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It’s very common that insurance companies deny all or part of your Illinois workers’ compensation benefits in bad faith .  It’s also somewhat common that attorneys file a motion for penalties and fees over that bad behavior.

What’s sadly less common is the lawyer for the injured worker following through on their motion by going to trial.  And when they do go to trial, Arbitrators don’t always order penalties and fees when they are appropriate and when they are do it doesn’t usually seem to be for a large amount.

Arbitrators can award penalties for disputes that are “unreasonable, vexatious and without merit.”  In doing so they can essentially fine the insurance company up to 50% of any unpaid medical bills, $30 a day for unpaid TTD benefits (up to $10,000) and order them to pay the attorney fees too.

In this Jewel case, a man died after a work related accident and according to the Arbitrator’s decision, there was not a shred of evidence to dispute that he was hurt at work.  Beyond that, the insurance company had a bunch of theories as to how he was hurt or what caused his death, but none of them were supported by actual medical evidence or testimony.  They had depositions taken of many medical providers and the Arbitrator noted that not only didn’t call the accident or death in to dispute, but bolstered the case of the injured worker and his family.

In this case, the injured worker hit his head and had major head trauma.  His medical bills were over $712,000 and there were unpaid permanent disability payments.  So the penalties were almost $350,000.00 in total and attorney’s fees were over $60,000, bringing the total punishment to over $400,000!!!

This is the only way insurance companies will stop acting in an unjust manner.  Yes the amount they would have to pay had they done the right thing was a large number, but that doesn’t give them the right to act in bad faith.  While I’m sure this case will be appealed and my guess is that the attorneys for Jewel will try to negotiate a lump sum settlement, there is a great lesson here on the value of getting an aggressive attorney who will fight for their client when it is called for.

Most cases don’t have that much in medical bills, but it’s not uncommon to have $100,000 in bills, especially if you have a serious surgery.  If there’s no reason for your benefits to be denied, penalties and fees are the correct strategy.