FAQ: Workers’ Compensation Cases in Colorado

What is Workers’ Compensation?

Workers’ compensation is a state-mandated program that provides compensation to employees who suffer injuries and illnesses on the job. It acts as a safety net for employees. In Colorado, businesses must have workers’ compensation insurance to cover employee injuries. Workers’ compensation laws are designed to ensure that employees who are injured on the job receive fixed monetary compensation, without having to litigate their claims against their employers. Thus, filing a workers’ compensation claim is similar to filing an insurance claim; it isn’t a lawsuit against an employer, but rather a request for benefits.

Does it Matter who is at Fault in a Colorado Workers’ Compensation Claim?

Workers’ compensation is a no-fault system, where an injured worker’s own negligence, or the negligence of his or her employer or co-workers, is not at issue. Instead, the employee is covered for all work-related injuries, regardless of who was responsible for the injury. The employer’s workers’ compensation insurance simply compensates the employee for his or her workman’s comp claim. This also means that the employee is generally not eligible to take legal action against his or her employer for injuries sustained on the job. In Colorado, workers’ compensation is considered a substitute for a lawsuit against an employer. In exchange for not suing the employer in court, an employee who is injured at work is entitled to workers’ compensation benefits.

Many workers’ compensation claimants are still eligible to take legal action if their injuries were caused by someone other than their employer. For instance, employees injured by a defective product or equipment while on the job can take legal action against the manufacturer of the product or piece of equipment. This action takes place within the civil court system, rather than through the worker’s compensation system.

However: if a claimant for worker’s compensation does win monetary compensation in a civil court from a third party, the claimant’s employer and his employer’s insurance company are eligible to recover some or all of any worker’s compensation paid to the claimant.

What Types of Injuries are Covered by Worker’s Compensation in Colorado?

Here are some types of injuries covered by worker’s compensation:

• Pre-existing conditions that the workplace accelerates or aggravates.
• Diseases contracted by exposure to toxins at work as a result of normal working conditions.
• Injuries resulting from mental and physical strain brought on by increased work duties or work-related stress.
• Injuries caused during breaks, lunch hours, and work-sponsored activities, and at-work injuries caused by company facilities.
• Some types of injuries may not be covered by workers’ compensation, such as injuries that result from horseplay, intoxication, or are deliberately caused by the employee.

Should I Hire a Personal Injury Attorney?

Due to the rigid procedural requirements of filing a worker’s compensation claim and the probability that your employer’s insurance company will not pay the benefits they owe you, you should contact a Colorado attorney experienced in personal injury and workers’ compensation if you are injured at work in Colorado. Additionally, if you are unhappy with the decision in a hearing that was held to determine some aspect of your workers’ compensation claim, procedures exist for you to appeal the unfavorable result. An attorney can navigate you through this process and get you the compensation and treatment that you deserve. Don’t take on the insurance companies alone: contact a Colorado personal injury attorney experienced in worker’s compensation today.

For more information concerning worker’s compensation in Colorado, click here to visit the worker’s compensation section of the Colorado Department of Labor.

Your Rights When an Insurance Company Acts Unreasonably

It is a violation of Colorado law for Insurance Companies to delay or deny claims without a reasonable basis.

We all have to buy insurance, and no one should have to experience unreasonable delay and denial after months, or even years, of paying premiums when you finally have to file a claim due to no fault of your own. Your own insurance company has an obligation to treat you fairly. Your own insurance company has an obligation to pay claims promptly. Your own insurance company has an obligation not to unreasonably delay or deny your claim. If they do not meet these obligations, you may have claims against them for additional damages for Bad Faith and Unreasonable Delay or Denial of your claim. In fact, your insurance company could have to pay double the amount of benefits owed if they unreasonably delay or deny your claim, plus attorneys fees and expenses. Your insurance company could owe additional damages beyond that for Bad Faith, or even Punitive Damages.

Here are some frequently asked questions about insurance claims:

What is Unreasonable Delay, and how long do Insurance Companies have to pay a claim?

