There are many ways a workers’ compensation insurance company can deny your claim. These ways may all seem the same to the injured worker. In fact, an insurance company may pay for some of your treatment at first, but don’t be fooled—your claim may still be denied in the long run. Sometimes, it may be more cost effective for the insurance company to pay for some initial (cheap) treatment for your injury.
Of course, the insurance company may deny your claim from the outset. This claim denial can occur for many reasons. Usually, an employee will have a preexisting condition and the insurance company will deny coverage. Or the claim may be denied because the employee failed to report the injury immediately. Very few workers’ compensation claims in the United States are fraudulent. Yet insurance companies continue to deny claims because the employee’s story isn’t believed.
If your claim has been denied because of a preexisting condition, you must act quickly. If you really did experience an injury at work, contact an attorney, and fast. A workers’ compensation attorney will be better able to fight the denial of your workers’ compensation claim the earlier you contact him or her. The fact that you may have had a preexisting condition—this occurs often with back injuries—doesn’t mean you won’t be able to win your claim. However, the insurance company may offer you a settlement instead of fighting your claim in court, and this money can help dig you out of a tough spot. In order to “play the game” with the insurance company, you need to approach the denial of your claim skeptically. Many individuals are naive about the way insurance companies operate—through no fault of their own. But remember that an insurance company is always scrutinizing your claim for reasons to issue a denial of the entire claim.
If your claim is denied by the insurance company, don’t be discouraged. Insurance companies often take a different approach once an attorney is retained. Hiring an attorney is a win-win situation for a worker whose claim has been denied. The attorney only gets paid if the denied claim results in benefits to the worker. The workers’s compensation attorneys at Bachus & Schanker, LLC specialize in denied claims. These claims require tough and experienced litigation attorneys.