Workers’ Compensation Insurance Bad Faith | Charlotte NC Attorney

🚩 Denying the Injury Is Work-Related

The insurer claims your injury did not occur at work or was not caused by your job duties, despite evidence to the contrary. This is especially common with repetitive stress injuries, cumulative trauma, and conditions that develop gradually.

🚩 Terminating Benefits Prematurely

The insurer cuts off your disability benefits before you have reached maximum medical improvement (MMI), often using a biased independent medical examination (IME) to justify the termination.

🚩 Refusing to Authorize Medical Treatment

The insurer denies authorization for surgery, physical therapy, or specialist referrals that your treating physician has recommended. Under N.C.G.S. § 97-25, the insurer must provide treatment necessary to effect a cure, give relief, or lessen disability.

🚩 Using Biased IMEs to Deny Claims

The insurer sends you to a doctor who routinely finds in favor of insurance companies. These so-called “independent” medical examinations are often anything but independent — the examining physician may have a financial relationship with the insurer and a track record of minimizing injuries.

🚩 Surveillance and Harassment

The insurer hires investigators to conduct surveillance on you, then uses selectively edited footage to argue you are not as injured as you claim. While surveillance itself is legal, using misleadingly edited footage to deny a legitimate claim can constitute bad faith.

🚩 Delaying Payments to Create Financial Pressure

The insurer deliberately delays benefit payments, knowing that an injured worker without income will eventually accept an unfavorable settlement out of financial desperation. This is a textbook violation of NC’s unfair delay provisions.

Workers’ Comp Claim

• Filed with NC Industrial Commission
• Seeks disability benefits, medical treatment, and compensation for permanent impairment
• Governed by N.C.G.S. Chapter 97
• No jury trial — heard by Deputy Commissioner
• Limited to scheduled benefits

Bad Faith Claim

• Filed in NC Superior Court
• Seeks damages for the insurer’s misconduct in handling the claim
• Governed by N.C.G.S. § 75-1.1 (UDTPA) and/or common law
• Jury trial available
• Treble damages + attorney’s fees

Yes. While workers’ compensation claims are handled through the NC Industrial Commission, a separate bad faith lawsuit can be filed in NC Superior Court against the insurer for its misconduct in handling your claim. This bad faith action can proceed under the common law bad faith tort and/or the Unfair and Deceptive Trade Practices Act (N.C.G.S. § 75-1.1), providing potential treble damages and attorney’s fees.

Common tactics include denying the injury is work-related despite evidence, terminating benefits prematurely using biased IMEs, refusing to authorize necessary medical treatment, conducting misleading surveillance, delaying payments to create financial pressure, and pressuring injured workers to accept low settlements.

Under N.C.G.S. § 97-18(d), the workers’ compensation insurer must begin payment of benefits or file a denial with the NC Industrial Commission within 14 days of receiving notice of the injury. Failure to respond within this timeframe may trigger penalties.

An Independent Medical Examination (IME) is a medical evaluation requested by the insurer. While IMEs are legal, insurers sometimes use doctors who routinely minimize injuries and find in favor of insurance companies. Using a biased IME to manufacture reasons to deny legitimate benefits can support a bad faith claim.

Yes. Under the UDTPA (N.C.G.S. § 75-16), if the insurer’s conduct in handling your workers’ comp claim constitutes an unfair or deceptive trade practice, the court shall award treble damages. This is in addition to any benefits owed under the Workers’ Compensation Act.

The NC Industrial Commission can impose a 10% penalty on overdue payments under N.C.G.S. § 97-18(g), order the insurer to pay attorney’s fees under § 97-18.1 for defending claims without reasonable ground, and order immediate payment of benefits. These penalties are separate from treble damages available through a Chapter 75 civil lawsuit.

No. N.C.G.S. § 97-6.1 prohibits employers from retaliating against employees who file workers’ compensation claims. If your employer fires, demotes, or otherwise retaliates against you for filing a claim, you may have a separate cause of action for retaliatory discharge.

For statutory claims under the UDTPA (N.C.G.S. § 75-1.1), the statute of limitations is four years under § 75-16.2. For common law bad faith tort claims, the standard three-year statute of limitations applies. The underlying workers’ comp claim has a separate two-year filing deadline from the date of injury under § 97-24.

A regular workers’ comp dispute is a disagreement about benefits, compensability, or medical treatment handled through the Industrial Commission. A bad faith claim is a separate civil lawsuit alleging that the insurer’s conduct in handling your claim was unreasonable and violated NC bad faith laws. Bad faith claims can yield additional damages not available through the workers’ comp system, including treble damages.

Document the termination notice and the stated reason. Continue following your treating physician’s instructions. Do not sign any settlement documents under pressure. Contact a workers’ comp attorney immediately — you may be entitled to reinstatement of benefits through the Industrial Commission and additional damages through a bad faith claim if the termination was unreasonable.

Yes. These are two separate legal actions. The workers’ comp claim seeks benefits through the Industrial Commission. The bad faith claim is filed in Superior Court and seeks damages for the insurer’s misconduct. You can and should pursue both simultaneously to maximize your total recovery.

Our firm handles workers’ comp bad faith cases on a contingency fee basis. You pay nothing upfront and owe no fees unless we recover compensation. NC law also allows courts to award attorney’s fees in UDTPA cases (§ 75-16.1), so the insurer may ultimately pay your legal costs.