New Jersey Supreme Court ruling helps comp insurers | Newark ...

While the rules and procedures may be complicated, the mechanics of workers' compensation are fairly straightforward:

Employers purchase workers' compensation insurance (or self-insure using a third-party administrator) for their employees. In exchange, they get immunity from nearly every type of personal injury lawsuits related to workplace accidents. Conversely, for giving up the right to sue, employees have the peace of mind that comes with knowing their medical expenses and a portion of their wage losses will be covered in the event they are injured in an on-the-job accident.

That's how it is supposed to work anyway. But what if an employer or insurance carrier refuses to pay benefits even after a workers' compensation judge has ruled an injured employee is entitled to benefits?

Unfortunately, this actually happens, and even more unfortunately, courts have said that workers still have to rely on the contempt remedy in the state's workers' compensation statute rather than the civil justice system. In fact, a similar scenario was involved in a recent New Jersey Supreme Court decision worth noting. The background to that case is as follows.

A man was injured in a work-related accident and filed a workers' compensation claim with his employer's insurer. After the insurer refused to pay his medical and transportation expenses, a workers' compensation court ordered the insurer to pay. But the insurer still refused to authorize treatment. As a result of being forced to delay needed medical treatments, the workers' condition got worse (which meant additional treatment). The delay also put the man through more pain and suffering. So he sued the comp insurer for the additional pain, suffering and worsening of the condition.

The lawsuit made it all the way to the Supreme Court of New Jersey, which held last month that the injured worker could not sue the workers' compensation insurer for pain and suffering caused by the delay in authorizing medical treatment.

Source: Risk & Insurance, "Workers must seek remedy for delay in treatment through comp system," Sept. 24, 2012

Source: http://www.northjerseypersonalinjurylawblog.com/2012/10/new-jersey-supreme-court-ruling-helps-comp-insurers.shtml

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