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Workers who are injured in Pennsylvania or New Jersey work accidents are often surprised to learn that legal claims for an on the job injury will usually be handled by making insurance claims.
First, there is a workers’ compensation claim for medical benefits and temporary/permanent disability. For the majority of injured workers in PA and NJ, their workers’ comp claims will be handled by workers’ compensation insurance companies.
Second, there may be a work injury lawsuit against a party whose negligent conduct caused the accident. These claims are most commonly made against non-employer parties, such as a subcontractor or property owner. This is the most misunderstood type of claim and will be explained below. It’s important to note that the laws of both Pennsylvania and New Jersey prohibit most tort claims against an employer for a work injury or accident, although there some exceptions.
Who can make an insurance claim for a work injury?
Under Pennsylvania and New Jersey law, any individual who is injured at work can file a legal claim for compensation against non-employer parties whose negligent or intentional conduct led to the injury. Any such legal claims are typically handled by the insurance company for the negligent party.
For example, a worker in PA falls at a construction site. The accident was caused by a subcontractor who was performing work at the site. A lawsuit is filed against the subcontractor who is covered under a general liability insurance policy. Accordingly, the injured worker’s claim is handled and processed by the insurance company, pursuant to the policy. Get more info about insurance claims after work accidents in Pennsylvania.
How do you make an insurance claim for a work injury?
Once a work accident lawsuit is filed, the defendant will notify its insurance company of the claim, if the defendant hasn’t already done so. In work accident cases, such as construction accidents, there will generally be multiple defendants. Therefore, multiple insurance companies may be involved.
How is an insurance claim handled for a job injury?
Insurance claims for work injuries work much the same as auto or homeowners’ insurance claims. The defendant’s insurance policy provides coverage for accidents and injuries which happen due to the negligence of the insured party. Using the example above, the subcontractor’s insurance policy provides coverage for negligent conduct leading to an injury. Because the work injury lawsuit claims that the subcontractor’s negligent conduct caused the accident, the insurance company opens a claim to assess the insured’s liability and resulting damages to the injured party.
From a practical standpoint, work injury insurance claims proceed as follows. An insurance adjuster gets assigned to the claim and works with an attorney hired by the insurance company to defend the claim. While the lawsuit is pending, the adjuster and the attorney will evaluate the merits of the claim by reviewing evidence exchanged during the discovery phase of the lawsuit, i.e., medical records, wage loss records, deposition transcripts of the parties and witnesses, etc.
When does the insurance claim get settled for a work injury?
In most cases, the insurance claim gets settled prior to trial. However, this doesn’t mean the case should not be prepared for trial. In fact, the opposite is true. Every work injury case must be vigorously prepared for trial. This sends a message to the opposing side, the insurance company, about the strength of the case and the plaintiff’s belief that they will prevail at trial.
In order to facilitate a settlement, most courts require the parties to engage in a settlement conference and discuss the possibility of resolving the case. In Philadelphia work injury lawsuits, for example, the parties are required to submit a settlement memo outlining their theories of the case and settlement demand, or how much they are willing to resolve the case for. A settlement master then discusses the case with the attorneys to see if the parties can reach a resolution. If the parties do not resolve the case then, the case proceeds to the trial docket. Cases can settle at any time, even after trial begins. It’s not uncommon for cases to settle in the middle of a trial.
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