Complex Workers’ Compensation Lawsuit Filed Against Injured Worker
Can workers be sued for gaining benefits under the workers’ compensation system? Sometimes, when the stars align just right, they can. In one case, a woman was severely injured in her vehicle while on the job. She filed a workers’ compensation claim with her employer. The employer filed the claim with their insurer, who had recently become insolvent. In that case, the Georgia Insolvency Board agreed to pay out the claim on behalf of the defunct insurer. Meanwhile, the woman recovered about $25,000 in various actions against the other driver and $50,000 in underinsured motorist coverage payments. Now, the insolvency board wants the money that they paid to the injured worker back. The court is now hearing arguments as to why the woman should or should not have to repay that money to the insolvency board. The woman was issued about $26,000 from workers’ compensation, but only about $3,000 in wage loss benefits. Most of that went to medical expenses. The insolvency board still wants that money back.
The incident is creating confusion
The insolvency board has a right to seek subrogation claims paid out by other insurers. A trial court agreed with their right to seek this money and attached a judgment to the defendant in this matter. She appealed on the basis that the insolvency board had no standing to bring the matter to circuit court before the issue was handled by the workers’ compensation board. The matter is still pending before the workers’ comp board, according to the court. In other words, the worker believes that the insolvency board had to take the matter up with the workers’ compensation board before getting a decision from the trial court. The appeals court thus ruled to vacate the decision in favor of the insolvency board until the matter is addressed by the workers’ compensation board.
What is a subrogation claim?
If you file a claim with your employer concerning injuries sustained at work, the insurance company may file a subrogation claim against a third-party that contributed liability. In this case, the third party was another driver. The insurance company would be able to file two subrogation claims against the insurers for the at-fault driver and the injured worker. However, since that money has already been paid out along with workers’ compensation benefits, the action is filed against the worker and not the insurance companies who have met their duties to their policyholders.
In situations like the aforementioned, a claimant would have a duty to report the civil action against the third party to the workers’ compensation insurer who can then seek remedy from the civil action.
Talk to a Decatur, GA Workers’ Compensation Attorney
One matter a Decatur workers’ compensation attorney can help you with is how a personal injury lawsuit will impact your workers’ compensation claim. It can get complicated quickly. Call The O’Connell Law Firm today to discuss your situation in more detail and we can advise you as to the best course of action.
Resource:
insurancejournal.com/news/southeast/2021/11/15/642183.htm
