Workers’ Comp Adjuster Tricks to Avoid
When you deal with an insurance company, the face of that company will be an insurance claims adjuster. Their job is to evaluate your claim to determine how much it is worth. However, it’s important to remember that the adjuster will be loyal to the company before they are to your needs.
Insurance adjusters have many ways to keep your worker’s compensation claim as low as possible without breaking the law. Knowing this, it may be a good idea to have an experienced workers’ compensation lawyer on your side when you are negotiating your workers’ comp settlement.
Have you been injured at work? Do you need help ensuring that your workers’ compensation settlement covers all your needs, now and in the future? Our highly experienced workers’ comp lawyers at the Matt Fendon Law Group can ensure that your employer’s insurance adjuster treats you fairly.
Call us today at (800) 229-3880 to talk with one of our workers’ comp claim specialists in a free consultation at one of our conveniently located offices in Phoenix, Scottsdale, Tucson, Flagstaff, and Prescott.
What Does a Workers Compensation Claims Adjuster Do?
An insurance adjuster is part investigator and part adjudicator. The adjuster will gather information about your injury or work-related medical condition, make a decision whether to approve your claim, compensate you for your medical bills, and help coordinate your health treatment plan.
What Are Some Insurance Adjuster Tactics To Beware Of?
It is important to remember that although insurance adjusters work for and are primarily loyal to the insurer, they are not inherently going to treat you unfairly.
Ultimately, the adjuster’s mission is to resolve your workers’ compensation claim as economically as possible for the insurance company, even if that means you don’t get everything you could in a settlement.
With that in mind, let’s look at some of the subtle ways an adjuster might use to benefit his or her employer to your potential disadvantage.
- Using Your Own Words Against You
When police make an arrest, they tell the person in custody, “Anything you say can and will be used against you.” The same can be true when you are talking to an insurance adjuster.
The adjuster will carefully listen to everything you say to see if you make an unwitting statement against your interest. Treat any conversation with one as a form of interrogation. Here are some possible traps to look out for when communicating with an adjuster:
- Do not agree to talk with an adjuster who calls you when you are unprepared to speak. Some adjusters will try to catch you off guard in the hope that you will say things to them spontaneously that they can use against you. If the timing of the adjuster’s call is inconvenient for you, ask the adjuster to call back at a better time.
- Do not volunteer information beyond what the adjuster asks you. You may think you are being helpful, but you could mention something that the adjuster can use as an opening later to challenge the validity of your claim or the seriousness of your injuries.
- Do not agree to make a recorded statement for the adjuster. In legal trials, attorneys often use inconsistent statements that a person made in a pretrial deposition or interrogatory to cast doubt on the accuracy of their testimony in court. Adjusters can use a pre-recorded statement you make in the same way.
Some adjusters will also look through your social media posts to see if you posted any statements that can hurt your claim. Others might go as far as to hire a private investigator to look into your activities, hoping to catch you doing something that belies your injury claims.
- Getting You to Sign a Blank Medical Release
Although an insurance adjuster can access your medical records, this access is restricted to only records that relate to your workplace injury claim.
If an adjuster asks you to sign off on a blank medical release form, do not go along with their request. This form could be used to access all of your medical records, which can lead to the adjuster using that additional information to deny or reduce your workers’ comp claim.
- Trying to Get You to Settle Too Soon
Being hurt on the job is stressful. Not only do you have to focus on recovering, but you may also be focused on making up lost income during this down period. Add the uncertainties of negotiating a workers’ compensation claim, and you can easily become overwhelmed.
Insurance adjusters know this and may use this sense of uncertainty and stress to guilt you into taking an early settlement offer. These offers are made with the hope that claimants will jump at the chance to return to normalcy. Some more aggressive adjusters will even add to the pressure you feel with threats of closing your case.
Accepting an early offer may result in receiving a lower compensation amount than you were initially willing to negotiate for.
An experienced worker’s compensation lawyer can help you negotiate the best possible settlement with the insurance company. This can require patience and persistence, but in many cases will result in you receiving a better final settlement outcome once the adjuster knows you cannot be buffaloed into accepting a low-ball early offer.
- Using an Independent Medical Examination to Challenge Your Claim
Your employer’s insurance company may schedule you for an independent medical exam (IME). Typically, the doctor who performs this examination is one hired by the insurer and who is inclined to see things the insurer’s way.
