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4 Ways Insurance Companies Avoid Paying Worker’s Compensation Benefits

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Insurers may dispute injuries, offer low settlements, rush authorizations, or secretly record claimants to avoid payouts.

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The Federal government protects your right to a fair settlement should you suffer a workplace injury or illness under the Federal Employees’ Compensation Act (FECA). Legally, most employers must purchase workers’ compensation insurance to guarantee compensation for work-related injuries and illnesses. 

However, most insurance companies are reluctant to approve workers’ compensation claims, and not always for malicious intent. With billions lost in workers’ compensation fraud, these companies must remain vigilant. On the flip side, some insurers avoid paying workers’ comp benefits for unscrupulous reasons.  

Here are a few ways insurance companies avoid paying workers’ compensation benefits, and what you can do about it.

Injury Disapproval

One of the most common ways insurance companies use to refute your claim is by flat-out disputing your injuries. Remember, insurance companies only apply to work-related injuries and illnesses. In short, no injuries, no workers’ comp settlement.

Insurers will often try to claim your injury or illness stems from a pre-existing condition unrelated to work activities. Insurance investigators will dig up your medical records and try to link your past conditions to the injury/illness. They may also rummage through your social media and probe your close circle to find any information that might disprove your injury.

The “Well Wishes” Tactic

Insurance agents use this sneaky tactic to get you to settle for less. They’ll call you right after your injury with well wishes and try to sweet-talk you into settling for a lesser amount. If that doesn’t work, they’ll try to intimidate you into doing the same by telling you that you could end up with nothing.

Rushed Authorizations

Be cautious of insurance agents who hurl authorization documents in your face before you get the chance to collect yourself. These authorizations give them access to information they may use to dispute your injury and claim. Only sign authorization documents after you’ve consulted your doctor and attorney.

Underhanded Recordings

Insurance agents are masters of the bait-and-trap technique, which catches most employees off guard. They may spark a friendly conversation, baiting you with questions and hoping for responses that jeopardize your claims. 

Secretly, the agents will record these conversations and later use your responses as evidence to dispute your claim. The best way around this is to avoid all direct communication with insurance reps and agents. Instead, have all correspondence addressed through your attorney.

Workers’ Compensation Is Your Legal Right

Insurance companies can use devious tactics to deny your workers’ compensation claim. Therefore, stay vigilant and avoid being careless with your words and social media posts. The wrong words, photos, and videos could jeopardize your chances of getting fair compensation. Your best bet against these deceitful tactics is to hire a skilled and experienced workers’ comp attorney. 

At the Law Office of James M. Hoffmann we have over 30 years of experience protecting the rights of injured Missouri workers. If you’ve been injured on the job, give us a call 24/7 to learn more about your legal rights and options.

Updated: October 30, 2023
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