The reservation of rights letter contains specific information about the claim, including the policy in question, the claim made against the policy, and the part of the claim that may not be covered. Contact us at (470) 268-5802 if you think you might qualify, consider speaking with our experienced and reputable workers’ compensation attorney.
A reservation of rights letter is provided by an insurance company to an insured party indicating that a claim may not be covered under a policy. Reservation of rights letters does not deny a claim. Contact us at (470) 268-5802 If you or your loved one do not have a worker’s comp attorney.
Atlanta Workplace Death Claims
If your loved one died due to a work-related injury or illness, you may be entitled to workers’ compensation benefits for wrongful death. Unfortunately, employers or their insurance companies may deny Atlanta Workplace Death Claims, even when they are legitimate—which leaves the family/deceased estate to face a complex system of appeals. At that point, most people simply give up, while others try their best to navigate the system on their own.
The claims adjusters and attorneys working for the insurance company are not looking out for your best interests, and they won’t hesitate to reject your bona fide claim for dubious reasons. Fortunately, there are several things a workplace death attorney can do to tilt the scales in your favor.
Hiring an experienced and dedicated wrongful death attorney will give you a much better chance of obtaining the benefits you deserve. An attorney will communicate with the workers’ comp insurer on your behalf, gather the medical evidence that supports your claim, try to negotiate a good settlement, and represent you at your wrongful death hearing if necessary.
Understanding Reservation of Rights Letter
What Is a Reservation of Rights Letter?
A reservation of rights letter is provided by an insurance company to an insured party indicating that a claim may not be covered under a policy. Reservation of rights letters does not deny a claim. However, the letter indicates that the insurer is investigating the claim and reserves the right to deny the claim after it completes its investigation.
Insurance companies will issue a reservation of rights letter to the insured party to serve as a notice that they are conducting an investigation into the claim. Reservation of rights letters can appear generic but are a formal indicator that while the insurance company is moving forward with a claim, some losses may not be covered. Insurers cannot maintain their reservation of rights indefinitely, an insured party can push for their decision to provide or deny coverage.
How a Reservation of Rights Letter Works
Reservation of rights by an insurance company is a statement of intention that they are reserving their full legal rights. This serves as a notice that they are not waiving their legal rights to take action at a later date. A letter is sent as a notice that an insurer is reserving its rights, and if it decides to deny coverage later on it can cite its original reservation of rights letter as a warning.
Insurers that issue a reservation of rights letter may ultimately deny a claim, or they may decide to defend the insured against a claim made against it. To get a better understanding of what happened, the insurer must conduct its own investigation.
The notice that it intends on conducting an investigation is the reservation of rights letter. These letters are required because when an insurer receives a claims notice, it contains only a small amount of information as to what happened, what caused the damages, and who was responsible.
Receiving the letter serves as an indicator to the insured that the claim may be denied, or that the information provided in the original claim triggered questions that need further evaluation. For example, the Atlanta workplace death claims may be incomplete or may contain contradictory information.
Insurance companies send a reservation of rights letters because not doing so could be considered a waiver of their rights at a later time. Most of the time, reservation of rights letters appear as generic form letters.
However, they should not be taken lightly. At the very minimum, anyone who receives one should contact their insurance company to see why they think the claim may not be covered. Often, they will tell you that they are just covering their bases.
Important: Under a liability insurance policy, your insurer may have a broader obligation to defend the insured than to actually secure against losses.
Requirements for a Reservation of Rights Letter
The reservation of rights letter contains specific information about the claim, including the policy in question, the claim made against the policy, and the part of the claim that may not be covered.
The insured parties that receive a reservation of rights letter should contact their insurer to find out more information about the claim and the investigation process. The insurer may provide some initial information as to what aspects of the claim it is investigating.
The insured party may consider contacting an experienced workplace death attorney if it seems like the insurer intends on denying the claim.
Even though an insurer may send a reservation of rights letter, it is still responsible for replying to lawsuits associated with a claim while it conducts its investigation. Insurers send the letter to indicate that they are reserving their rights, since failing to send the letter can be considered a waiving of rights.
Death Benefits in Workers’ Compensation
If you have lost a family member because of a work-related injury or disease, you may be entitled to receive death benefits through your state’s workers’ compensation system. This article will give you a general idea of who is eligible to receive benefits, how much you might receive, and for how long.
However, because workers’ compensation laws are different in each state, the exact rules will be determined by the state where you file for benefits. Learn about the requirements and limits on workers’ comp death benefits after your spouse, parent, or other family member died from work-related injuries or illnesses.
Am I Eligible for Death Benefits?
