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Workplace Injury

Is a worker’s compensation carrier liable for delays in approving treatment? Maybe…

Everyone gets frustrated with delays.  Traffic jams, long lines at the DMV and waiting at the airport can be infuriating.  But when your health is on the line, delays can be deadly.   What happens when you are injured at work, your doctor proscribes emergency treatment and the worker’s compensation carrier delays approval causing further injury?  Do you have a claim?  The short answer – only if the carrier’s delay constitutes an intentional tort. 

Generally, Florida’s Workers’ Compensation Law provides immunity to a worker’s compensation carrier.  See § 440.11, Fla. Stat. (2011)Aguilera v. Inservices, Inc., 905 So. 2d 84 (Fla. 2005), however, illustrates an important exception to this rule – statutory immunity does not apply to intentional tort claims.  In Aguilera, the carrier engaged in egregious conduct including, cancelling medical appointments, blocking prescriptions and failing to heed the advice of its own doctors.  As a result of the carrier’s delay in approving treatment, Aguilera suffered additional damages.  The Aguilera court held that “only injuries that occur within the system, ‘workplace injuries,’ are covered under the workers’ compensation law, not injuries intentionally inflicted by an insurance carrier during the claims administration process.”   The court also stated that Florida’s “workers’ compensation legislation does immunize an insurance carrier for mere negligent conduct, simple bad faith, and minor delays.”

 After the Aguilera decision, several courts upheld employees’ claims against their carriers for intentional torts.  See, e.g., Thristino v. Crawford & Co., 932 So. 2d 1162 (Fla. 4th DCA 2006) (reversing dismissal of claim that carrier intentionally and purposefully deprived claimant of necessary care and services prescribed by her physicians).  Keep in mind, that while worker’s compensation carriers are protected against claims for mere negligence or minor delays in the claims process, any intentional harm is actionable.

If you, or someone you know, have been injured as the result of negligence, medical malpractice or a dangerous or defective product, contact me at (305) 358-3109 or mmazzarella@hannonboyers.com today for a free evaluation of your claim.


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Matthew Mazzarella is a trial attorney at Hannon & Boyers, P.A.


The comments on this blog are provided for informational purposes only and DO NOT constitute legal advice or create an attorney-client relationship.

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