Tag Archive for: work injury

BREAKING NEWS: Increase in UIM Policy Limit Considered a ‘Purchase’ Requiring New Stacking Waiver

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UIM Coverage

On February 5, 2018, the federal District Court for the Eastern District of Pennsylvania ruled that an increase in Under Insured Motorist (UIM) benefits is a new purchase of insurance coverage.  As such, automobile insurance carriers are required to obtain a new waiver of the stacked benefits under the auto insurance policy.

Stacked benefits, in UIM coverage, means that a person who purchases automobile insurance on more than one vehicle under the same policy can elect to purchase up to double the UIM insurance coverage.  The Pennsylvania Motor Vehicle Financial Responsibility Law (“MVFRL”) requires an insurance carrier to offer stacked benefits to every policy holder who purchases insurance.  If the policy holder decides not to take advantage of the stacked benefits, the insurer must obtain a written waiver of those benefits.

For instance, if you insure two cars for $20,000.00 each, you are eligible for stacking benefits that would allow you claim up to $40,000.00 on each vehicle.  The MVFRL requires that the insurer offer this option to each and every insured.

If the insured declines, then the insurer must obtain an express written waiver of the option to purchase “stacked” benefits.

According to the Pennsylvania Eastern District Court in Barnard v Travelers, No. 17-00290, whenever an insured chooses to increase the amount of coverage under her UIM policy, the insurance carrier must obtain a new written waiver of stacked benefits as required by the MVFRL.

Background

Michelle Barnard, the Plaintiff in this case, held a UIM policy with The Travelers Home and Marine Insurance Company, the Defendant, since 2007.  When she initially secured the policy, she had UIM coverage limits of $50,000.00 for each of her two vehicles.

At the time of purchasing the initial insurance coverage, she signed a written waiver of stacked benefits under that policy, i.e., Ms. Barnard waived her right to stack UIM benefits under her policy.  With that, the maximum amount of UIM benefits that she could claim, and ultimately receive, under her policy was $50,000.00.

However, in May 2009, Ms. Barnard increased her third-party liability coverage limits under the policy from $50,000.00 to $100,000.00 on each insured vehicle.  So, this meant she would have been entitled to claim up to $200,000.00 on each car, as per her allowable stacked benefits.  Notably, Ms. Barnard did not sign any written waiver of her stacked benefits upon this increase in coverage.

Thereafter, when Ms. Barnard was injured in a car accident on June 17, 2016, she submitted a UIM claim under her policy with Travelers Insurance.  Travelers tendered $100,000.00 in UIM benefits to Ms. Barnard, assuming that she had waived her option to stack her UIM benefits in 2007.  Ms. Barnard, however, rejected this tender and, claiming that she was entitled to more than was tendered, she sued the Travelers.

Increase in UIM limit is a ‘Purchase’

Travelers argued before the Eastern District Court that, among other things, it had no duty to obtain a new waiver of stacked benefits under the policy, even after Ms. Barnard had increased her liability insurance coverage limits in 2009.  In other words, Travelers claimed that the initial 2007 waiver was still in operation and effective, despite the increased coverage purchased by Ms. Barnard in 2009.

The federal district court, however, rejected Travelers’ argument.  Judge Gerald McHugh held that the language of the MVFRL requires a renewed waiver of stacked benefits when liability coverage limits are increased and/or purchased.

According to Judge McHugh, because an increase in coverage under an existing policy requires that an insured pay a higher premium, an increase in coverage limits also qualifies as a “purchase” as defined by the MVFRL.  As a result, the court ruled that Travelers should have obtained a new waiver of UIM stacked benefits, in 2009, when Ms. Barnard increased her liability insurance limits.  Pursuant to the district court’s ruling, Travelers was responsible, and required, to pay Ms. Barnard up to $200,000.00 in UIM benefits under her policy.[1]

For questions relating to the MVFRL and Pennsylvania auto insurance coverages, please contact Matthew R. Zwick, partner of Zwick Law, at (814) 371-6400 or mrz@zwick-law.com, to schedule a legal consultation.  At Zwick Law, we’re always here for you.[2]

 

[1] Note: Travelers filed an appeal of the district court’s decision to the United States Third Circuit Court of Appeals, which remains pending at the time of publication of this article.

[2] Disclaimer: The use of the Internet, Facebook and/or any other form of social media communication with the firm or any individual member of the firm does not establish an attorney-client relationship.  Time-sensitive information should be directed immediately to the office of Zwick Law at (814) 371-6400.

 

What is Workers’ Compensation?

