If you get hurt while working, you have a right to receive benefits from your employer’s workers’ compensation insurance, regardless of fault. However, insurers often try to reduce the amount they pay on your claim by disputing the evidence regarding your case.
If this sounds familiar and you’re having trouble getting the workers’ comp benefits you deserve, reach out to one of our experienced work injury lawyers in Wilmington, Greensboro, or Charlotte to schedule a free consultation.
What’s an insurance adjuster?
Workers’ compensation insurance companies employ insurance adjusters to investigate injury and damage claims. The adjusters use collected evidence to calculate how much the insurer needs to pay for medical bills and other damages.
Can you be fired after a job injury in NC?
In North Carolina, you shouldn’t have to wonder or worry about your employment status after reporting a work injury or illness. Employees are given specific protections under the law that should help you keep your job.
What do insurance adjusters do?
To assess your workers’ comp claims, insurance adjusters may take the following steps:
- Interview you and your employer
- Review documentation and medical records
- Talk to coworkers who witnessed the accident
They then use the evidence they collect to assemble a value for your claim and determine the amount of compensation you’ll receive.
What insurance adjuster tricks are used to reduce injured workers’ claims?
Insurance adjusters may act friendly and supportive, but they’re not on your side. The following tactics are the most common ways they try to reduce or invalidate your claim, and you may need an attorney’s help to fight back.
1. Pressuring you to settle quickly
An insurance adjuster is tasked with minimizing the amount of your claim so the insurance company can pay less. They may pressure or bully you into settling right away, telling you that this is their best offer.
This tactic is a red flag that you need an attorney to help you understand the total amount of compensation you deserve before settling.
2. Asking you to sign a broad medical release
The insurance company may need to review your medical records for the existing claim, but they often try to get you to sign a broader release allowing access to all of your medical records. If you agree to this, the adjuster can go back through your medical history before the incident and try to claim that you had a preexisting injury to invalidate your claim.
3. Refusing to approve physician referrals
If your doctor refers you to a specialist, the insurer may delay approving the referral in an attempt to avoid the extra costs associated with a specialist. In addition to creating a frustrating situation, this tactic also prevents or delays you from getting the medical treatment you need.
4. Finding reasons to delay approving your claim
An insurance adjuster wants to slow your claim processing in hopes that you will run out of money or become impatient and accept a lower settlement. The adjuster will be even happier if you give up on pursuing the claim and go back to work due to the financial pressure of your lost wages and outstanding medical bills.
Adjusters may ignore your phone calls and emails, tell you they didn’t receive documents, and use a variety of other stall tactics.
5. Placing you under surveillance
Insurers will try pretty much anything to cut their costs when paying your claim, and workers’ comp adjuster tricks include some extreme measures. Some will even hire a private investigator to follow you and take pictures to document your activities. The insurer will then use the photos as evidence to create doubt about the severity of your injuries.
Be especially careful of your social media posts after your injury. An innocent photo of you pushing your child at the park or taking your dog for a walk could be used against you.
Don’t suffer at the hands of a bully employer or tricky insurance adjuster
Regardless of what your employer or the insurance adjuster tells you, remember that you are legally entitled to file a workers’ compensation claim. Some employers will even threaten to terminate you if you file a claim. Fortunately, the law protects you from retaliatory termination, so don’t allow yourself to be intimidated.
Contact an experienced workers’ compensation attorney
Workers’ compensation claims can become complex and overwhelming. An experienced attorney will help you understand all the benefits you’re entitled to and how to get them. If your claim is stalled, denied, or cut short without warning, you need to speak to an attorney as soon as possible.
Don’t walk away from the money you deserve. In some cases, if you were pressured into a settlement and your condition later worsens, you may be able to reopen your workers’ comp claim to get additional benefits. You need a legal advocate that will advocate for your rights, and the sooner you involve an attorney in your case, the more likely you are to have a successful outcome.
What to expect after hiring a work injury attorney?
A detailed overview of the workers’ compensation claims appeals process in North Carolina—from calling an attorney to taking your claim to court.
At Wilder Pantazis Law Group, our experienced workers’ comp attorneys are committed to helping workers in North and South Carolina recover maximum compensation for their injuries. We offer free initial consultations, and we work on contingency—so you won’t pay a fee unless we win your case.