Speaking with Insurance Companies for a Montgomery County Workers’ Compensation Claim

When it comes to the insurance companies responsible for your workers’ compensation claim, it is never safe to assume that they are on your side. These companies exist to make a profit and they may go to great lengths to protect their financial interests. One way the insurer in your workers’ comp claim could work against you is by encouraging you to make a statement that could harm your claim. This could be anything from a contradictory statement to an admission that you overstated the severity or mechanism of your injuries.

Meeting or speaking with insurance companies during a Montgomery County workers’ compensation (WC) claim can be risky but at times necessary. To ensure your rights are protected, you could benefit from consulting with a skilled workers’ comp attorney.

When Communicating with the Insurer Might be Necessary

Speaking with the insurance company may be required in some cases. Claimants must comply to some degree with the insurance companies’ efforts to investigate the claim and refusing to deal with them entirely could lead to a denial.

Insurance companies often have a legitimate need for more details about how the injury happened, often so that they can determine if another party (a 3rd party) is responsible for causing the claimant’s injuries. If a 3rd party was responsible and negligent, the claimant has the right to pursue a lawsuit against the negligent 3rd party and, because it has the right to recover/subrogate its payments from any 3rd party settlement, the WC insurer wants to see that happen.

For example, if Driver X negligently ran a red light and crashed into claimant’s car while claimant was driving for work, claimant can sue Driver X for his injuries. This would be in addition to filing a WC claim against claimant’s own employer. When claimant settles his case against Driver X, the WC insurer has the right to subrogate its lien against the settlement and recover a large percentage of any money the WC insurer paid toward the claimant’s medical treatment and disability benefits. If the claimant does not pursue a lawsuit against Driver X on his own (with his own lawyer) within a specified period of time, the WC insurer can sue Driver X directly for subrogation.

When the insurance companies doubt the severity of a claim, they have the right to request an independent medical evaluation of your injuries. They are entitled to seek these evaluations, making it necessary to coordinate with them to schedule one.

It is also necessary to communicate with the insurance company to reach a negotiated settlement and to get countless individual services approved and benefits paid each week.  Small mistakes can result in delays or complete denials, so having a WC lawyer act on your behalf is incredibly beneficial.

The Risk of Speaking with the Insurance Company

Even if meeting or speaking with the insurance company is necessary, it is imperative to be careful. The insurance adjusters handling these cases are trained to trick the insured into making statements against their own interest.

Many of the questions an adjuster might ask are transparent. Any discussion of pre-existing injuries or prior compensation claims could provide information that is harmful to the claim. Other questions might not be as obvious. Some of the statements an insurance adjuster might try to elicit from an insured during a meeting could include:

  • Admissions regarding pre-existing conditions
  • Admissions regarding the severity of an injury
  • Determining if the worker is under financial strain
  • Contradicting statements

While a certain level of compliance is necessary, it is vital to avoid saying too much during a meeting with an adjuster. A local attorney could advise a worker on what to say to insurance companies during a workers’ compensation claim and serve as their direct advocate.

Let a Local Attorney Deal With Workers’ Comp Insurance Companies on Your Behalf

There are many benefits to seeking legal help after suffering an injury on the job. Your attorney could advise you on avoiding damaging statements that the insurance company could use against you.

A Montgomery County lawyer could handle all direct communication with the workers’ compensation insurance company and might reduce the risk of the adjuster tricking you or taking your words out of context. Contact an attorney to learn about your next steps.