Does Workers’ Comp Insurance Cover Legal Fees if an Employee Sues for Injury?

Legal disputes surrounding workplace accidents are an understandable concern for employers. If an employee sues you for a work-related injury, will your Workers’ Compensation insurance carrier cover the associated legal fees?

Your Workers’ Compensation insurance carrier doesn’t have to cover legal fees if an employee sues you for injury because, in most cases, a worker cannot file an injury lawsuit if their employer has Workers’ Compensation coverage. Hearings might be necessary during the course of the claims process, especially if a worker has appealed their denied Workers’ Compensation claim. However, that will be handled by your carrier as part of the services it provides to you, the insured. Legally, Workers’ Compensation carriers do have to provide certain benefits to injured workers, provided they have filed valid Workers’ Compensation claims.

Call NPN Brokers at (561) 990-3022 to get coverage from our Workers’ Compensation insurance brokers today.

Will Workers’ Comp Insurance Cover Legal Fees if Your Employee Sues for Injury?

Typically, as long as an employer has Workers’ Compensation insurance, an injured worker can’t sue them directly for damages. This erases the issue of who pays legal fees in a Workers’ Compensation lawsuit altogether.

Your carrier won’t cover legal fees if an employee sues you for injury because, in all likelihood, your employee can’t sue you for injury if your Workers’ Compensation insurance covers them. The reason states have no-fault Workers’ Compensation systems is to minimize the need for workplace accident lawsuits as much as possible. Employees who are injured at work can file a Workers’ Compensation claim to recover damages, regardless of who is at fault for their injuries.

Generally, the only type of workplace accident lawsuit that can arise is a third-party lawsuit. For example, if someone other than an employer caused a worker’s injuries, like a negligent product manufacturer, a worker can sue that party. But, when employers get coverage from our Workers’ Compensation insurance brokers, they become immune from litigation arising from workplace accidents.

So, as long as you have Workers’ Compensation insurance and live in a state where filing a claim is an employee’s only path to recovery, you don’t need to worry about lawsuits and legal fees. If you do not have coverage, you may face litigation from employees. Since such employers don’t have a carrier, the only entity responsible for paying legal fees, in this case, will be their company.

Will Your Carrier Cover Legal Fees for Workers’ Comp Hearings?

An employee’s Workers’ Compensation claim might be denied for several reasons during the claims process. In some cases, workers might file appeals to be heard in court. Who pays legal fees in this situation?

When employers get Workers’ Compensation coverage, they pay a premium. This premium works to cover all benefits paid out to employees as well as any procedural other matters involving a claim. During disputes over denied claims or benefit amounts, the main issue is between your carrier and an injured employee. This is because your company doesn’t have the final say in whether a claim is approved or denied or how much money a claimant receives. While these disputes are often heard in court by an administrative law judge, they aren’t lawsuits.

During an appeal or other dispute, you may want to have a legal representative from your company present. Your carrier won’t cover legal fees if you retain a company lawyer to be present during Workers’ Compensation appeals or hearings.

Because you pay premiums to your Workers’ Compensation insurance carrier, you do not have to pay additional funds for it to engage in a claims dispute with an employee. That is part of a carrier’s responsibilities in addition to providing you with coverage and paying claims. Engaging in a claims dispute in court is not a separate service your carrier provides for an additional fee.

What Costs is Your Workers’ Comp Carrier Legally Required to Cover?

Depending on the validity of a Workers’ Compensation claim, your carrier may not be legally required to cover any costs associated with a workplace accident at all. If a claim is valid, the benefits paid out by an insurer will depend on the state and a claimant’s injuries. Many states impose legal limits on benefit amounts and do not allow a carrier to pay more than a certain sum to injured workers.

Medical Benefits

Each state legally requires Workers’ Compensation insurance carriers to pay out different medical benefits in different amounts to injured employees. In Florida, for example, carriers must cover an employee’s medical expenses, provided an approved medical professional confirms their injuries. Suppose a worker has reached maximum medical improvement. In that case, your carrier may not have to pay additional benefits for medical expenses, as they might be unnecessary for an employee who has already recovered.

Disability Benefits

State-imposed Workers’ Compensation benefit limits for lost wages vary. For example, in Florida, workers can receive lost wage benefits equal to two-thirds of their average weekly wages for the duration of their disability. Florida offers lost wage benefits for temporary disability, temporary partial disability, and permanent total disability. Though Florida does not, other states may provide lost wage benefits for permanent partial disability injuries. Some states offer a lower percentage of Workers’ Compensation average weekly wage benefits, around 60%.

Death Benefits

If an employee dies as a result of injuries sustained in a workplace accident, their employer’s carrier must pay out death benefits to eligible family members. The death benefits carriers must legally pay will depend on their state. In Florida, carriers must cover up to $7,500 in funeral expenses. Workers’ Compensation insurance carriers can only legally pay a maximum of $150,000 in lost wage benefits to eligible family members of a deceased employee in Florida.

Speak with Our Brokers About Getting Workers’ Comp Insurance Today

If you need coverage for your business, call the Workers’ Compensation insurance brokers at NPN Brokers now at (561) 990-3022.