Each claim is different and it depends on the circumstances. Many Insurance Companies’ own policies provide that they should respond within 30 days. Failure to comply with their own policies could be evidence of unreasonable delay.

If you have submitted a claim to your insurance company and they have delayed processing the claim for 30 days or more, please contact Franklin D. Azar & Associates today.

Should you wait until your claim is delayed or denied to hire an attorney?

There is no reason to delay retaining a Colorado attorney when dealing with a claim. Since we work on a contingency basis and you pay no money out of pocket, your interests are protected throughout the claims process. Insurance companies own studies conclude that people who deal with an insurance company without an attorney receive 80% less than people who hire an attorney. More importantly, proper documentation throughout the claims process is extremely important to receiving all of the compensation you may be entitled to.

How are fees handled in an insurance bad faith case?

We typically handle each of these cases on a contingent basis, which means we only charge a fee if we are successful, usually winning or settling a lawsuit in favor of the client, or collecting funds due with or without filing a lawsuit.

Why do Insurance Companies have to pay my claim in a reasonable time period?

Simply put, under Colorado law, your Insurance Company has a duty to pay your claim in a reasonable time period. This has been defined in the Unfair Claims Settlement Practices Act. The purpose of the Unfair Claims Settlement Act is to set forth standards for the investigation and disposition of claims arising under policies or certificates of insurance issued to residents of Colorado.

Any of the following acts by an insurer, if committed in violation of Section 3, constitutes an unfair claims practice:

1. Knowingly misrepresenting to claimants and insureds relevant facts or policy provisions relating to coverages at issue;
2. Failing to acknowledge with reasonable promptness pertinent communications with respect to claims arising under its policies;
3. Failing to adopt and implement reasonable standards for the prompt investigation and settlement of claims arising under its policies;
4. Not attempting in good faith to effectuate prompt, fair and equitable settlement of claims submitted in which liability has become reasonably clear;
5. Compelling insureds or beneficiaries to institute suits to recover amounts due under its policies by offering substantially less than the amounts ultimately recovered in suits brought by them;
6. Refusing to pay claims without conducting a reasonable investigation;
7. Failing to affirm or deny coverage of claims within a reasonable time after having not completed its investigation related to such claim or claims;
8. Attempting to settle or settling claims for less than the amount that a reasonable person would believe the insured or beneficiary was entitled by reference to written or printed advertising material accompanying or made part of an application;
9. Attempting to settle or settling claims on the basis of an application that was materially altered without notice to, or knowledge or consent of, the insured;
10. Making claims payments to an insured or beneficiary without indicating the coverage under which each payment is being made;
11. Unreasonably delaying the investigation or payment of claims by requiring both a formal proof of loss form and subsequent verification that would result in duplication of information and verification appearing in the formal proof of loss form;
12. Failing in the case of claims denials or offers of compromise settlement to promptly provide a reasonable and accurate explanation of the basis for such actions;
13. Failing to provide forms necessary to present claims within fifteen (15) calendar days of a request with reasonable explanations regarding their use;
14. Failing to adopt and implement reasonable standards to assure that the repairs of a repairer owned by or required to be used by the insurer are performed in a workmanlike manner

Meet Chris and learn about his Car Crash & Workers’ Compensation Experience

The Car Accident Lawyers At FDAZAR

For more than thirty years the attorneys at Franklin D. Azar & Associates have helped thousands of injured people obtain complete and timely compensation for their losses. Our proven track record and expertise in serious injury cases have allowed us to grow into the largest personal injury law firm in Colorado, with offices in Denver, Aurora, Thornton, Fort Collins, Greeley, Grand Junction, Colorado Springs, and Pueblo. If you’ve been injured in a bus, car, truck, or motorcycle accident, you may be entitled to compensation. Please call the car accident attorneys at FDAzar day or night at 800-716-9032, or contact us here for a free consultation and no-obligation evaluation of your case.