Settlement may occur prior to OR following SITF acceptance of a claim. In the case where a claim is settled prior to SITF acceptance, SITF does not consider itself a party to the agreement and is not subject to its provisions.
When settlement negotiations are initiated during the evaluation process, SITF must be notified by the employer/insurer of any and all settlement demands. The employer/insurer must submit a Settlement Authority Request in writing. The settlement authority request must include a full evaluation of the claim, including a determination of future expenses and totals paid for the medical and indemnity expenses at that time. The SITF also requires that the employer/insurer consider a Medicare Set-Aside provision. After its review, the fund will render a decision regarding the acceptability of the settlement.
If a settlement mediation conference is imminent, the fund must have complete information at least 21 days prior to the mediation date. This courtesy will allow the fund to make an informed assessment of the settlement request.
Considering that employers/insurers may be reimbursed for all weekly income benefits payable after 104 weeks, for 50% of all medical and rehabilitation expenses between $5,000 and $10,000, and for 100% of all medical and rehabilitation expenses in excess of $10,000, a large portion of a settlement agreement may be covered by the Subsequent Injury Trust Fund rather than out of the pockets of the employer/insured.