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How might insurers contest a workers’ compensation claim?

On Behalf of | Sep 2, 2021 | Workers' Compensation |

Most Virginia employers must carry workers’ compensation insurance. It is no-fault insurance designed to cover you if you are injured while at work. So, it may seem surprising that some injured workers struggle to get the compensation they need because their employer or the insurer contests their claim.

There are two things to bear in mind here. First, some employers only hold the insurance because the state forces them to. The more their insurer pays out, the higher their premiums are likely to rise, so they might not want to pay up.

Second, for insurers to increase their profits, they either need to sell more or reduce the amount they pay out in claims. So when you file a claim, you may be fighting against your employer and their insurer.

Claiming benefits for a workplace injury is not straightforward

Here are some of the ways your employer and their insurer might use to reject or limit your claim:

  • You did not fill the form correctly: You need to ensure you fill out all the appropriate boxes in the correct manner. Errors could see you required to do it again.

 

  • You did not provide appropriate evidence: Insurers can be picky over what they consider sufficient proof of injury. You need to understand what they are looking for to be able to submit it the first time.

 

  • You did not file in time: There are limits to how long you have to report an accident and file for your injuries. Usually, it is two years.

 

  • You did not get injured at work: If a digger runs you over on the job, it would be hard for someone to claim your injury happened elsewhere. Yet, some injuries or illnesses do not result from a one-off incident, and an employer may argue they are down to a previous job or the sports you play.

 

Having appropriate help to complete your workers’ compensation claim reduces the chances of denial or receiving less than you should.