Should You Meet with Insurance Companies During a Workers’ Compensation Claim in MA?
If you recently reported a work-related injury to your employer, there is a good chance you will receive—or already have received—a call from a claims adjuster or other representative of your employer’s insurance company. Before you take this call, however, it might be beneficial to know more about the workers’ compensation process and the role of the adjuster in your claim.
Unfortunately, workers’ compensation insurance companies and their representatives are not on your side. Their goal is usually to save money and pay as little as they legally can toward benefits. Before meeting with insurance companies during a Boston workers’ compensation claim, you may want to consider contacting a qualified workers’ compensation lawyer to ensure you can stand up for your rights and effectively seek the benefits you deserve.
The Role of the Workers Compensation Insurance Company
Massachusetts General Laws Chapter 152 establishes that employers in Boston and elsewhere in the state must carry workers’ compensation for their employees. When a worker suffers an injury on the job or contracts a work-related illness, the law requires him or her to give notice to his or her employer as soon as possible.
After receiving notice, employers must officially submit a workers’ compensation claim to their insurance company within seven days. The insurer then has 14 days to accept or deny the claim. If the employer fails or refuses to make a claim, the injured worker could submit his or her own claim and report possible violations to the Massachusetts Department of Industrial Accidents.
Because of these tight deadlines, you could expect to hear from the insurance company shortly after you report an incident to your employer. Sometimes this will be in person, but more often it will be via telephone. When preparing for meeting with the insurance company, you could benefit from contacting a workers’ compensation lawyer to understand your rights in Boston.
Reporting Workers’ Compensation Claims to Insurance Companies
After employees report a work-related illness or injury to their employers, state law requires the employers to report the claims to their insurance companies within seven days. The insurance company then has 14 days in which to deny or approve the claim for benefits. Due to these deadlines, workers can expect to hear from the insurance company right away.
The insurance company would typically want to take a recorded statement from the claimant, whether by phone or in person. The stated purpose of this statement is for the insurance company to learn more about the claim to evaluate it properly. However, the company is also likely interested in gaining information that may allow them to reduce or deny payment to the worker.
Some of the factors that an insurance company representative may explore during a recorded statement that might affect their coverage and decisions about a claim include:
- Preexisting medical conditions
- An urgent financial need that may cause claimants to accept a lower settlement
- Your reliability as a potential witness
- Other information not relevant to your claim, such as private medical insurance coverage
In its haste to meet required deadlines, insurance companies often pressure injured workers to make ill-advised, uninformed, or simply incorrect decisions. Therefore, getting legal representation for a Wakefield Worker’s Compensation claim and meeting with insurance companies may be wise.
Giving a Statement to Insurance Companies
When an insurance company contacts an injured worker, they often want to take a recorded statement. In taking this statement, the insurer is evaluating numerous factors. Some of these are transparent, such as learning more about the injury in question, but others are tactics meant to reduce how much they may have to pay.
For example, when a claims adjuster takes a statement from you, they may be looking to:
- Find out about pre-existing conditions
- Assess whether you have urgent financial problems and would be willing to take a low settlement
- Evaluate whether you are a reliable or unreliable witness
- Learn about private health insurance or other information that is not relevant to your workers’ compensation claim
- Create a record of events that could be used to cross-examine you
It is necessary for you to cooperate in the claims process in order to receive Boston workers’ comp benefits, but you also need to be prepared for meeting with insurance companies. Speaking with a knowledgeable attorney as soon as possible following an accident could be crucial if you want to fully understand what you should do when the insurance company contacts you.
Protecting Rights When Speaking with Insurance Companies
When individuals are speaking with insurance companies about their workers’ compensation claims, they must take care to protect their rights to compensation. Otherwise, they risk receiving a decision from the insurance company that reduces or denies their available benefits.
For instance, workers should take care to speak as precisely as possible about their injuries. Rather than speaking in generalities, employees should be extremely detailed and specific about how and where their injuries occurred. They should also give concrete examples about their level of pain or impairment and how the injury affects their daily activities, in addition to their work duties.
Workers should also be consistent in their statements about all aspects of their claim. Insurance companies tend to look for inconsistencies in employee statements, which they then use to undermine the credibility of the employee. This tactic often leads to denied or reduced claims.
Medical Authorizations and Workers’ Compensation Claims
In the context of insurance companies meetings during a Wakefield Worker’s Compensation claim, insurance adjustors may ask employees to sign a general medical records release. Individuals should avoid signing a general release, as their preexisting medical conditions and mental health records are not relevant to the pending workers’ compensation claim.
Workers should limit release forms to those that request medical records from on or after the accident or injury date. Otherwise, workers risk giving insurance companies unnecessary information that may adversely affect their workers’ compensation claims.
Help with Insurance Companies During a Boston Workers’ Compensation Claim
Following an on-the-job injury, you may be able to obtain needed workers’ compensation benefits that you and your families need. However, insurance companies often act fast in these situations, meaning many unrepresented people end up giving a statement before they have a chance to get legal advice.
If you have been hurt at work, you may benefit from meeting with a workers’ comp lawyer as soon as possible. A dedicated attorney could advise you about your legal rights, including what to do when meeting with insurance companies during a Boston workers’ compensation claim. To learn more about your legal options, call today.