When an injured worker seeks insurance benefits after a serious accident, the expectation is that coverage will provide timely and adequate support for medical care and recovery. Unfortunately, disputes over insurance obligations can create additional hardship for workers already facing devastating injuries. A recent Massachusetts decision highlights how courts review claims of unfair settlement practices and bad faith under Massachusetts law when an insurer delays or denies benefits. If you were hurt at work, it is important to understand your options, and you should speak to a Massachusetts workers’ compensation attorney.
Factual Background and Procedural History
It is reported that the plaintiff suffered severe injuries in March 2022 while working as an independent contractor for a food delivery service. The injuries included head trauma, facial disfigurement, spinal damage, and hand injuries, among others. At the time of the accident, the plaintiff was covered under an occupational accident policy issued by the defendant insurance company and administered by its third-party claims handler. The policy was intended to provide medical and dental expense benefits of up to $1,000,000 for work-related accidents.
It is further reported that shortly after the accident, the plaintiff attempted to secure treatment for his injuries through the policy but encountered repeated obstacles. The insurer’s adjuster failed to provide a recommended provider list for nearly two months, leaving the plaintiff to attempt to schedule appointments on his own. In some cases, the adjuster suggested the plaintiff pay out of pocket and later seek reimbursement, even though his injuries left him financially vulnerable. When the plaintiff eventually scheduled a specialist appointment, it was canceled due to the adjuster’s inaction, causing additional delays in critical treatment. Continue reading →