Death benefits are intended to help compensate certain family members for the loss of financial support they had received from the deceased employee. While the exact eligibility requirements vary from state to state, death benefits are usually (but not always) reserved for those who were related to the deceased employee by blood or marriage—typically spouses, children, and other close relatives—who lived with and depended on the deceased employee for their living expenses. Certain states allow some benefits for relatives who were only partially dependent on the deceased employee.
There are different rules for deciding who qualifies as a dependent, depending on their relationship to the deceased employee and state law. Children under 18 are almost always considered dependents.
The same goes for older children who have certain physical or mental disabilities that make them unable to earn a living. Several states also extend eligibility to children over 18 (up to 21 or 25) who are enrolled in qualifying educational or vocational programs.
Many states assume that spouses are dependents regardless of their own incomes. In other states, spouses won’t necessarily qualify if they earn over a certain amount of money, or they may have to prove their financial dependence no matter how much they earn.
For all other family members, eligibility is usually determined based on the specific circumstances and evidence in each case.
Which Deaths Count for Benefits?
To file successful Atlanta workplace death claims and receive death benefits, a work-related injury or illness must have caused or contributed to your loved one’s death. These benefits aren’t limited to situations where an employee dies on the job, such as in a serious workplace accident.
Injured workers may die months or years later—although a few states don’t allow benefits for deaths that happened too long after the original accident. Death benefits may also be available when employees eventually die from illnesses they developed as a result of working conditions, like exposure to dangerous chemicals.
Even if your loved one had other medical conditions unrelated to work, you still may be eligible for death benefits if the work injury or occupational disease contributed to or accelerated the death. For example, you might be able to claim death benefits if a workplace accident aggravated your husband’s preexisting heart condition and led to his death.
How Much Can I Get in Death Benefits?
Death benefits are often paid in regular installments. The amount of those payments is based on a percentage of what the employee used to earn before the injury. The percentage varies from state to state, but the typical weekly payment is two-thirds of the deceased employee’s average weekly wage, with maximum and minimum amounts.
Instead of installment payments, some states pay a one-time lump sum, usually representing two-thirds of the deceased employee’s wages for a certain period, such as two years. The lump-sum is also generally subject to a minimum or maximum amount. Even in states that pay installment benefits, you may be able to negotiate a lump-sum settlement of your death benefits.
In some states, the total amount of death benefits is the same regardless of how many dependents there are. For example, the same total benefit amount may be divided among a surviving spouse and several dependent children. In other states, however, the benefit amount increases as the number of dependents increases.
If you are also receiving survivors’ benefits through Social Security, there may be an offset that reduces your workers’ comp death benefits following the approval of Atlanta workplace death claims.
How Long Do Death Benefits Last?
When death benefits are paid in installments, there are limits on how long those payments continue. In many states, surviving spouses receive benefits until their own death or remarriage.
Children can typically receive death benefits until they turn 18, or in some cases until they complete certain types of post-secondary education or vocational training.
In other states, death benefits will stop after a certain number of weeks or a certain maximum dollar amount has been reached, regardless of the children’s age or the surviving spouse’s remarriage.
What Other Benefits Are Available Through Workers’ Comp?
In all states, workers’ comp pays at least a portion of funeral expenses for employees who have died as a result of their work injuries. There is usually a maximum amount, which could be anywhere from a few thousand dollars to more than ten thousand dollars.
Workers’ compensation also covers the medical treatment that the employee received before dying. In general, you should not be stuck paying the remaining medical bills. However, the employee’s insurance company (or the state workers’ compensation agency) may review those bills to ensure that the treatment was necessary and related to the work injury or illness.
When Should I File a Claim?
There are strict time limits for filing a claim for death benefits. In many states, the limit is one or two years from the date of death or the last payment of disability benefits. However, your state’s laws might have longer or shorter time limits. For that reason, it is best to make a claim as soon as possible.
Getting Help with a Claim for Death Benefits
Because the workers’ comp rules for death benefits are complicated and vary from state to state, you should consider speaking with an experienced and reputable workers’ compensation attorney if you think you might qualify. The benefits from successful Atlanta workplace death claims can be an important financial resource for surviving dependents.
But depending on your relationship with the deceased employee, you may need help proving that you relied on that person’s income or disability benefits to get by. An experienced workers’ comp lawyer at Bobe & Snell Law Office LLC can explain how your state’s laws apply to your situation, how to file a claim for death benefits, and how to protect your rights in the process. And it’s good to know that because of the way workers’ comp lawyers charge for their services, the lawyer generally will receive only a limited percentage of the benefits you receive.
Atlanta Workplace Death Claims
If your loved one already had a worker’s comp attorney, that is a good place to start. Otherwise, feel free to contact us at (470) 268-5802 or online to schedule a FREE, no-obligation case review/consultation.