Why an Insurance Broker May Need to Dispute a Claim
As a workers’ compensation insurance broker, you play a critical role in the workplace infrastructure across the state of California. Most people do not realize just how complex the workers’ compensation system is in the state. California law dictates that every employer in this state carries workers’ comp insurance, even if they are a small business, a family business, or only have one employee.
However, there are times when insurance brokers get caught in the middle of workers’ compensation insurance disputes. This can include issues that arise on the part of an employer or disputes about whether or not to pay a claim.
For example, there are various reasons why an employer or an insurance carrier may need to deny a workers’ compensation plan. This can include:
- A dispute over how the injury occurred
- The injury did not occur during work hours
- The employer being intoxicated by alcohol or drugs
- The injury happened due to horse playing in the workplace
- The worker is not seeking medical care
- …and more
When a dispute occurs, the alleged injured worker could file a lawsuit against multiple parties in an effort to receive compensation, including the employer, the insurance provider, and the insurance broker. Even though an insurance broker typically plays no role in the denial of these claims, simply being named in a lawsuit can create headaches.
Additionally, employers could engage in various types of behavior that could end up falling back on the insurance broker. This could include:
- Serious and willful misconduct, particularly around purposely not having workers’ compensation insurance
- Wrongfully denying workers’ compensation claims
- Committing various types of insurance fraud
- …and more
Why an Attorney is Needed For These Disputes
At Sacks Law Group, APC, our dedicated team has extensive experience handling every aspect of workers’ compensation laws throughout the state of California. We have the resources necessary to get to the bottom of these situations. Our team regularly defends employers, insurance carriers, and insurance brokers when it comes to disputes that arise with workers’ compensation claims.
The reality is that an attorney is needed to defend these claims in court. Going into these situations without legal assistance could be devastating to the bottom line of employers and insurance carriers, as well as insurance brokers. An attorney can fully examine the facts of the case, conduct an independent investigation if necessary, and fully represent workers’ compensation insurance brokers in court.
Experienced Defense for Insurance Brokers and Small Businesses
For more than 40 years, the law firm of Sacks Law Group, APC, has represented employers facing difficult or unique workers’ compensation problems. The firm’s lawyers understand the idiosyncrasies of workers’ compensation law. They have worked with investigators and prosecutors to uncover criminal insurance fraud in workers’ compensation matters.
Sacks Law Group, APC, energetically defends the rights and interests of small business clients facing legal problems in workers’ compensation and related areas.
If you are an insurance broker who has a client-facing problem involving workers’ compensation, Labor Code 132a, serious and willful, or insurance fraud, the attorneys at Sacks Law Group, APC, would like to talk with you.
For a consultation with Sacks Law Group, call 310-216-7778 or contact the firm online.
Uninsured
Employers
Providing expert defense against fraudulent and frivolous workers’ compensation claims.
Insurance Carriers &
Self Insured Employers
Providing comprehensive workers’ compensation defense to insured and self-insured Employers.
We defend uninsured employers.
We wrote the book on it.
Available on Amazon & Booksellers
READ THE REVIEWSEmployers Workers' Compensation Defense
The workers’ compensation defense attorneys at our firm know how to build a strong wall of defense around employers, protecting California employers from frivolous and fraudulent workers’ compensation claims. Sacks Law Group, APC, is skilled at working with in-state and out-of-state employers on all workers’ compensation defense issues, particularly in the areas of:
Prior to any alleged injury or accident, we also counsel employers on ways to stay compliant with the ever-evolving California workers’ compensation laws. California employers benefit from our extensive experience and strong credentials when dealing with employee workers’ compensation fraud, as well as allegations of employer workers’ compensation fraud.
Our Blogs
Workers’ compensation claims are designed to support employees injured on the job. However, fraudulent claims can undermine this system, driving up costs for businesses and hurting employees with legitimate needs.…
Facing a workers’ compensation claim as an uninsured employer can be overwhelming. California has strict laws requiring employers to carry workers’ compensation insurance, and failing to comply can lead to…
Workers’ compensation insurance typically covers the costs when an employee is injured on the job. However, when a third party is responsible for the injury, employers in California have the…