Top 10 Insurance Adjuster Tactics

The Top 10 Insurance Adjuster Tactics

This list of Top 10 Insurance Adjuster Tactics (and employer) are used to close your workers’ compensation claim quickly after you have sustained a work injury.  Insurance companies are in the business of minimizing losses, and their goal is closing the workers’ compensation claim for the least amount of money. Hopefully, the insurance adjuster will be friendly, but do not assume they are working for you.

1. Make a Quick Settlement Offer

Again, the insurance adjusters in the business of minimizing expenses. Therefore, they may be willing to offer you a smaller settlement  if you take it quickly and before you’ve hired a lawyer.  I never recommend signing any settlement offer before discussing it with an attorney.

2. Refuse to Approve the Physician Referral

Sometimes your doctor (Authorized Treating Physician) will refer you to a different doctor or specialist for a consultation.  The insurance company might not like the recommended doctor, so they may fight the recommendation.  This can delay your treatment if you were having difficulty getting a referral approved.  In this case, you need to speak with an attorney that knows the Georgia Worker’s Compensation laws.

3. Request Referral To Specific Physician

Along these lines insurance adjuster may contact the doctor to ensure the referrals made to the physician of their liking. This is a situation where litigation is likely you will need to speak with an attorney.

4. Risk Payment Penalties

Unfortunately sometimes insurance adjusters will try to “starve out “” injured workers who are not receiving monetary benefits in hopes that they will result their case for as little as possible.  If you have been off work from with in a week and are not receiving any monetary benefits or medical treatment, you need to speak with an attorney immediately.

5. Fire You

Unfortunately, injured workers are often fired by their employer because they can’t work anymore. If you were fired while working light duty work restrictions, this could increase the exposure to the insurance company.  In a case where you were terminated after suffering a work injury, it is important to speak with a Georgia workers’ compensation lawyer.

6. Offer a Temporary Light-Duty Job

An insurance company and employer can minimize their exposure for ongoing income benefits if they offer major worker of light-duty job that has been approved by the Authorized Treating Physician. However, often times the job is only available  temporarily (even though that may not be disclosed to you). Therefore, you still may be eligible for ongoing benefits if the position is not permanent.

7. Offer a Light Duty Job That Isn’t Light Duty

If you’re receiving weekly income benefits from the insurance company, the employer could offer you a light-duty job if it is been approved by the author is your position pursuant to a WC-24 form, or they may just informally make the offer stating  you are free to return to work at anytime. If you do not attempt to return to work pursuant to the informal offer, the insurance company will likely argue that you are being unreasonable and use this as evidence that  you do not want to return to work. If you do not return to work pursuant to the WC-240a job offer form,  your benefits could be suspended if you are unable to complete a full workday.

8. Ask to Sign a Medical Release

The insurance company is entitled to investigate your claim and will frequently ask for a release to obtain your past medical records.  If you are asked to sign a release, consult an attorney to determine if the release is too “broad”.  In many cases, it is not appropriate for your case, and an experienced workers’ compensation attorney can assist.

9. Request a Recorded Statement 

During the initial investigation into a claim the adjuster will often ask to take a recorded statement to investigate the claim. Depending on how soon after the accident is or how severe the accident is, you may or may not be ready to give a statement and may have difficulty remembering all the details. Inevitably this information could be used against you if you have to give a deposition later and the insurance adjuster/employer could argue you gave inconsistent information. Always consult an attorney before giving a recorded statement regarding the accident.

10. Only See Doctors on the Panel of Physicians

If the claim has been accepted as compensable and the employer has a valid “Panel of Physicians” posted, you are entitled to make one change to another physician on the Panel.  If your employer says you are not allowed to see anyone else and you have not yet used your one time change on the Panel, call an attorney without delay.

Contact Beth Gearhart Today

The list of Top 10 Insurance Adjuster Tactics can serve as a starting point.  However, if you are injured and need legal advice, please read “Why Gearhart Law Group.”  Beth Gearhart listens and cares about her clients, and she is waiting to speak with you at (404) 445-8370.  Alternatively, please fill out the contact form for an immediate callback personally from Beth Gearhart.