Having your first work related injury can be a real eye opener as to how the world works. Many people assume that if you are a good person who was hurt at work that you’ll be able to get benefits and go on with your life. It should work that way, just as if you are rear-ended at a stop light nobody should say you did anything wrong.
The reality though is that insurance companies do whatever they can to limit the amount of money they pay in a case. Some are more shady than others, but any of them will fight a case if they have a leg to stand on.
First they will look at the case facts. Then they will look at your medical history. If needed they will send you to an IME doctor. If you are out for a long time or need a major surgery you can bet there will be surveillance done on you in the hopes of catching you doing something. A nurse case manager will talk to your doctor to try to limit your care or get you returned to a phantom job. Sometimes they’ll just deny a case in hopes that you go away.
So when a frustrated caller asked me, “What is Travelers Insurance like? Do they fight every case?” the answer had nothing to do with Travelers. It could have been Gallagher Bassett, Chubb, Zurich, ESIS or anyone else. They will fight the cases when they can. In most instances they have nothing to lose because if we fight back they’ll just pay what they were going to do anyway.
It’s not personal to them, it’s business. You are a name and a case number. You are not a person to them. It sounds callous, but when you handle thousands of cases a year, that’s how insurance companies look at it. It’s the big difference between them and us. We see our clients as people first and when you are struggling or hurting, we do too.
So what are you to do?
You have to treat your case like it’s a business decision because it is. The business is your life. Ask questions. Document what has happened. Listen to your doctor. Don’t take legal advice from people who aren’t in your corner. Learn your rights. We don’t look for battles and you shouldn’t either, but we also stand up when there is one and you should too.
Bonus tip, don’t think that the insurance company is out to get you or has a personal vendetta against you. The adjuster might if you are really rude to them on the phone, but in general they are just doing their jobs, no matter how awful a job it must be much of the time.
Need help? Questions? Want a free consultation? We have an Illinois wide network to help injured workers. Call us at (312) 346-5578 or fill out our contact form and we’ll reach out to you ASAP.