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Have you been injured on the job? Maybe you twisted your ankle while rushing into the elevator for that meeting with the boss or sprained your wrist while trying to beat that deadline. If you have suffered a work-related injury, you may be entitled to benefits under the Pennsylvania workers’ compensation laws.

workers' compensation

workers’ compensation

The Pennsylvania Workers’ Compensation Act (the “Act”) was enacted to provide no fault recourse for workers who suffer injuries in the workplace.  The Act ensures that no worker will go without some form of compensation for workplace-related injuries. The Act thus requires that all Pennsylvania employers register with an insurer for workers’ compensation coverage.

Every Pennsylvania worker is covered by the Act.  So, even if your employer has failed to procure workers’ compensation insurance coverage, you are still able to obtain compensation benefits under the Uninsured Employer Guaranty Fund.

What is workers’ compensation?

Workers’ compensation laws and regulations provide for you in the event of work-related injuries.  The Act provides financial, medical and other related benefits and support to workers who have been injured on the job.

The Act ensures that injured workers can obtain no-fault compensation for work-related injuries.  However, this “no-fault” insurance coverage comes with a compromise — your right to sue your employer for the injury.

What are some of the requirements to obtain workers’ compensation?

Before you can be eligible to receive benefits under the Pennsylvania workers’ compensation law, you must fulfil some requirements

  1. There must be an employer/employee relationship.

While this is usually straightforward, there are some situations when it is difficult to determine whether the relationship is an employment relationship under the law. For instance, an independent contractor does not qualify as an employee. For the purpose of determining whether a person qualifies as an employee, four things are usually considered:

  • The right of the employee to select the employer;
  • The employer’s right to “sack” the employee;
  • The employer’s power to direct the manner of performing the job; and
  • The employer’s power to control the employee;

Even if you don’t qualify as an employee under these conditions, you may still be an employee under the definition of a “statutory employer”.  For instance, if you are an employee of a sub-contractor that has been hired by a general contractor for a construction-type job, you may be entitled to compensation for work-related injuries. Your employer in this case is a “statutory employer.”

  1. The injury must have occurred under Pennsylvania jurisdiction

If you are hired in Pennsylvania, but often have to work in other states, it won’t matter whether the work injury happen in Pennsylvania, or some other jurisdiction.

  1. You must have suffered the injury in the course of employment

Each situation is usually decided on its merits, on a case-by-case basis. You don’t have to be actively working when the injury occurs, though. You could be playing tennis as part of the company’s sports team or attending a party for the company and possibly still be covered. The important requirement is that you must have been furthering the interest of your employer.

What type of workers’ compensation are you entitled to receive?

Under the Act, you are generally compensated for any disability that occurs as a result of work-related injuries.

Disability, under the Pennsylvania workers’ compensation law, is defined by work loss. A disability may result in total disability, temporary total disability or temporary partial disability. It is total disability scenarios when you are completely unable to work because of the work injury.

The Act defines an “injury” to include any condition caused by an accident or activity at work. As such, injuries need not be caused by accidents alone. Injuries caused by having to do the same thing over and over, such as typing with your back bent or injuries cause by abnormal working conditions, would also qualify as an “injury.”

What benefits can you receive under the Pennsylvania workers’ compensation law?

Depending on your injury, you may be entitled to any one or more of the following benefits:

  • Medical benefits. This would typically include the cost of obtaining medical treatment for the injury.
  • Wage benefits. You are generally entitled to compensation of up to two-thirds, sometimes more, of your average weekly wage. These benefits are not taxable.
  • Death benefits. This would be applicable only in the event of death caused by a wok-related injury. These benefits would be paid to the family or survivors of the employee.
  • Scarring benefits. This compensation is applicable in the event of disfigurement caused by work injury.
  • Specific loss benefits. If loss of limbs is involved, compensation would be payable for that specific loss. This does not mean that the whole limb must be lost though. It would suffice if it is shown that it has been made useless for the job.

How can you obtain workers’ compensation?

The Pennsylvania workers’ compensation law requires that workers who suffer any work-related injury must report the injury to their employer within 120 days – this period starts to run from the date of the injury.  You should always report a work-related injury to your employer, and make sure that an accident report is generated.

Your employer then either accepts or denies the claim. If the claim is denied, you can file a lawsuit to establish your work-related claim. You do this by filing a Claim Petition.

While there is no law that says you can’t fight for the claim on your own, it is generally a good idea to get in touch with an experienced workers’ compensation attorney from the moment you get injured.  The experienced worker’s compensation lawyers at Zwick Law understand how vital quality representation is to your claim.  We are prepared to review your situation and take over the time-consuming and stressful task of negotiating and fighting for you.

