Affirmative defenses allow insurance companies to refuse to pay workers’ compensation benefits even when an injury occurs at work. This blog is part of a series of blogs covering one of the most common affirmative defenses in Georgia workers’ compensation claims – willful misconduct.
Our previous blog posts in this series have discussed willful misconduct in the form of intoxication, failure to follow a safety rule, and attempting to injure yourself or someone else.
What Is A Statute?
This blog post will discuss the affirmative defense associated with failure to perform a duty required by statute. A statute is a law that is passed by a governing body such as the Georgia legislature.
There are thousands of statutes in Georgia. Some statutes define criminal acts such as battery, robbery, or speeding. Other statutes define civil responsibilities.
Can Insurance Companies Deny Benefits For Traffic Violations Like Speeding?
Sometimes, injuries at work occur in a situation where the insurance company claims that the injured employee violated a statute. One example is automobile accidents.
Take the situation where an employee is injured in a car wreck while on the job. If the injured worker was speeding, does that allow the insurance company to deny him or her payment of workers’ compensation benefits?
The courts in Georgia have generally found that proof of speeding is not enough on its own to prove willful misconduct and deny benefits. Generally, the courts have required that insurance companies prove intent to violate the law instead of mere carelessness. So, if you are injured while speeding, you will usually be able to recover workers’ compensation benefits.
What Should I Do If My Benefits Are Denied?
However, it is important to understand that you may have to fight to get the benefits to which you are entitled. The law allows the insurance company to claim that your injury was caused by willful misconduct and file a Form WC-3 denying your claim.
If this happens, you will usually have to take the insurance company to court to get your benefits paid.