If you have never had to work with an insurance adjuster specifically due to a workers’ compensation claim, the process can easily become daunting. It is a common misconception to believe that the insurance adjuster is there to guide and assist you. This is not always the case. The adjusters’ main purpose is to represent the employer and the insurance company, not you!
Their main goal is to close the claim out as quickly as possible and to close it by paying out as little money to you as possible. These adjusters are highly trained professionals who have a multitude of strategies that they practice in order to save their employer’s money.
Here we have provided you with a quick guide of helpful tips to navigate your way around a workers’ compensation adjuster’s tricks. This list will help identify five commonly used tricks and how to avoid them.
Table of Contents
#1 Manipulating Your Words
Initially, the adjuster may try to contact you at an inopportune time to catch you off guard by design. The purpose of this is for the adjuster to document you saying or writing anything they can use against you in the claim. Always agree to speak at a time that is convenient for you. Be sure that you are prepared to speak with them in a quiet environment and when you are not tired or on any medications from your injury that may cause you to be altered in any way.
The adjuster may ask you to provide a recorded statement over the phone. Under no circumstances should you agree to and provide this verbally recorded statement. This is a tactic designed by the insurance team to catch you making a statement that they will use against you later in the process of the claim. For example, they may ask questions to receive a response from you that suggests you were previously injured or injured somewhere else and not at your place of employment. This would assist them with possibly closing your claim with zero payouts.
When you do communicate with the adjuster, be sure to always be direct and only give the facts. Every question they ask has a specific purpose, so it is very important to be honest and clear with your responses. If they ask, “How are you?” and you innocently respond “Doing really well.” they may use that against you later stating that you are not injured because you are doing good. Be sure to stay on point and not stray from the purpose of the call or email either. They do not need to know any extra information about your personal life and matters.
#2 Signing a Blank Medical Release Form
The second trick to watch out for is a request from the adjuster to sign a blank medical release form. The adjuster is allowed to have copies of your medical records but only the ones pertaining to the injury sustained at your workplace and no other records.
They may try to trick you by asking you to sign a blank release form so that they can get their hands on all your medical records. They would then attempt to utilize those complete records to disclaim your injury in any way they can.
#3 Asking You to Agree to a Medical Examination With a Doctor of Their Choosing
Another way the insurance adjuster may try to bring your character and claim down is by using social media, your personal email, and statements made by your family, neighbors, and friends against you. This is one of the ways they try to prove pre-existing conditions by looking through your social media posts.
They may even hire a private investigator to dig up any information to use against you and to make you look bad so they can deny your claim. They will be paying attention to dates and activities. They may take pictures or videos of you showing your daily activities. It is important to be aware that this is a possibility and to always remain vigilant during your workers’ compensation claims.
#4 Tricking You Into Settling for Less Than You Deserve
The adjuster is aware that you may be frustrated, scared, and exhausted regarding the entire claims process. Whether it is taking too long to settle the claim or you are not getting the answers you deserve. They may wait for this time to offer you a low settlement in order to close the case quickly and with as little money paid out as possible. It is generally recommended that you do not rush to settle the claim quickly and that you explore every option available to you.
It may seem as though accepting the first offer is the best option, but most likely, if you wait for additional offers, you will end up with a more reasonable amount of money for yourself and your family. Do not let them intimidate you into accepting. They may say that by not accepting the first offer, you will get less or no money, but this is another tactic they use to get you to accept quickly.
#5 Threatening to Close Your Case
Finally, an adjuster may threaten to close your case or inform you that it is already closed. They will list a bunch of reasons explaining why this has happened. In most cases, this is untrue, and it is just another trick they use to wear you down or deceive you. The most important response strategy is to know your rights and to have trustworthy guidance.
Always approach your insurance adjuster in a calm and polite manner, no matter how you feel. It may be difficult, but in the long run, it will pay off. Remember to document everything you say or do. Keep yourself organized, and do not miss the due dates for submitting documents. Be aware that the workers’ compensation adjuster is not on your side and that their goal is to save money by tricking you. Do not be afraid to reach out for guidance and support during the time of your claim.
Connect With a Workers’ Compensation Lawyer Today
A work injury can disrupt your life, so let us put your mind at ease and help you get the compensation you deserve. Our experienced and dedicated workers’ compensation attorneys at Krasno Krasno & Onwudinjo are ready to support your workers’ comp claim journey and protect you from profit-hungry insurance adjusters. Contact our firm for a free case evaluation today when you call our office or complete our convenient contact form.