Florida’s 120-Day Pay-and-Investigate Rule: What Happens If a Carrier Waits Too Long to Deny Your Claim

A worker hurt on the job usually wants two answers fast: will the paychecks and medical care keep coming, and has the insurance carrier accepted the claim? Florida law lets a carrier begin paying before it has made up its mind, and it puts a clock on that decision. For anyone in Fort Lauderdale or elsewhere in Florida who sees a workers’ comp claim denied after 120 days, the timing of that denial can matter a great deal.

Step One: the First Payment or a Denial

Under section 440.20(2)(a), Florida Statutes, a carrier must pay the first installment of compensation for total disability or death benefits, or deny compensability, no later than the 14th calendar day after the employer receives notification of the injury, when disability is immediate and continuous for 8 calendar days or more.

Step Two: Paying While Investigating

A carrier that is unsure of its obligation does not get to wait in silence. Section 440.20(4) directs it to begin investigating immediately and in good faith, and to start paying and keep paying all benefits as if the claim had been accepted, without prejudice and without admitting liability. The carrier must also give the worker written notice that it has chosen to pay pending further investigation and that it will report acceptance or denial within 120 days.

Step Three: the 120-day Window

The 120 days run from the initial provision of compensation or benefits, meaning the first installment or first benefit provided, not from the date of the accident. The same concept appears when a worker files a petition for benefits. Under section 440.192(8), the carrier has 14 days after receiving the petition to pay the requested benefits without prejudice to its right to deny within 120 days, or to file a response with the Office of the Judges of Compensation Claims.

Step Four: When the Clock Runs Out

The statute says a carrier that fails to deny compensability within 120 days waives the right to deny it. There is one exception: the carrier can establish material facts relevant to compensability that it could not have discovered through reasonable investigation within the 120-day period. Section 440.192(8) adds that a carrier that does not deny in accordance with section 440.20(4) is deemed to have accepted the injuries as compensable, subject to the same exception.

A timely denial does not end the story. The worker can file a petition for benefits, and the dispute then moves toward mediation and, if needed, a final hearing before a judge of compensation claims.

Where This Stretch Leads

By the end of the 120 days, a claim is generally in one of two places: accepted as compensable, with benefits continuing, or denied on time and headed into the petition process. Clear, consistent records of dates, payments, and medical visits help a claim move smoothly down either path.

Contact Our Workers’ Compensation Lawyers Today

Questions about a pay-and-investigate letter or a denial are common, and our Fort Lauderdale workers’ compensation claims lawyers can explain how these timelines apply to a particular situation. We welcome injured workers across Broward, Miami-Dade, and Palm Beach Counties to contact the Law Offices of David M. Benenfeld, P.A. at our offices in Sunrise, Fort Lauderdale, and West Palm Beach.

Sources:

leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499/0440/Sections/0440.20.html

flsenate.gov/Laws/Statutes/2026/440.192