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Watch Out for These Workers’ Comp Insurance Company Tricks

Posted On Behalf of Schmidt Kramer Injury Lawyers on Jun 20, 2013 in Workers' Compensation

When you suffer a workplace injury in Pennsylvania, your employer is required to pay your medical bills and give you a portion of your regular wages while you’re unable to work. In most cases, your employer will have purchased a workers’ compensation insurance policy for this purpose. Your boss pays a regular premium to the insurance company. Then, whenever an employee files a valid workers’ compensation claim, the insurance company pays the benefits.

On the face of it, it’s simple. The reality is much more complicated.

The bad gear in this machine is the insurance company. Insurance companies make money by collecting premiums, not by paying out benefits. That means the insurance company has every incentive not to give you the full benefits you deserve. Your workers’ compensation insurance case manager may resort to sneakiness, trickery, and deception to get you to forfeit your rights. Every dollar he saves for the company may fatten his bonus at the end of the year.

Don’t leave yourself vulnerable to these dirty tricks

Now, we’ve met a number of workers’ compensation insurance adjusters off-duty, and mostly, they are pleasant, professional men and women who don’t think of themselves as engaged in trickery. They call it “taking reasonable precautions to protect the company’s interests.” Regardless of the name, it’s an attempt to deny benefits—or to cut off benefits early—for someone who would otherwise be getting income and medical coverage.

We tell our clients to watch out for these tactics in particular:

  • Recording your statements. The insurance adjuster may call you or visit you in the hospital, perhaps just a few days after your accident when you are woozy from powerful painkillers. He will ask for permission to record what you say. Any statement you make can be taken out of context later to deny your claim. You might say something that can be interpreted as minimizing your pain, or suggesting that you were hurt other than during work hours, or even that you do not know the precise cause of the accident. Any such statement can be used later as evidence to suggest you trying to commit fraud. Never agree to a recorded statement.
  • Spying on you. Some insurance adjusters may hire private investigators to secretly record video of you at home or in a public place. They hope to capture pictures showing you engaged in physical activity that exceeds your claimed disability or work restrictions. You must be very cautious about what you do in public, to avoid giving the false impression that you’re faking your injury.
  • Looking at your social media postings. Your Facebook discussion about a recent family picnic or your Tumblr postings about going bowling with your grandchildren can be used as evidence that your injuries aren’t getting in the way of your daily life. The insurance adjuster will imply you have reached your maximum medical improvement and that you’re ready to return to work.
  • Talking to your family and neighbors—especially those who don’t like you much. Do you have an ex-spouse with a grudge? A neighbor with whom you’ve been having a property dispute? You can be sure your workers’ comp case manager will make it a priority to call on these people. All the adjuster needs is an affidavit (true or not) from one of these “witnesses” that your back injury actually happened years ago or that you have been much more active at home than you claim, in order to terminate your Pennsylvania workers’ compensation benefits.

Your protection against deception

Even if you follow the rules in filing your workers’ compensation claim, you may find your benefits blocked by an insurance company more interested in its profits than in your wellbeing. Where will you turn then?

Turn to us. Our Harrisburg workers’ compensation lawyers regularly work with people who have been hurt at work in Carlisle, York, Lancaster, Lebanon, and other nearby towns. We know the insurance companies and can warn clients about their tricks and sharp dealings.

If you have been injured in a Pennsylvania workplace accident, give us a call at 717-888-8888 (or 888-476-0807 toll-free, from anywhere in the Commonwealth) to schedule a free, confidential case review. When you call, request a copy of our client book, Who Pays The Bills When You Are Injured At Work?, and we’ll send it to you FREE just for asking.