwise being dishonest about the coverage within the policy.
  • Not communicating with you or your attorney about the state of the claim at any time. Delaying payment without providing a justifiable reason to do so.
  • Making unreasonable demands of you throughout the claims process in the hopes that you will withdraw your claim.
  • Denying a claim that is otherwise valid.
  • Misrepresenting the law that applies to your claim.
  • Failing to send payment to the right address that the company had on hand.
  • Ignoring legitimate evidence that proves your claim should be successful.

If you have experienced any of these instances or others that you believe are bad faith, you will need to show proof of that. This typically leads to the insurance company investigating what occurred and doing so in a timely manner. The “acting in good faith” policy for the workers’ compensation team should get this settled quickly.

Unfortunately, that does not always happen. There are some situations where the insurance company will continue to delay or may be misleading to you. In these situations, you have the right to take legal action. That can include filing a lawsuit against the workers’ compensation insurance company.

Are you the victim of a bad-faith insurance claim? Call the office of Dawson & Rosenthal, P.C., today to schedule a free consultation.