Workers’ compensation insurance companies delay claims as a negotiation tactic so they do not have to pay out as much. It is an illegal, immoral strategy that workers should be aware of so they can spot it in practice.
Unfortunately, the world can be a difficult place for workers looking to get money back for injuries sustained on the job. Although employers are required to protect workers, they do not always live up to these requirements. By understanding the ways in which a claim can be delayed, employees can prevent the insurance system from leaving them behind.
Workers’ Compensation Requirements by Law
Employers are required to buy workers’ compensation insurance. They usually purchase the coverage of a private-sector carrier. Legally responsible insurers quickly respond to claims brought by employers after accidents and pay employee benefits immediately. However, some insurance companies break the law by purposely dragging their feet. It is against the law for an insurance company to delay processing as a negotiation tactic. If a worker ever sees such a practice play out in his or her claim process, he or she can seek legal help from a workers’ compensation attorney.
Legitimate Reasons To Delay a Claim
After a work accident, the employer must send a claim to the insurer. The insurer then must conduct an investigation before providing benefits. During this time, there may be a delay.
There are, of course, legitimate reasons for an insurance company to delay processing a claim. One of the most common and unfortunate reasons claims are delayed is mistakes on the required forms. Employees dealing with forms might want to work with an attorney to make sure their claim is handled correctly. Other reasons the claim may be slow include clerical issues, poor training, and understaffing.
When Insurers Break the Rules
When an insurance company breaks the rules by delaying a claim as a negotiation tactic, they face serious consequences. If they do not complete an investigation in one month, injured workers can compel them to show how their investigation could have been finished before their deadline. Additionally, once that 30 day period has passed, insurance companies must give claimants a written explanation every 45 days.
Delays Caused by Employers
Of course, insurers are not always the ones at fault when insurance claims move slowly or do not move at all. Sometimes, employers fail to move in a timely fashion. Some of these situations may include:
- Weak reporting procedures
- Negligent claim handling
- Poor communication between departments
- Lost forms
- Ignoring the claim while hoping the employee will forget to file
Employers must give their employees workers’ compensation benefits. When they fail to provide these crucial benefits, they are illegally infringing on workers’ rights. People who work with a negligence attorney can get the help they need in these scenarios.
Suspect Workers’ Compensation Is Being Intentionally Delayed?
Employers or employees who suspect the workers’ compensation benefits are being delayed purposely should speak with an injury lawyer. Working alongside an attorney can help get to the root of these problems.