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The insurance company won't settle.

Discussion in 'Workers Compensation' started by Tony Beigle, Aug 28, 2021.

  1. Tony Beigle

    Tony Beigle Law Topic Starter New Member

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    Jurisdiction:
    New York
    I have won coverage of my job related injury being covered for life. But I , now,
    don't want the insurance company hanging over my head anymore. Now I am 67
    years old. I approached the worker's comp company and they refuse to settle. Can anyone tell me why they won't settle? And do I have a right to WANT to settle? Thanks,

    Tony
     
  2. Tax Counsel

    Tax Counsel Well-Known Member

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    Someone at the worker's comp insurer I'm sure could tell you that. No one here will be able to even make a reasonable guess at it because you've provided no details whatsoever about your injury, the coverage decision, or what settlement you want. I assume what you want is to just get a lump sum payment now instead of getting the benefits for life, but you haven't even made that much clear.

    Certainly you have a right to WANT whatever you want. But you don't have a right to get whatever settlement you ask for. Settlements are voluntary agreements between two parties. To get a settlement, the insurer has to be on board with what you want.
     
  3. Zigner

    Zigner Well-Known Member

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    I agree with everything Tax Counsel said...
    My guess, however unreasonable is that maybe they're hoping you'll die soon, making any settlement or future payouts irrelevant.
     
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  4. Redemptionman

    Redemptionman Active Member

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    Yes companies and insurance companies do what @Zigner state. They anyone who pays out on your claim has a right to subrogation. They will fight this tooth and nail leaving you will as little as possible. Just how they roll.

    Is New York a Made Whole State?
     
  5. Tony Beigle

    Tony Beigle Law Topic Starter New Member

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    In terms of what exactly happened in terms of the injury, I didn't feel that was relevant, because I DID say the coverage was for life and that should have been enough. Also I was not demanding an amount from the insurance company. And in conclusion, I DID go down to the 'worker's comp' heading to post this. How it ended up with a tax person, I have no idea.
     
  6. Redemptionman

    Redemptionman Active Member

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    @Tax Counsel provides decent sound advice on applicable law for your state.

    Yeah, you have an attorney representing you on this? if not then you should probably get one. If you bring suit against at fault parties then the insurance will be bound for the verdict you receive. Don't let those bastards off the hook. Piss on them you paid premiums for the insurance.
     
  7. justblue

    justblue Well-Known Member

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    TC is a highly respected attorney volunteer to this site. He wouldn't have said more information was necessary unless it WAS necessary.
     
  8. adjusterjack

    adjusterjack Super Moderator

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    No one?

    What am I, chopped liver? :p

    Here's my guess. When the WC carrier agreed on life time wage benefits it may have bought an annuity for a fraction of the cost of a lump sum settlement or set aside a reserve equal to the cost of an annuity.

    1 - The WC carrier has nothing to do with personal injury claims.
    2 - The employee doesn't pay premiums for WC coverage, the employer does.
    3 - WC law provides immunity to employers from personal injury lawsuits in exchange for having WC coverage which is mandated by law.
    4 - If the employee had a cause of action against an at-fault party (other than the employer), it would be subject to the personal injury statute of limitations (3 years in NY). That's more common when employees drive company vehicles, not so much in job site injuries, though it could happen, like in the case of defective machinery causing an injury.
    5 - If the employee successfully recovered money from an at-fault party he would have to reimburse the WC carrier for any benefits paid by the WC carrier
     
  9. Tax Counsel

    Tax Counsel Well-Known Member

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    Well, no. The employee does not pay the unemployment comp insurance premiums; not even a penny of it. That cost is borne entirely by the employer.
     
  10. Redemptionman

    Redemptionman Active Member

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    @adjusterjack, everything you stated is correct. The WC has first rights to subrogation.

    Employee DOES pay STD and LTD
     
  11. Tax Counsel

    Tax Counsel Well-Known Member

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    Short term disability (STD) and long term disability (LTD) benefits are NOT part of worker's comp. Again, the employee pays no part of the premium for WORKER'S COMP.

    Except for state provided STD and LTD benefit programs (which only a handful states like CA and WA offer) these benefits are voluntary and if a company chooses to offer them then who pays the premiums is subject to negotiation between employer and employee.
     
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  12. Redemptionman

    Redemptionman Active Member

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    Okay TC you are full of juice today, all I will say is it depends on the state and the company for whom you work.

    Fair?
     
  13. Tax Counsel

    Tax Counsel Well-Known Member

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    That what depends on the state and the company for whom you work? If you mean who pays for LTD/STD benefits, then yes, I agree with you.

    But let's try not to confuse the OP here. His payments are from worker's comp, and he paid no part of the premiums for that. LTD/STD benefits are a different deal.
     
  14. Redemptionman

    Redemptionman Active Member

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    first part yes, Workers comp payouts will want their money back either from the claim or subrogation to the at fault party.
     
  15. adjusterjack

    adjusterjack Super Moderator

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    Disability insurance can exclude job related injuries that are paid for by WC. But that depends on the state and the coverage and the cost of the coverage.
     
  16. Tax Counsel

    Tax Counsel Well-Known Member

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    The worker's comp insurer would indeed want subrogation, if there was an at fault party to sue other than the employer. There is no indication from the OP, though, that any such claim exists.
     
  17. zddoodah

    zddoodah Well-Known Member

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    The only person with that information is the decision maker with the insurance company.

    Is this a serious question? No one can regulate what you WANT, but just because you want something doesn't mean you're entitled to it.
     

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