For questions relating to a work-related injury, contact Matthew R Zwick, partner of Zwick Law, at (814) 371-6400 or mrz@zwick-law.com, to schedule a legal consultation and free case analysis.  At Zwick Law, we’re always here for you.[1]

 

[1] Disclaimer: The use of the Internet, Facebook and/or any other form of social media communication with the firm or any individual member of the firm does not establish an attorney-client relationship.  Time-sensitive information should be directed immediately to the office of Zwick Law at (814) 371-6400.

 

Tips for Handling a Workers’ Compensation Claim

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Unfortunately, injuries can occur to anyone – at any time.  If you have been injured while on the job, you have a right to receive workers’ compensation benefits from your employer and its workers’ compensation insurance company.  Pennsylvania workers’ compensation laws were enacted to protect injured employees and their families through the provision of medical benefits, wage loss benefits, and other benefits, such as special loss, death, and funeral benefits.compensation

Knowing how to fully collect your workers’ compensation benefits under the law can sometimes be a daunting and complicated process.  In most situations, after a work-related accident occurs, employers (or, more likely, an employer’s insurance carrier) make obtaining fair and full compensation difficult, regardless of the circumstances, to avoid financial losses or other negative effects of losing an injury claim initiated by an employee.  For many employees and their families, dealing with and managing a workers’ compensation claim often becomes time-consuming, highly adversarial, and complex, as your employer’s insurance carrier attempts to reduce or completely deny your injury claim.

Whether a workers’ compensation claim is approved, contested, or even denied outright, often depends upon whether you were injured at work – and while working in the course and scope of your employment.  To be eligible for workers’ compensation benefits, you must show that: (1) you were employed at the time of your injury; (2) your injury occurred while you were on the job; and (3) your injury was related to and in furtherance of your employment.  Here are a few tips for handling a workers’ compensation claim, which will help to increase your chances of successfully navigating a potentially complicated process.

Record Names and Contact Information For All Witnesses

An aggressive claims adjuster will try to use every trick at their disposal to make it appear as though your work-related injury was an existing medical problem, or one that occurred while you were not working.  With that being said, identifying witnesses who can verify and confirm that your injury occurred while you were at work will carry a lot of weight in winning your case.  So, as soon as is practicably possible, obtain the names and current contact information for all persons who witnessed your incident.  Remember, you may be unable to return to your place of employment, so getting telephone numbers, e-mail addresses, and even social media account details of witnesses is something that you should do as soon as possible after a work accident.  If you are physically unable to get the information yourself, you should ask a coworker or family member for assistance.

Be Consistent and Protect Your Interests

The manner in which you explain the work-related accident, your injuries and how the accident occurred – to your supervisors, coworkers, physicians, etc. – should always remain consistent.  Even the smallest discrepancy can be used to discredit your account of the accident and/or create a basis to devalue or deny your claim.  To avoid inconsistencies, document all relevant events in writing at your earliest opportunity and obtain copies (or take pictures) of any and all incident reports and other documents referring or related to the accident and your injuries.

Consult an Attorney as Soon as Possible After a Work-Related Incident

Unsurprisingly, an injured worker, who is eager to have medical bills paid, and to be compensated for time away from work, is also often eager to comply with all requests made by an employer’s insurance carrier.  While cooperation with your employer’s carrier is encouraged (and many times required), it is important that you protect your own rights and interests – remember that your employer, and its workers’ compensation insurance carrier, will always focus on and put their interests first.  If an insurance adjuster requests that you provide a recorded statement, do not do so without first consulting and experienced workers’ compensation attorney.  A statement that is recorded under what appears to be casual circumstances can, and likely will, be used against you later, usually when you least expect it.  Consulting an attorney to handle and manage your workers’ compensation claim, as early as possible, will reduce the amount and number of times that you have to communicate with a claims adjuster.

Talk to a Attorney – Call Zwick Law

Before attempting to handle your claim alone, consider consulting with an experienced workers’ compensation attorney at Zwick Law.  Our attorneys have experience dealing with employers and their insurance companies – Zwick Law will protect your interests while ensuring that you get the compensation that you deserve.

Our team at Zwick Law understands that a workplace injury can be life-altering, and we work on your behalf to obtain the full compensation you need and deserve.  For questions relating to a work-related injury claim, contact Matthew R Zwick, partner of Zwick Law, at (814) 371-6400 or mrz@zwick-law.com, to schedule a legal consultation and free case analysis.  At Zwick Law, we’re always here for you.[1]

 

 

[1] Disclaimer: The use of the Internet, Facebook and/or any other form of social media communication with the firm or any individual member of the firm does not establish an attorney-client relationship.  Time-sensitive information should be directed immediately to the office of Zwick Law at (814) 371-6400.