How Insurance Companies Fatten Their Profit Margins by Deceiving You about Pennsylvania Workers’ Compensation
Insurance adjusters aren’t always under a legal obligation to tell you the truth.
If you have been hurt on the job in Dauphin County or one of the surrounding communities, your Pennsylvania workers’ compensation benefits are almost certainly going to be administered by an insurance company selected by your employer. Your bosses pay the insurer a quarterly premium to provide coverage for any workplace injuries. That makes it seem as if you, your employer, and the insurance company are all working on the same team.
That’s not really true, unfortunately, because the insurance company has its own set of priorities and interests. Insurance companies make money by collecting premiums (and investing them). Paying out benefits hurts their profits, so insurers aren’t in any particular hurry to pay out the full value of claims. They assume every claimant is potentially trying to commit fraud. And they sometimes resort to trickery and deception to deny claims, to coerce people into backing off their claims, or to terminate benefits early.
Classic cases of deceit and misdirection
There are three things that everyone seeking workers’ compensation coverage in Harrisburg needs:
- Competent medical care for both acute needs and long-term recovery
- Income to maintain one’s household and family during an extended period of disability
- Physical and occupational therapy to enable a return to work
The trouble is that all of these components are very expensive. Remember, insurance company representatives are trained to believe that almost all claimants are exaggerating their injuries. That gives them an extra incentive to use any means at hand to cut off benefits as early as possible. Yes, they will sometimes go as far as lying.
Some of the examples of deception and sharp practice we have seen:
- Telling a comp recipient he must go to a doctor from the insurance company’s list of approved physicians—with the knowledge that all the doctors on the list will be hostile to patient claims.
- Dismissing a report from a beneficiary’s own doctor as biased or unreliable.
- Disputing that the symptoms are not consistent with the diagnosis.
- Asserting that a workplace injury was really a problem the person had before she was employed, rather than an injury acquired at work.
- Asserting that, even though the injury happened when the employee was present at the workplace, it was not while the employee was engaged in work duties (for instance, during a work break or lunch hour).
- Claiming a beneficiary is ready to go back to work—when he really isn’t.
- Claiming a beneficiary has reached his maximum possible recovery and needs no more assistance.
- Saying that the employee was in danger of being fired or demoted, and faked an injury to get free money from his employer.
- Saying that the employee is not covered by workers’ compensation because the injury was his own fault.
Usually, when the claims representative from the insurance company talks to you, he will make a few veiled threats. He will say that filing false claims is a criminal offense that can be punished by huge fines and extended jail time. This is all an attempt to get you to back away from your legitimate workers’ compensation claim. You will be pressed to sign a release saying you will take only a tiny amount of money (or maybe no money at all) for your claim, and in exchange, the insurance company will not report you to law enforcement.
You need an ally alert to all insurance company tricks
If the insurance representative convinces you to withdraw your claim, the game is over—and you have lost.
We will send you a FREE copy of Who Pays The Bills When You Are Injured At Work? our client manual.
At any time, you can make an appointment for a free consultation with one of our Pennsylvania workplace accident attorneys. We’re familiar with the tricks the workers’ comp insurance companies use, and we won’t let you be victimized.
Protect your rights to a fair recovery, and call us today.
Before you sign away your rights, call Schmidt Kramer at 717-888-8888 or 888-476-0807 toll-free to talk to an experienced Harrisburg workers’ compensation lawyer.