They'll have to pay if you don't get paid.
When you have had a work injury and you need treatment and time off of work, you need money to pay for these expenses. Workers’ compensation benefits should be available to you, but what happens if you are entitled to these benefits and the insurance company isn’t paying you?
You don’t have to sit back and suffer. Illinois workers’ compensation law protects you from being withheld your benefits inappropriately. Whether there is an intentional refusal to pay, or just an unreasonable delay in payment, you can be compensated for the insurance company’s unreasonable behavior in not paying you.
Where payment is intentionally withheld, or it’s done for the purpose of delaying, harassing, or with some other ill motive, the penalty can be quite severe. The insurance company could have to pay you 50% more than the original award. So if you have been awarded $10,000 for your medical bills, and the insurance company doesn’t pay, they could owe you an additional $5,000 if there was no good reason for their not paying.
The insurance company can also be assessed a penalty even where the non-payment is not so intentional, but is still unreasonable. Where there is a delay in payment, or a non-payment which isn’t justified by the facts, you can be awarded $30 per day extra for each day that your benefits weren’t paid, up to $10,000.
Recently in Illinois, a cashier suffered a hand and wrist injury from her job. Her symptoms would flare up when she was at work and then get better when she was off of work. She was entitled to disability benefits, but the insurance company did not pay. They later requested an independent medical exam of her condition.
The cashier asked the Arbitrator to assess penalties for not paying the benefits. It was determined that the insurance company needed to be penalized for not paying her during the period where her treating physicians and medical records indicated that she had a work-related accident that required treatment. Once there was an independent medical exam which showed that her symptoms resolved, the insurer could reasonably rely on that opinion. But prior to that, there was no reasonable basis to withhold her benefits. The insurance company could not just close its eyes to the medical evidence and refuse to pay.
If the insurance company doesn’t have any facts in front of it that would make it reasonable to believe that you aren’t entitled to benefits, then they can be assessed penalties for not paying. Even an honest belief by the insurer that you don’t have a compensable work injury isn’t enough to avoid penalties, if that belief isn’t based on facts that are appropriate to rely on.
So where there is more extreme behavior for non-payment, you could be entitled to a significant amount in penalties. But even where the non-payment is the result of less bad behavior, but still unreasonable, you may receive penalty payments. You don’t need to be passive and fret about not getting your bills paid. You can go into court with your lawyer and demand the money, and extra penalty payments.
We are workers' compensation attorneys that help people with Illinois work injuries anywhere in IL via our statewide network of attorneys. Contact us and we will answer your questions or find the right lawyer for your situation.
