In the United States, there are more than 130 million workers. Of these workers, about 60 million are covered by workers’ compensation insurance. This insurance is designed to help injured workers with financial assistance. However, not all workers’ compensation claims are paid out. Insurance companies use several strategies to avoid paying workers’ compensation claims. Here are the top 5 tricks that insurers use to avoid paying Workers’ Comp Payouts.
Number One: Deny, Delay, and Hope You Go Away
One of the most common tricks insurers use to avoid paying out on workers’ compensation claims is to deny that the injury is work-related. If they can’t get away with that, they’ll try to delay payments as long as possible, hoping the claimant will give up and go away.
So how does that work? Insurers will use any excuse to deny a claim. They might say that the injury wasn’t severe enough to qualify for benefits or wasn’t reported promptly.
If they can’t find a way to deny the claim outright, they’ll try to delay workers’ com payouts by requesting more and more documentation. They might drag out the investigation process or stall on making a decision. The bottom line is that insurers are motivated to avoid paying out on claims and will use any tactic they can to achieve that goal.
Number Two: Physical Examination From Hell
Another standard trick insurers use is to require the injured worker to undergo an “independent medical examination” (IME). Doctors who the insurance company hires conduct these exams, designed to give the insurer an excuse to deny or reduce the claim.
IMEs can be incredibly stressful and invasive experiences. The doctor will ask the claimant detailed questions about their injury and will often perform a physical examination. This examination can be harrowing, and claimants do not often feel like they’re being interrogated.
Number Three: Surveillance
If insurance company suspects a claimant exaggerates their injuries, it will often hire a private investigator to conduct surveillance. The investigator will follow the claimant and take photos or videos of them engaging in activities the company believes they shouldn’t be unable to do.
For example, if a claimant says they can’t lift heavy objects, the investigator might take pictures of them raising a heavy object. This tactic is designed to intimidate claimants and make them second-guess their claims.
Number Four: Intimidation
Insurance companies will often use intimidation tactics to discourage claimants from filing a claim or to get them to drop an existing lawsuit. They might call the claimant repeatedly, or they might show up at their home or place of work. They might also threaten to sue the claimant or garnish their wages. Some common ways to do so are:
- Making repeated phone calls
- Showing up at the claimant’s home or place of work
- Threatening to sue the claimant
- Threatening to garnish the claimant’s wages
Number Five: Cut You Off
One of the most common ways insurance companies avoid paying out on workers’ compensation claims is to stop paying the benefits. This tactic is known as “rescission,” designed to force the claimant to give up and drop their claim.
If the claimant doesn’t have another source of income, they might be forced to take a job that doesn’t pay as much, or they might be forced to go on government assistance. Either way, the insurance company wins by avoiding giving out the workers’ comp payouts.
All in all, insurance companies have a variety of tricks they use to avoid paying out on workers’ compensation claims. These tactics can be very stressful and overwhelming for claimants, and they often succeed in getting claimants to give up on their claims.
If you’ve been injured at work, it’s essential to seek out the help of an experienced workers’ compensation attorney. An attorney can help you navigate the workers’ compensation system and fight for the benefits you deserve.
While there are many tricks that insurers use to avoid paying workers’ compensation benefits, the five listed in this article are among the most common. If you have been injured at work and are having trouble getting the benefits you need, contact us at San Gabriel Valley Workers’ Compensation Attorney ((626) 602-9483). We can help you get the compensation you deserve.