Effective Accident Claim

Effective Accident Claim

How insurance companies deny workers’ compensation claims

On Behalf of | Mar 27, 2024 | Blog, Workers' Compensation |

When you suffer an injury on the job, you expect the insurance company to handle your workers’ compensation claim fairly and efficiently. However, insurance companies often employ various tactics to deny or minimize payouts.

You should understand the most common ways that insurers attempt to avoid paying workers’ compensation benefits before you file your claim.

Questioning the severity of your injury

One of the most frequent strategies used by insurance companies is to downplay the severity of your injury. They may argue that your condition is not as serious as you claim or that it is a pre-existing condition unrelated to your work. Seek medical attention immediately after the incident and maintain detailed records of your treatment and progress to help combat this.

Disputing the cause of your injury

Insurance companies may also try to deny your claim by asserting that your injury did not occur at work or that it resulted from factors outside of your job duties. They might suggest that you engaged in horseplay or that your injury happened during your commute. To protect yourself, report the incident to your employer promptly and gather evidence, such as witness statements and accident reports.

Challenging your employment status

In some cases, insurers may question your employment status to avoid paying benefits. They might claim that you were an independent contractor or that you were not officially on the clock when the injury occurred. Keeping thorough records of your work hours, pay stubs and any contracts or agreements can help establish your employment status and eligibility for benefits.

Pressuring you to return to work prematurely

Insurance companies may pressure you to return to work before you have fully recovered from your injury. They might offer you light duty or a modified position, even if you are not physically ready. It is essential to prioritize your health and follow your doctor’s recommendations regarding your recovery timeline and work restrictions.

By understanding these common strategies and taking proactive steps to protect your rights, you can improve your chances of receiving the benefits you deserve.