When an insurance company pays more benefits to a claimant than they are entitled to, they may try to obtain reimbursement of the overpayment from the claimant. However, the Workers Compensation Act does not allow the insurance company to seek reimbursement directly from the injured worker Hurst v. WCAB (Preston Trucking Co.), 823 A.2d 1052 (Pa Cmwlth. 2003); Murphy v. WCAB (Ames Dept. Store), 605 A.2d 1297 (Pa. Cmwlth. 1992).
There are only two permissible methods of seeking their money back:
- When the injured worker is continuing to receive benefits, the insurance company may request court permission to assert a credit against FUTURE benefits and pay a reduced amount to the claimant until the overpayment is absorbed. They may NOT do this on their own but must have court permission.
- Where the overpayment occurs due to a Court decision termination or suspending payment of benefits after those benefits have already been paid, the insurance company may seek reimbursement from the ‘supersedeas fund’.