If you’ve been injured on the job, a workers’ compensation claim can help you with medical bills, lost wages and more. However, insurance adjusters don’t always play fair when it comes to making settlement offers. In fact, certain workers’ comp adjuster tricks can be used to devalue or outright deny your insurance claim.
What is an insurance adjuster?
An insurance adjuster is someone who looks at claims and determines if the insurance company should pay them.
For example, when you file a worker’s compensation claim, you’re telling the insurance company, “I suffered these damages, and I deserve this amount of compensation for it.”
An insurance adjuster is the person who reviews the claim, determines its legitimacy, and either denies it or makes you an offer.
What does an insurance adjuster do?
Insurance adjusters can have many different duties, but speaking very generally, they’re investigators. Their responsibilities might include everything from reading police reports to conducting interviews or inspections with persons of interest. In a worker’s compensation case, they also might be responsible for:
- Interviewing you
- Talking to witnesses and your employer
- Calculating damages based on things like wage loss and medical expenses
Insurance adjusters aren’t on your side. They’re employed by the insurance company, and insurance companies are all about minimizing loss and quickly processing claims. This can result in the following:
- Reduced benefits
- Lowball monetary offers
Top insurance adjuster tricks
To receive fair compensation as an injured worker filing for worker’s comp, you’ll need to fight back against their usual tactics for reducing claims. Here are just a few of the most common insurance adjuster tricks to avoid big payouts.
Learn about unjust practices when filing a claim in Montana. Personal injury plaintiffs (injured in a car accident, slip-and-fall accident, product liability accident at work, etc.) have to deal with insurance companies that may try to trick them.
Asking for a recorded statement
This is a common tactic by insurance adjusters who are trying to trap you with your own words. You might misremember the details of your accident, underestimate your injuries, admit personal fault, or do other things to accidentally devalue your claim.
Making a hasty offer
Insurance adjusters will sometimes make a swift settlement offer in the hopes that you’ll grab it quickly and gratefully. However, these tend to be low offers, and the insurance company is banking on the fact that you’ll be so relieved by the fast payout that you won’t even ask yourself if it’s a fair amount.
They’re also hoping that you won’t get the settlement offer reviewed by a lawyer before you accept.
Delaying your offer
The opposite of the above scenario is when an insurance company drags its feet about offering you a settlement. This is done in the hopes of “drying you out” or “starving you out.”
If you’re facing lost wages, mounting medical bills and other inconveniences, you’ll be more likely to accept a low settlement when it finally comes because it’s better than nothing.
Demanding control over your physicians
There are many ways that insurance adjusters can try to circumvent your medical care, including denying referrals that your doctor has made to specialists. They may do this because they’re trying to avoid costly specialists, but this tactic can ultimately delay your treatment and prevent you from recovering from your injuries.
Making an offer of light duty
If you’ve been cleared by your doctor for light-duty work, an insurance adjuster can try to force you to take it. Keep in mind that they’re allowed to deny your claim if you refuse.
However, light-duty work can come with many complications, including reduced or temporary hours, lack of accommodations for your injury, or bosses pressuring you back into full duties before you’re ready. All of these things can impact your insurance claim.
Murphy Law Firm recently prevailed in a week-long trial in Montana’s Workers’ Compensation Court involving nurse case manager Candi Krezelak.
How an attorney can help combat insurance adjuster tactics
These are just a few ways that insurance adjusters can try to deny and devalue your claim. To receive fair compensation after being injured on the job, it’s essential that you reach out to a worker’s compensation lawyer with the skills and experience that you need to get the money that you deserve.
An attorney can help by:
- Communicating with the insurance adjuster so you’re not tricked into saying something that could devalue your claim
- Advising you about how much your claim should be worth so you don’t accept an unfair offer
- Filing all paperwork to ensure your claim is processed in a timely manner
- Ensuring any demands made by the insurer and your employer are fair and legal
Contact an experienced Montana workers’ comp attorney to help with your claim
If you get injured on the job, you have the right to compensation, but that doesn’t prevent an insurance adjuster from trying to deny or reduce your compensation. That’s why it’s always best to consult an experienced workers’ comp attorney to ensure your rights are protected.