What You Need to Know About Insurance Adjusters (Part 2)

Our office has handled hundreds (if not thousands) of cases during this time. By representing hundreds and hundreds of work accident victims over the years, we began to see how the insurance industry deals with victims after they begin the claim process following the work accident.

• We have found that most insurance adjusters are highly trained adversaries. Most people do not realize this, at least not at the beginning of the workers compensation claims process. Most people understand that the insurance company’s job is to make money. One way it does this is by settling claims for less than the claim is worth. Yet, most people are unaware of how sophisticated, yet simple, the methods the carrier will utilize to help accomplish this goal.

Questions you MUST ask the insurance carrier:

Now, the carriers don’t like it when you ask these questions because they either cannot answer the question, or worse, they don’t want you to have the answer.

QUESTION 4: If I give you a recorded statement, can I then get a recorded statement from your own insured, i.e., your employer, supervisor, or co-workers?

Answer: No! This will never happen. It seems fair though, doesn’t it? If you have to give a recorded statement about the accident, then why can’t you also get a statement from the other individuals involved? Yet, the insurance adjuster will never allow this for the same reasons you should never give a recorded statement to the insurance company.

QUESTION 5: Why do I have to give you unrestricted medical authorization before I can get any medical treatment?

Answer: So the adjuster can go fishing into your past medical history and find anything about your prior health which will help the company either deny your claim or payout as little as possible. You can just as easily collect your accident-related records and send them to the carrier for its review. But usually, if you are not represented by counsel, the carrier will never accept this. By using a Virginia Workers Compensation attorney, the attorney can usually put a few limits on how much medical information needs to be disclosed. There is no doctor/patient privilege in a workers’ compensation case, so they can get any medical records but an attorney can help steer them in the right direction.

QUESTION 6: Shouldn’t I wait until my medical status is stabilized to settle the claim?

Answer: Yes, because the insurance company knows that the quicker you settle the claim the less money it will have to payout. Once you settle the claim you can’t reopen the case if it turns out your injuries are more severe or if you need more treatment as recommended by your doctor.

QUESTION 7: Why haven’t you told me about mileage reimbursement, COLA (cost of living adjustments), or other benefits?

Answer: Probably because they don’t have to. The injured workers have the burden to prove their case. The insurance company can sit back and do nothing. They probably have a don’t ask, don’t tell policy to save their company money. If you do not independently find out about your benefits, the insurance adjuster will not tell you.

Check out Part 1 and Part 3 for more tips to shed some light on the misinformation adjusters give to injured workers. It could mean the difference as to whether or not you are awarded benefits for your work injury!