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What to Do If a Workers’ Comp Insurance Company Doesn’t Believe Your Claim

Workers’ compensation is a no-fault insurance system, which means that a claimant can get benefits even if they contributed to their accident. But no-fault does not translate to guaranteed benefits. Insurance companies always have the opportunity to investigate a claim and deny it if they suspect any fraud or misinformation. Specifically, if the insurance company doesn’t believe that your workplace accident was an accident at all.

If the workers’ comp insurance company doesn’t believe the details you provide in your claim and moves to deny it, then you will have to approach the situation like a personal injury case. Essentially, you will have to prove your case to advance it, as if you were proving liability before a court.

Evidence to Create Your Case

Hiring an attorney can help you with this difficult and unexpected process. They will know where to look to find evidence that shows your case has not been exaggerated or created in a fraudulent way.

Evidence that can help show you were injured in a workplace accident includes:

  • Testimonies: The statements from your coworkers could be the best form of evidence. If anyone saw your workplace accident, then let your workers’ compensation attorney know. They can reach out to that coworker to get a testimony and more information that they might have about why your accident happened.
  • Camera footage: If your workplace has security cameras positioned through the premises, then your accident might have been caught on tape. Tell your attorney right away so they can immediately contact your employer and instruct them to save all files and footage from around the time and date of your accident. Sometimes, a dishonest employer will delete the footage to try to unravel the employee’s claim. If this happens and our attorneys have instructed them to preserve the footage, then it could be what forces the insurance company to accept your claim due to the possibility of case contamination.
  • Workplace safety records: An examination of your workplace’s safety records could reveal a history of accidents similar to yours. Such a revelation would suggest that your employer has insufficient safety protocols in place, which makes the workplace more dangerous on an average day and lends to the credibility of your claim.
  • Medical reports: Did you already see a medical provider after your workplace accident? The medical reports they create can serve as useful evidence for when a claim is denied or otherwise challenged by the insurer. The medical reports will show that your injuries did happen and will probably include a mention in the notes as to why the medical provider thinks they happened. For example, your treating physician might note something like “patient fell at work.” This little jotting could be what convinces the insurer to reverse its stance and accept your claim or offer a settlement.

For advanced legal help with a workers’ compensation claim in Chicago, contact Leonard Law Group now. We focus on plaintiff cases that go up against major insurance providers and employers of all sizes.

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