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Court Finds Insurers Not Responsible For Known Losses

Employers cannot put a new workers’ compensation insurer on the hook for an old workplace injury, according to a recent decision by the Florida 1st District Court of Appeals. This ruling could make it more difficult for injured employees to properly identify the company responsible for their workers’ compensation claims, which makes it all the more important to find a Coral Springs Workers’ Compensation Lawyer.

In the case of Normandy Insurance v. Jose Sorto, Jimerico Construction, Inc., and Amerisure Insurance Company, the appeals court overturned the lower court’s ruling and held that Normandy Insurance was not obligated to pay for a workplace injury that occurred before the employer applied for a new policy.

In 2016, Sorto was injured after a piece of heavy machinery drove over his foot. Immediately after Sorto’s injury, his employer, subcontractor J.A.M. Construction, contacted an insurance broker to obtain a workers’ compensation policy, but did not disclose Sorto’s injury. Unaware that an accident had already occurred, Normandy Insurance enacted a policy, which became effective the same day as Sorto’s injury.

When Sorto filed his workers’ compensation claim, Normandy Insurance began paying for his treatment and indemnity benefits until it learned that Sorto’s injury has occurred before J.A.M. Construction applied for the Normandy Insurance policy. Normandy Insurance objected to covering Sorto’s injury, and began a dispute over what company was actually responsible for Sorto’s workers’ compensation claim.

Normandy Insurance claimed that Jimerico Construction, Inc, the contractor on the job site, and Amerisure Insurance Company were obligated to pay Sorto’s costs, and they claimed it was Normandy Insurance’s responsibility.

Ultimately, the appeals court found that Normandy could not be responsible for Sorto’s loss, as it was not disclosed to the insurer in J.A.M. Construction’s application. The court also noted that the purpose of insurance is to ensure that employers are covered for uncertainties, not for known losses.

Although this ruling is good news to help insurers avoid being tricked into covering old injuries, it may cause one more hurdle for injured employees. Although Florida law requires that employers carry workers’ compensation insurance, not all employers do so, and workers can be left uncertain who will ultimately pay their workers compensation claim.

A Coral Springs Workers’ Compensation Lawyer like the Law Offices of Evan M. Ostfeld can help workers navigate this legal process and file their claim against any and all companies who may be responsible for an employee’s injuries. So if you or someone you know have been in a workers’ compensation accident, feel free to contact The Law Offices of Evan M. Ostfeld, P.A. at (866) I SUE YOU, (866) 478-3968, (954) 227-7529, and or for a no obligation consultation.

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