If you were hurt at work in Wisconsin, it is extremely frustrating to wait while the worker’s compensation insurance company “investigates” your claim. You may be missing paychecks, waiting for medical treatment, and wondering whether the insurer is allowed to simply ignore you. Unfortunately, Wisconsin worker’s compensation law does not give the insurance company one clear, universal deadline to finally approve or deny every claim. There is no simple rule that says the insurer must make a final decision within a specific number of days in every case. However, that does not mean the insurer can sit on the claim forever. For a reportable lost-time claim, the insurer generally should act quickly. Within about 14 days, it should begin paying benefits, deny the claim in writing, or tell the injured worker in writing that the claim is still being investigated and what information the insurer says it needs.
The most important practical deadline often involves temporary disability benefits. If temporary disability benefits are owed and the insurance company delays the first payment beyond 30 days, it may face a statutory delay penalty unless it has a valid excuse. In other words, the insurer may be allowed to investigate, but it is not supposed to use “investigation” as an excuse to leave an injured worker in limbo indefinitely. The longer the insurer withholds benefits—especially beyond the first few weeks—the more pressure builds on the insurer to justify the delay. Depending on the facts, an unreasonable delay may support penalties or even a bad faith claim. So, while Wisconsin law does not give a simple one-size-fits-all approval-or-denial deadline, an insurance company that refuses to pay, refuses to deny, and refuses to explain what it is doing may be creating legal problems for itself. Our law firm is experienced in dealing with delayed Wisconsin worker’s compensation claims, pressing insurers to explain or pay what they owe, and pursuing penalties when the delay is unreasonable.
If you suffered a work injury in Wisconsin and the insurance company denied your claim, please contact one of Hawks Quindel S.C.’s experienced worker’s compensation attorneys for a free consultation. We serve clients throughout the Midwest and are ready to help you secure the benefits you deserve.