Employers carry workers’ compensation insurance in order to have coverage in the event of an employee becoming injured while on the job. It is California state law that all employers, with the exception of sole proprietorships, carry this insurance. However, being an insured employer does not guarantee coverage if an employee files a claim for benefits. In some instances, carriers may refuse liability and refuse to pay benefits to an injured employee, leaving both the employee and employer in a conundrum as to how to get the benefits paid to the employee.
Coverage issues can arise in a variety of ways. Among the most common situations in which coverage issues occur are when a carrier refuses liability because they believe the employee’s injury took place off of covered property (i.e., away from the worksite), and when multiple insurance carriers are involved and there is an issue determining which carrier is liable for coverage. In these situations, the carrier(s) and the employer may opt to go to arbitration to settle the dispute without escalating the matter to the courtroom.
Arbitration is a means of settling legal matters outside of the courtroom and without going to trial. While trials involve juries and/or judges making final decisions for the conflicting parties, the process of arbitration does not involve a judge, but rather, uses an arbiter. The arbiter offers advice to each party involved in the legal dispute and suggests a path forward. This may involve negotiations and a compromise or settlement between the involved parties (i.e., the insurance carrier and the employer). This can be beneficial when the parties want to reach a resolution to their dispute without having to deal with the time and costs of going to court over a coverage issue.
Arbitration is only one of the legal services that our firm provides to its clients. We specialize in handling legal matters pertaining to workers’ compensation coverage issues and arbitration, including:
Contact us for a case evaluation if you have any questions about how a workers compensation defense attorney can aid you and your business.
Sacks Law Group, APC’s employer defense team, can assist you if you deal with a workers’ compensation issue during arbitration. We can negotiate with insurance carriers on behalf of your business and help you achieve a swift and satisfactory resolution. We wrote the book on workers’ compensation defense, and we can use our knowledge and experience to help you, both in arbitration and at trial; contact us today for a consultation if you are experiencing issues with coverage.
Providing expert defense against fraudulent and frivolous workers’ compensation claims.
Providing comprehensive workers’ compensation defense to insured and self-insured Employers.
