Workers comp insurance companies are notorious for using a variety of tactics to reduce your benefits or deny your claim. After 17 years as a worker’s compensation lawyer, I’ve seen these tricks time and again. Every injured worker should know these pitfalls and how to protect themselves. Here are the top ten dirty tricks insurance companies use, plus my best tips for defending your claim.
When you first get injured, you're vulnerable. You don’t know how long you'll be out of work, how much medical treatment you’ll need, or what your case is worth. Insurance companies exploit this by offering you money early on. It might seem like a good deal, but it’s often far less than what you’ll need. Remember, the insurance company is not on your side. Before accepting any offer, get legal advice to ensure you're getting fair compensation.
Insurance adjusters or investigators might ask for a recorded statement to "avoid misunderstandings." In reality, they’re hoping you’ll say something that can be used against you later. Your statements can be twisted to question your credibility and reduce your benefits. Never give a statement without consulting a lawyer first. Simply direct any inquiries to your lawyer.
Insurance companies may "miscalculate" your average weekly wage to reduce your benefits. For example, they might only consider part of your salary if you're paid by multiple entities. Always review your wage calculations carefully. Compare them against your pay stubs and tax returns. If something doesn’t add up, challenge it with evidence.
Surveillance is a common tactic. Insurance companies might hire investigators to watch you and catch you doing activities that contradict your claimed injuries. Be cautious and aware that you might be under surveillance. If you suspect you’re being watched, consult your lawyer immediately.
Insurance companies will magnify any inconsistency in your statements. If you contradict yourself, even on minor details, they’ll use it to attack your credibility. Always be honest and consistent. Think carefully before you answer questions, especially about preexisting conditions.
One of the most damaging tricks is blaming your injury on preexisting conditions. They might argue that only part of your injury is due to your current accident or claim a previous insurer is responsible. Always disclose your preexisting conditions truthfully. Ensure your medical records clearly show how your current injury is work-related.
Insurance companies delay cases hoping you’ll give up. They know injured workers often need money urgently. If you don’t have a lawyer, they might ignore your requests for treatment, hoping you’ll use your private health insurance instead. Be persistent and document all communications. Hiring a lawyer can also expedite the process.
You might receive a letter saying you’re cleared for light duty work based on the insurance company’s doctor. However, you only need to follow your own doctor’s advice. Always consult your doctor before agreeing to return to work under any restrictions.
Insurance companies will try to catch you in a contradiction. They might ask trick questions in court or on forms. Answer questions slowly and carefully, only providing the necessary information. Avoid discussing your case with anyone other than your lawyer.
Near the end of your case, you might face pressure to settle. They’ll threaten appeals or claim their offer is final. Don’t let them rush you into a decision. Consult your lawyer to ensure any settlement is fair and considers all your future needs.
Remember, the insurance company’s goal is to minimize their payout. Knowing their tactics and how to counter them is essential in getting the compensation you deserve. For more information on how insurance companies spy on you and how to protect yourself, check out my other video on surveillance. Stay informed and protect your rights!