If the IME physician determines that your claim is invalid, such as by determining that it is because of a pre-existing condition, the claims adjuster can use this decision to challenge your claim.
- Discouraging You From Hiring a Workers’ Comp Attorney
Insurance adjusters know that having a workers’ compensation attorney on your side will make it harder for them to encourage you to accept a quick settlement.
To try to dissuade you from hiring an attorney, these adjusters may tell you that hiring a lawyer will complicate the settlement. They may also tell you that hiring a law firm will make no difference in the final offer you receive and that you may even lose money to legal fees.
The validity of such claims is usually dubious. The reality is, having an attorney on your side improves your chances of receiving a better final settlement.
- Stonewalling You in Communications
Some adjusters exploit your stress and uncertainty by delaying responses to your emails and phone calls. They hope this will make you either abandon your claim or accept a lower settlement offer when they finally contact you.
On the other hand, a variation of the stonewall tactic is to keep peppering you with requests for more information. These requests are made consistently in an attempt to wear you down into accepting the offer as-is.
Rather than giving in to despair when your adjuster gives you the silent treatment, consider hiring a workers’ comp lawyer instead. In addition to strengthening your negotiating leverage, when adjusters receive notice that you have a lawyer representing you, they usually stop these delay tactics.
- Using Hardball Negotiation Tactics
Sometimes, especially before you hire an attorney, an insurance adjuster may take a friendly approach with you in negotiations. However, the adjuster may also start with aggressive tactics to intimidate you on other occasions.
Some of the more common hardball tactics include:
- “Take-it-or-leave-it” offers
- Giving a short timeline to accept or reject an offer
- Threatening to disclose unfavorable information in the adjuster’s possession
- Threatening to report you for making a false claim
- Stating that the insurance company intends to fight your claim in court if you refuse to accept its offer
You should never be subject to such abuse by an adjuster. One significant advantage to having an attorney representing you in your claim is that the adjuster must communicate only to the lawyer and not directly to you. Adjusters know that quality workers’ compensation lawyers will not knuckle under strong-arm tactics, which is a powerful disincentive for them to use those tactics on you.
- Trying to Convince You That Your Claim is Closed
Sometimes, an adjuster will attempt to bluff you into thinking that your case has been closed when it has not. This is a simple attempt to get you to give up and walk away from your claim without taking the time to fact-check.
Do not assume that everything an adjuster tells you about your claim is true. Instead, work with a workers’ compensation professional who can punch through attempts to bamboozle you into giving up your valid benefits claims.
- Telling you that you cannot change doctors (or not volunteering that you can)
Unless you work for a self-insured employer, you most likely can change doctors by filing a request to change physicians with the Industrial Commission of Arizona. Of course, an adjuster will not tell you this and, in some circumstances, will tell you that you cannot change doctors. This is absolutely false.
- Manipulating Light-Duty Work to Thwart Your Claim
It is not uncommon for an adjuster to support claimants by providing them with “light-duty work” opportunities after being injured on the job. This type of work is typically assigned to employees who are recovering from an illness, injury, or surgery and are not yet able to perform their usual tasks.
However, some light-duty work may affect your workers’ comp claim. Additionally, you may discover that the “light duties” are actually beyond your current work restrictions, that you’re overqualified for the position, or that your new work schedule is unattainable.
Before accepting any additional light-duty work, it may be in your best interest to check with a workers’ comp attorney to learn exactly how the role will affect the rest of your claim.
Don’t Let Insurance Claims Adjusters Keep You From All You Deserve
There are so many tricks that a claims adjuster can use on you after an accident at work that we cannot list them all here. But, what we have shown you should make you aware that if you take on a workers’ compensation claims adjuster by yourself, you can quickly find yourself at a disadvantage in settlement negotiations that could be decisive.
At the Matt Fendon Law Group, our highly skilled and compassionate workers’ compensation lawyers are ready to help you deal with claims adjusters who want to play hardball.
Our quality, experienced workers’ comp lawyers are experts in settling workers’ compensation cases for our clients. We know all the tricks that claim adjusters use to diminish and even deny injured workers the benefits they deserve. Even better, we know how to fight back against this kind of game-playing with your claim.You don’t have to be like most injured workers who try to take on claims adjusters on their own. Call us today at (800) 229-3880 to discuss your workers’ comp case in a free consultation. Or, if you prefer, you can contact us here to ask a question about our workers’ comp specialists or to set up an appointment with an experienced workers’ comp lawyer to review your options after a work injury.
