In some cases, workers’ comp insurers deny legitimate claims, forcing an employee to hire a workers’ comp attorney in Clarks Summit, PA to protect their rights. Why do insurers deny valid claims? They do it for a variety of reasons, including the following:
- The injury was unobserved.
- It was not reported right away.
- Medical records show illegal drugs in one’s system.
- The claim was filed after termination.
These reasons, among others, will be discussed in the article below.
The Injury Wasn’t Observed
Workers’ comp insurers prefer observed injuries, and they cast doubt on most unwitnessed events. If one is hurt at work and the accident wasn’t witnessed, they should report the event to a supervisor right away. Above all, the victim should be consistent when providing a description of what happened.
The Injury Wasn’t Reported Right Away
Insurers don’t like to see cases where an injury isn’t reported immediately. The insurer typically assumes that, if a report isn’t made right away, the injury isn’t serious. Additionally, most state laws require workers to report an injury within seven days or less. If one is hurt on the job and they believe that the injury could cause missed work days, they should report it at once.
Positive Drug Test
If a worker seeks emergency medical treatment after a workplace injury and medical records indicate the presence of illicit drugs in their system, the insurance company will be very reluctant to provide workers’ comp benefits.
Claim Filed After Termination
In some cases, an injured employee delays filing a claim, and they are subsequently laid off or fired. Insurers usually deny claims filed after a termination, and they often assume that the claim is based on revenge. If one delays filing and is then laid off, they will have a hard time convincing the insurance company that the injury is genuine.
Workers’ compensation claims are very complex, and they can be difficult to prove if one delays filing or is alone when injured.