Workers’ comp insurance is intended to act as a financial safety net for employees who become injured at work. It typically pays weekly benefits to cover medical bills and sustain employees financially while they recover at home.
Unfortunately, attorneys dealing with workers’ compensation cases have witnessed numerous dirty tricks insurance carriers use to minimize the money they pay for claims.
What is an insurance claims adjuster?
A claims adjuster, or insurance adjuster, is hired by the insurance company to investigate a claim and determine whether the insurer needs to pay for damages. The insurance company can keep adjusters on its payroll or hire them from an outside contractor agency.
What does an insurance adjuster do?
An insurance adjuster performs multiple steps when assessing a claim, including:
- Reviewing the accident details
- Assessing the damage
- Looking at medical records
- Speaking to the injured party and witnesses
They then determine the amount of money for which the insurance company is potentially liable.
If you’re injured and file a claim, the insurance adjuster may employ tricks to limit the amount of money the insurer has to pay you.
Sneaky Tactics by Insurance Companies to Deny Workers’
Comp Claims
Be on the lookout for these signs of bad faith with your employer’s workers’ compensation insurance company.
What tactics do insurance adjusters use against injured workers to reduce their claims?
You need to be aware of the dirty tricks adjusters use to take advantage of you. Here are just some of the ways adjusters try to cheat you out of the insurance settlement you need and deserve.
1. Avoid your calls and emails to trigger your frustration
Understandably, after an injury, you want to get your questions answered, complete your insurance claim and receive compensation as soon as possible. Adjusters may be very difficult to get on the phone and may not reply to emails either.
While adjusters work on multiple cases at once, their lack of responsive communication can be a strategy to increase your frustration. They hope you will give up if they don’t respond immediately. After waiting you out, they will try to make a lowball offer in hopes that you’ll accept any amount just to be done with the process.
2. Try to record you
A dirty trick some adjusters use is to tell you they need to record your statement. Since you’ve been telling the truth, you think nothing of it. However, adjusters have many sneaky ways to take your words out of context and hurt your settlement with a recorded statement.
You might say, “I’m fine,” out of habit when the adjuster asks, “How are you feeling this morning?” They will use your response to make your injuries seem much less serious than they are in reality. Small mistakes or nuances in how you phrase your answer can cost you a lot of money on your claim.
Please be aware that you don’t have to consent to the recording. If an adjuster tries to bully you by insisting on a recording, you should consult a Phoenix injury attorney, who can advise you on what to say (and not say) to the adjuster.
Workers’ Comp Insurance Surveillance Tactics
Being followed or having an investigator talk to your family members feels like an invasion of privacy, and it often is. There are lines that an investigator shouldn’t cross, and you should never be harassed or made to feel unsafe.
3. Delay payment of your claim
Workers’ comp insurance adjusters know you’re burdened financially due to an accident, and they might try to use this against you by delaying any payments on your claim. While recovering from your injuries, you may have racked up a long list of other expenses. Your medical costs alone can break the bank, especially in serious accidents.
Adjusters can dangle a much smaller settlement in front of you because they know you’re financially strapped. The offer will be a small fraction of what you need and deserve.
Don’t accept a lowball amount because, in some cases, you can double the amount an adjuster offers if you hold out and don’t settle while under pressure.
Wrongful (Unlawful) Termination Due to a Work Injury in Arizona
It’s important to understand exactly how employment law in Arizona gives certain rights and protections to injured workers who file a workers’ compensation claim.
4. Attempt to use your medical records against you
It’s important to understand that an adjuster is entitled to the medical records from the applicant, but typically the providers do not honor that statutory requirement unless there’s a medical release.
Adjusters might try to trick you into signing a blanket authorization, which allows them to go back through years of your medical history, looking for pre-existing injuries and other reasons to disqualify you from receiving benefits.
Never sign anything for an insurance adjuster or allow them to review your medical records without speaking with an attorney first.
5. Purposely not advise you of your legal rights
One of the dirtier tricks adjusters play to reduce insurance payouts is to avoid informing people of their legal rights. Remember that adjusters protect the insurance company that pays their wages and are not concerned about you or your situation.
They might avoid letting you know that your mileage to and from doctor appointments is covered under workers’ comp benefits or that relatives helping you out may be eligible to receive compensation for attendant care. They might also “forget” to tell you that modifications to your home or vehicle are also covered.
Workers’ Compensation Claim Denied?
A denial of your workers’ compensation claim could result in you paying out-of-pocket for medical expenses, lost wages or other issues related to your injury.
You need an attorney to help you fight back against insurance adjuster trickery
The best move you can make after any work injury is to speak with an attorney about your workers’ comp case.
At the Law Offices of Robert E. Wisniewski, our experienced workers’ comp lawyers have been witness to every insurance adjuster trick that exists, so we can help increase your chances of having a successful claim.
Our office specializes in workers’ comp cases and is proud to have been helping injured Arizona workers recover the compensation they deserve for more than 40 years.
