The insurance adjustor will take care of me.
They are not a good neighbor, you are not in good hands, and they are definitely not your friend. You are actually at war and at a fairly sophisticated war. The insurance adjuster is experienced and knows all the workers’ compensation laws. His or her job is to save the insurance company money. Many get bonuses and recognition for saving their company money. The only way to save money is to deny claims and to pay the least amount possible. That’s why they will get a nurse case manager to try to force the doctor to get you to return to work. That is why they hire private investigators to try to find any appearance that you may not be following your doctor’s orders. The worst thing that they do, in my opinion, is deliberate delay. They like to delay, delay, deny, delay, delay, deny. This is their normal routine. They will delay making payments, they will delay medical treatment, they will deny that you’re eligible for the MRI or some other test, then they will delay setting up your doctors’ appointments, and then they will deny medical treatment by setting up a second opinion. If they do this systematically with every case, they literally save billions of dollars. If they delay paying out $1 million dollars for 30 days across the board with all the injured claimants that they have, they save $50,000 for one month of delays and denials in interest alone. One of the more egregious types of delay is denying claims frivolously while knowing that an injured worker is under a financial crunch, in order to try to get him or her to settle a claim for pennies on the dollar due to his or her financial situation. This forces the injured worker to choose between whether he should wait for approval to get medical treatment he needs or settle his claim in order just not to have his house foreclosed upon. Just remember: If there is any gray area in a case, the insurance company will deny your claim. That’s why it’s very important to be very clear and avoid appearances that could harm your case.