Q: Can I sue/file a lawsuit if an insurance company doesn't complete the settlement agreements?
Settlement included 9 months worth of compound cream, there was not a time limit on the 9 months. After paying for 4 months worth I received a successful experimental treatment. After 1.5 years the treatment no longer worked and I went to order a refill and it was denied twice. Since it was part of the agreement I believe something should be able to be done to fix this or penalize the insurance company. I have been having non-stop painful flare ups or my RSD since 2017 started. Thank you in advance!
A:
I am sorry to hear the difficulties that you are having with your Workers Compensation Claim, despite the Settlement that you reached several months ago.
Without seeing the contents of the Settlement, it is unclear as to whether, or not, the Workers Compensation Carrier is violating the terms of the Judge's Decision.
Assuming that you had the assistance of an Attorney, I believe it would be best to discuss this issue with your Attorney to resolve the issue with your Workers Compensation Carrier.
If you are not represented by counsel, at the time of the Settlement, you should consider consulting with an Attorney who is a Certified Specialist in Pennsylvania workers Compensation Law to discuss the possibility of filing a Petition for Penalties, Petition to Review Medical Treatment & Billing and/or a Prospective Request for Utilization Review.
A: If you were represented by an attorney in the settlement, you should contact him first since he is already familiar with your claim. Regardless, the language of the agreement would control. It would be unusual for a carrier to leave potential entitlement open in the fashion you describe, but certainly not impossible. If you are correct in regard to the agreement, you may be able to pursue a Petition for Penalties.
Justia Ask a Lawyer is a forum for consumers to get answers to basic legal questions. Any information sent through Justia Ask a Lawyer is not secure and is done so on a non-confidential basis only.
The use of this website to ask questions or receive answers does not create an attorney–client relationship between you and Justia, or between you and any attorney who receives your information or responds to your questions, nor is it intended to create such a relationship. Additionally, no responses on this forum constitute legal advice, which must be tailored to the specific circumstances of each case. You should not act upon information provided in Justia Ask a Lawyer without seeking professional counsel from an attorney admitted or authorized to practice in your jurisdiction. Justia assumes no responsibility to any person who relies on information contained on or received through this site and disclaims all liability in respect to such information.
Justia cannot guarantee that the information on this website (including any legal information provided by an attorney through this service) is accurate, complete, or up-to-date. While we intend to make every attempt to keep the information on this site current, the owners of and contributors to this site make no claims, promises or guarantees about the accuracy, completeness or adequacy of the information contained in or linked to from this site.
