One of the most important things for any injured Illinois worker to know is that insurance companies are nothing but businesses trying to maximize profits. In many ways this can hurt you as they will look for reasons to deny your case or cut off benefits and in many cases they will illegally not pay benefits without a reason at all.
They aren’t just a business when it comes to how they handle your case. They also are a business in terms of how they treat their employees. They don’t want to pay huge wages, don’t want to spend a lot on office space and don’t want to pay too much for their adjusters to have training. This can all work to your advantage. The lower wages mean some companies don’t attract the best talent or have happy employees. The trend to work from home prevents inner office communication that can often aid people in learning their job. And the lack of training means you might be dealing with an adjuster that doesn’t know Illinois law or really what they are doing.
I’ve had an uptick of insurance adjusters reaching out to me to try and learn particulars about the law. I will do this if it can help an existing client, but generally speaking I say no as I’m for injured workers only and don’t want to help a billion dollar corporation, especially if this knowledge can be used to hurt a worker. Take for example a recent chat I had online:
This was from a guy who doesn’t know how to spell “Illinois” and I’d bet that he’s never handled an Illinois work comp case. It still wouldn’t be surprising if due to staffing shortages or budget cuts if “Sam” was asked to process a case in Illinois.
For you as an injured worker, this demonstrates why you can’t listen to the adjuster when they tell you that your case is being denied. They might just be making stuff up or hoping you will go away. They might assume the law they know in some other state is the same in Illinois. Whatever the situation, they aren’t looking out for you.
Beyond that, I’ve also seen cases where an adjuster wrongly approved benefits when they didn’t know the law. For example, if you fall down stairs at work and get hurt, you have to show there was some defect in the stairs in order to win your case. A defect could be it was slippery, there was a crack, there was something on the stairs that you tripped on, etc. Plenty of newbie adjusters don’t know this and have awarded benefits to workers who literally were day dreaming and missed a step.
The bottom line is that their ignorance can be used to your advantage and it’s one reason that even when we are fighting for you, a good attorney won’t act like an asshole to the adjuster. If they like us, they will often listen to us when we tell them what should happen on a case without seeking outside counsel. Many of them just want to get through their day and don’t want to feel like they are asking a stupid question to their boss.
So while this isn’t every adjuster or even the majority of them, I’d estimate around 1 in 20 fall in to this category and it’s certainly something to look out for.