A recent caller to my office had a recommendation for shoulder surgery after a work related accident. She was upset because the insurance company had approved and then declined her surgery “pending an investigation” and was three weeks late on her TTD payments.
She wanted to know how she could solve the problem on her own and the honest answer is that she can’t because she has no leverage.
Because she hadn’t filed a case with the Illinois Workers’ Compensation Commission, she hadn’t been assigned an arbitrator or a status call date. As a result there was no trial motion that could be filed. There also wasn’t a way to file a petition for penalties against the insurance company.
While these problems can be solved by actually filing a case, until then it’s not uncommon for an insurance company to just mess with you in the hopes that you will go away or use your personal insurance to cover your bills (which is a huge risk to you). The strategy certainly must work because they keep on doing it.
Even once a case is filed, if the insurance company knows your lawyer doesn’t like to take cases to trial you don’t have leverage. Believe it or not there are law firms who have a reputation for never going to trial and as a result their clients get hurt.
There are other ways you can create leverage. A man called me wanting an opinion on what to do because the other side hadn’t responded to his attorney’s settlement offer and it had been over five months. In a case like that he needs to show that he will go to trial and the first step (often) is to take the deposition of your treating doctor. You’ve probably heard that a lot of cases settle right before a trial was about to start and it’s true. It happens because you put the pressure on the insurance company to make a decision and present their best offer.
You also put pressure on them by filing 19b petitions when your benefits are denied and penalties petitions that you follow through on when they act unreasonably. Believe it or not, an attorney can also put pressure on an insurance company just by picking up the phone. It’s human nature that people don’t like to say no or be confrontational. So when we put them on the spot they often role over.
Bottom line is that just a little bit of aggression or even mild aggressiveness (if that’s what you call just filing a case) can help you stop the games and win the benefits you are entitled to by law. If you have questions or want help with a case, get in touch for a free, confidential consultation. We cover all of Illinois.