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How to Avoid a Workers’ Compensation Insurance Adjustor’s Strategies

Posted in Workers Compensation on March 1, 2024

If you or a loved one sustains a workplace injury, you should be able to recover workers’ compensation benefits to help with medical expenses related to the injury as well as lost wage replacement and even long-term disability benefits. However, workers’ compensation insurance carriers may use various strategies to limit how much compensation they pay, even to the point of denying a claim. Here, we want to discuss some of these insurance carrier strategies and how to avoid them with your workers’ compensation claim in Arizona.

Be Wary of Early Settlement Offers

One of the first strategies insurance claims adjusters employ is to present an early settlement offer. While this might seem appealing at first, especially when facing medical expenses and lost income, these initial offers are typically significantly lower than what your claim is truly worth. Before considering any offer, consult with a workers’ compensation attorney in Phoenix who can help you assess the full extent of your injuries, future medical needs, and the total compensation you’re entitled to.

Do Not Underestimate the Importance of Medical Documentation

Insurance adjusters will scrutinize your medical records for any discrepancies or gaps in treatment to challenge the severity of your injuries. To counter this tactic, ensure you seek immediate medical attention after your injury and follow all prescribed treatment plans meticulously. Keep detailed, accurate records of any medical visits, treatments, and recommendations.

Accurate and comprehensive medical documentation is your strongest ally in proving the extent of your injuries and the necessity of your medical care.

Guard Your Words Carefully

Post-accident, you may receive a call from the insurance adjustor seeking a recorded statement. While they may claim this is to expedite your claim, the primary aim is to find inconsistencies or admissions that could be used to devalue your claim. Politely decline to give any recorded statement without legal representation. Remember, you are not obligated to provide one (no matter what the claims adjuster says), and it is in your best interest to consult with an attorney who can guide you on how to communicate effectively with the insurance company.

Understand Surveillance Tactics

Insurance companies sometimes resort to surveillance tactics to gather evidence that could question the legitimacy of your injury. This could include social media monitoring or even private investigators. To safeguard your claim, be cautious about what you post online and be aware of your surroundings. Consistency between your reported injuries and your actions is crucial. If your claim includes limited mobility, photos or videos of you engaging in physical activity could severely impact your claim.

The Role of Independent Medical Examinations (IME)

Insurance adjustors may request you undergo an independent medical examination (IME) by a doctor of their choosing. While labeled “independent,” the IME doctors often have ongoing relationships with insurance companies. This can affect their assessments. You have the right to question the necessity of an IME and should discuss this with your attorney. Additionally, consider requesting a copy of the IME report, as you have the right to review and contest any findings.

Seek Professional Legal Assistance

The complexities of workers’ compensation regulations and laws and the strategies employed by insurance adjustors highlight the importance of having an attorney by your side throughout this process. An experienced Arizona workers’ compensation attorney can navigate these challenges, advocate on your behalf, and ensure your rights are protected throughout the claim process. Legal representation can level the playing field, allowing you to focus on your recovery while your attorney handles negotiations and any potential disputes.