What I love about my job is that almost every day I get an interesting question and even if it’s something I know the answer to, often it’s a great question that I think others should know about too. This just happened so I thought I’d share.
A caller was being represented by a competent law firm. Not someone in our state wide network of attorneys, but not an idiot either. The caller was concerned because his case was settled after the insurance company initially denied it. Even though they were settling the case, the settlement contracts reflected that the case was disputed and they were denying liability. The injured worker didn’t want to agree to that and wanted to know what I thought.
This type of language in a settlement contract is rare, but does happen. Basically it will occur when there is a good faith dispute as to whether or not you got hurt while working. Maybe they have a credible IME. Maybe there is a witness against you. But they also know that if they go to trial there is a risk they’ll get hammered and you know there’s a risk you’ll walk away with nothing.
Often in these cases some or all of the medical bills have been paid for by a group insurance plan. If the work comp insurance company admits that there was an accident they could end up having to pay back all of these bills. In a worse scenario, it’s possible that you could have to pay back these bills.
So the contracts get written making clear that it’s a disputed case and that essentially they are just “purchasing peace” by giving you money, even if it’s the full value of what your case is worth.
These types of deals are ok, depending on your situation. I wouldn’t recommend them in most cases, but if you had no other way of getting much needed medical care other than your group insurance policy and there is a real dispute as to whether or not your case is a winner it’s worth looking in to. You may actually end up with full value because the insurance company isn’t paying the medical bills, but it’s very important that the contract is written in a way that protects you. Often this means getting a hold harmless agreement for the bills which in plain English says the insurance company will pay if you get sued. But it’s a case by case basis thing again.
In this case I don’t think the caller had anything to worry about as there was a solid firm in his corner. But it’s good to be skeptical and ask questions. Once an Arbitrator approves your settlement the case is over. Any concerns you have at that point are out the door. There is no re-opening a case so don’t be afraid to ask hard questions.
Bonus settlement question that comes up all of the time. It’s common for your lawyer to ask you to sign a power of attorney form that authorizes them to endorse your name to a settlement check. This is nothing to worry about and standard practice which allows them to deposit the check in to a bank account faster and pay you faster. That said, you should ask for a copy of this completed form and a disbursement statement when your case is done.
As always, if you have any questions about anything you can fill out the form to the right or call us at (312) 346-5578.