Workers’ Comp Delay Tactics Used By Insurance Adjusters
Are you injured on the job? You may need to file a Wisconsin workers’ compensation claim with your employer’s insurance company. Insurance adjusters serve their employer’s interests. Your needs and concerns are secondary.
If you need to file a workers’ comp claim, look for some of the insurance adjuster delay tactics highlighted below. In addition, Milwaukee workers’ comp lawyers Gillick, Wicht, Gillick & Graf know how to get the best settlement in these complex cases, so contact them if you have questions.
Insisting on a Recorded Statement
A classic insurance adjustor delay tactic is to demand a recorded statement from you. It sounds reasonable. But recording your version of events is never used to benefit you. The insurance company wants to record your story to use it against you.
For instance, you might be recovering from a slip-and-fall accident in the warehouse. You may take pain medication and have a fuzzy memory of what happened. Or, you may underestimate the severity of your injuries. If you fail to provide all necessary information in the recorded statement, it can hold up the claim.
Leaving out critical details could cause the insurance company to question your injury. You are not required by the law to give a recorded statement. Therefore, it is always best to refuse to give a recorded statement.
Wanting Information About Your Medical History
Many insurance companies use a pre-existing condition against you. A significant delay tactic is to continue asking for information about your medical history. It is not unreasonable to inquire about your previous medical conditions, but it can quickly turn into a delay tactic.
Occasionally, the insurance company will blame the victim. For example, the insurer may say that you failed to provide a document, so the case is delayed.
Attorneys see many workers’ comp cases where the injured worker provided everything required. Still, the insurance company argued they did not receive all the required information. That is why keeping copies of all records submitted to the insurance company is essential.
They Want More Information
A popular workers’ comp delay tactic is asking for more information about your injury and treatment. Before the claim is approved, the insurance company may continue to ask for more information. For example, they could ask for a doctor’s report one week, then a statement from your physical therapist two weeks later.
The truth is the insurance adjuster knows from the start what they need to process your claim. It is a delay tactic if they ask for additional information over several weeks. Talk to an attorney right away.
Sometimes the insurance company will not authorize every prescription you need to recover. For instance, they may approve your pain medication but delay the approval of your sleep medication. Even if the delay is only a few days, it is still a major hassle during your recovery.
Workers’ Comp Check Delays
If you were hurt at work, you probably are not working and need treatment. If the insurance company delays your workers’ comp checks, it can be a huge problem.
Not Authorizing Requests
Another stressful delay tactic is when the insurance company does not approve requests. Most physicians want the insurance company to pre-authorize a treatment before treating you. The doctor wants to ensure they will be paid for their services. The insurance company may take weeks to respond to your doctor’s request.
There is little doubt that insurance companies may try to delay your claim. However, delays in the claims process are not always the insurer’s fault. Sometimes, payments can be delayed because the employer fails to report the worksite injury on time. Common reasons for these delays are:
- Did not have the proper incident reporting procedures
- Handled the workers’ comp claim recklessly or negligently
- Did not submit the appropriate claim form
- Inadequate communication between managers
- Lost claim form
- Ignoring the workers’ comp claim
Companies are required under state law to give employees workers’ comp if they are hurt on the job. However, it is illegal if they intentionally impede your ability to submit a claim. The good news is an experienced workers’ comp attorney can help follow up on your claim. They will ensure the employer and insurance company are held to account if they fail to process a claim on time.
Wisconsin ‘Bad Faith’ Workers’ Comp Penalties
Delaying tactics are common with insurance companies. After all, they stay in business by paying as little in claims as possible. But Wisconsin laws penalize the insurer if they engage in ‘bad faith’ by unreasonably denying or delaying a claim.
Wisconsin law establishes two requirements to prove an insurance company’s bad faith:
- There was not a reasonable basis for denying the workers’ comp claim
- The insurance company was aware there was no reasonable basis for denying the claim
When the insurance company acts in bad faith, state law requires it to pay a fine of three times the amount due to the injured employee. This includes medical expenses and other benefits. Or, the insurer must pay $30,000 for each case of bad faith, whichever is less.
Wisconsin also has another penalty if the insurance company delays making a workers’ comp payment. The law establishes a 10% fine on unreasonably delayed workers’ comp payments. If you think your claim is being unfairly delayed or denied, talk to a Milwaukee workers’ comp attorney immediately.
Contact The Best Milwaukee Workers’ Comp Lawyers
What if you got hurt on the job? How would you pay your mortgage and car payments? Yes, you can file a workers’ comp claim without a lawyer. But many injured employees get far less compensation when they do not have an attorney. You will receive the best compensation with a Milwaukee workers’ comp lawyer in your corner.
Our Milwaukee workers’ comp lawyers proudly represent injured workers in Waukesha, Milwaukee, Appleton, Brookfield, Fon du Lac, Green Bay, Kenosha, Madison, Manitowoc, Menomonee Falls, New Berlin, Oshkosh, and Wisconsin Rapids. Contact Gillick, Wicht, Gillick & Graf today for a complimentary consultation: (414) 257-2667.