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Court: Florida Workers’ Comp Benefits Cannot be Backdated

Florida workers’ comp benefits cannot be backdated in order to cover a previous work-related injury. That’s the recent ruling from Florida’s 1st District Court of Appeals, which held (unsurprisingly) that people who are uninsured can’t suffer a loss, scramble for insurance and then assume that cost will be covered.

It’s not a stunning ruling by any means, given that this is generally the way insurance works – whether it’s workers’ comp benefits or car insurance or health insurance. You can’t be covered after the fact.

As noted by the Florida Division of Workers’ Compensation, pretty much all employers conducting work in the state of Florida are mandated to maintain workers’ compensation insurance for their employees, with specific requirements dictated by type of industry, organization structure and number of workers. Companies do not need to pay insurance for workers’ comp benefits for those who are independent contractors as opposed to employees, but employee misclassification is a serious problem in Florida employment law. Some companies have been caught skirting their obligations by wrongly classifying workers as independent contractors to avoid paying workers’ compensation insurance. If a work injury or illness occurs in this scenario, that injury won’t be covered by insurance, but the worker will have the right to sue the employer for negligence and obtain compensation far in excess of what would have been paid in Florida workers’ comp benefits. 

Florida Workers’ Comp Benefits Claim Rejected

Although many Florida workers’ comp benefits claims don’t require litigation, it is important still to contact an experienced Miami workers’ compensation attorney. There may be more complication to your claim than you realize – or it could be much more simple than your employer/ workers’ compensation insurer is making it sound.

In the 2016 case of Jose Sorto, the plaintiff was at work on a construction site when a heavy piece of machinery ran over his foot. The construction company employer called its insurance broker that morning regarding the anticipated workers’ comp benefits claim. The broker immediately submitted paperwork to obtain coverage with the company – and failed to disclose the accident that morning. The insurer wrote the policy effective that morning. However, when it discovered the work injury occurred the very same day coverage started, the timeline was more closely scrutinized and ultimately denied – despite the policy technically being in effect as of 12:01 a.m. that morning per the contract, which was prior to the accident.

The trial court decided in favor of the construction company, ruling that because the policy indicated the coverage started earlier that morning, it was in effect at the time of the accident and the work injury should be covered. The appellate court however reversed, ruling the claim involved an undisclosed yet known loss.

Florida insurance law recognizes the “known loss principles,” and these specifically exclude coverage for losses that have already happened. Companies can’t avoid paying workers’ compensation and then suddenly buy in at the last minute after a work injury. Insurers would go bankrupt if this was common practice.

If you are hurt on the job in Miami and are concerned about being able to secure Florida workers’ comp benefits, our dedicated South Florida workers’ compensation lawyers can help.

Call Freeman Injury Law — 1-800-561-7777 for a free appointment to discuss your rights. Now serving Orlando, West Palm Beach, Port St. Lucie and Fort Lauderdale.

Additional Resources:

Normandy Insurance Co. v. Sorto, Jimerico Construction Inc., Oct. 31, 2018, Florida First District Court of Appeals

More Blog Entries:

Freeman Injury Law Announces New Workers’ Compensation Department, Nov. 19, 2018, Miami Workers’ Compensation Lawyer Blog

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