Settlement of a workers’ compensation usually takes place through a mediation. Mediations became a popular way to settle not only workers’ compensation claims, but also other injury claims. Here is how it works.
How Does Workers’ Compensation Settlement Mediation Work?
You and the insurance company either agree to use the Georgia Workers’ Compensation Board (SBWC) or a private mediator to meet (or zoom) for a settlement meeting. The SBWC provides mediation for free. A private mediator must be paid for the time spent by the mediator. The mediation is usually set 4 to 8 weeks out.
Preparation for the mediation is critical. Your attorney will review your case and discuss with you the strengths and weakness of your case. Your attorney will discuss the dollar range of potential settlement of your claim. Your attorney will draft a settlement demand. Once you approve the demand, your attorney can then send it to the insurance company through its attorneys. You always have the right to approve or disapprove of a recommended demand before it is communicated to the insurance company. Your attorney will make sure that the demand can be fully documented through records and medical peer review articles if there is a medical dispute involved.
At the beginning of the mediation, the mediator who is also an attorney will explain that his purpose is to help you and the insurance company come to an agreement to settle the claim. You will be told that at the mediation, you can control the decision of how to settle your claim whereas if the claim goes to a judge for trial, you will not have a say in the outcome. Typically, the mediator will review how workers’ compensation works and what you can expect if the claim does not settle.
After the introduction and explanation by the mediator, the mediator will give your attorney the opportunity to explain your case and what you want. If a proper demand has been sent, the mediation presentation is not usually necessary and negotiations for money can begin immediately. The mediator will then ask the insurance company what it wants to say. The insurance company always says something like: We are glad to have this opportunity to discuss settlement and although we do not agree with your demand, we believe we have brought enough money to settle the claim.
Since the written demand to the insurance company has already given a figure, it will be the insurance company’s turn to make an offer. First offers are meaningless and should typically be ignored. You should have no emotional response to any offer. Each offer should be considered and countered. Early offers are typically a reaction to the demand. High demands cause insulting offers which should be carefully countered to maintain your position but encourage the insurance company to raise its offers.
After some back and forth, the gap between your demand and the offers will narrow. At this point the skill of the negotiating attorneys comes into play to reach a final figure. Sometimes, the case cannot be settled which is often because the insurance company did not bring enough money unless your evaluation of the claim was not accurate.
Insurance Company Tactics
During the actual mediation, the insurance company will often try several tactics to make you worry about your claim during the mediation. These tactics need to be considered but are often just scare tactics. Matters that come up which were not anticipated should be explored to see if there is any basis for the insurance company’s claims.
The potential for the insurance company employing any tactic will depend upon the relationship between your Employer and its insurance company. Investigation of the relationship helps determine the likelihood of the insurance company making good on any threats.
Many times, the insurance company will start sending questions through the mediation that have nothing to do with money. This is a way the insurance company can try to get information from you that may be useful if the case is tried. Any discussion other than money should be discouraged, but any question that comes to you should be seen as something to be aware of if the case goes to hearing.
At the conclusion of the mediation, the claim will either be settled or not. A failure to settle at a mediation is still time well spent since you will know how the insurance company sees your case and you will have secured some offer. Depending on the offer and how the mediation concludes, many times the claim will settle a month or so after the mediation for a number between the last demand and last offer of the mediation.
To finalize the settlement in Georgia, paperwork must be submitted to the SBWC for approval. Until the settlement is approved by the SBWC, it is not final.
If you want to learn more about your right to workers’ compensation benefits after a serious injury, contact our Atlanta office. Since 1976, we have been enforcing injured workers’ rights throughout Georgia. Contact our Atlanta workers’ compensation attorneys today for a free consultation.