Illinois work comp insurance companies will deny cases for any reason at all even when they clearly make no sense. They do this because they want you to say, “Well, I guess I can’t get workers compensation,” and then go and use your own insurance or Public Aid to pay for your bills. It’s a business decision and the goal of their business is to spend as little money as possible on claims, even good ones. And if they spend $0 on a case they should have covered, some insurance adjuster is probably looking at a bonus.
We’ve seen this over and over in the last 25 years. You’ll get a letter with lies that state they’ve done an investigation and then they’ll encourage you to use your own insurance. It’s not unusual for this to happen, but it is frustrating for sure.
While we are used to getting calls that reference these denial letters, I have to say that it seems that insurance companies are getting more aggressive about denying cases with no good reason at all. Recently we got a call from a factory worker who had the most ridiculous denial letter of 2022 and it’s probably a contender for the worst one ever.
He does a lot of lifting on the job as you can imagine. So it’s no surprise that he has a back injury after working there for almost a year. There was no specific accident, just an allegation that working over time caused his back to break down. That’s a very common and straight forward case. Usually.
A MRI showed a herniated and bulging disc. The insurance company sent out his records to a doctor they use and because he signed a medical authorization form, they had records from when he was in his early 20’s which was 30 years ago.
The hired gun doctor stated that his problems now aren’t at all due to lifting heavy items on the job every day, but instead have to do with him getting in a car accident 30 years ago. How bad was that injury? He went to the ER and had four weeks of physical therapy. He hasn’t had any treatment for his back in 30 years! It’s absurd to state that suddenly his back gave out because he had a strain on it 30 years ago.
This denial will never hold up in court and I expect the insurance company will roll over once the case is filed. But that’s not their point. They want to wrongly deny 1,000 injured workers. If 100 of them don’t seek out legal advice and learn their rights and just go away, they will save millions of dollars they’d otherwise have to spend by law on your healthcare, time off work, a settlement, etc.
It’s just how they strategize and screw people over. It’s all business to them.
The lesson to learn is that insurance companies aren’t lawyers, they aren’t Judges and they don’t have the final say on anything. Don’t take a letter you get from them as legal advice or as the truth. You don’t have to hire a lawyer in order to get educated on your rights either. If you’d like a free consultation with an attorney, you can call us any time at 312-346-5578.