Here’s a comment I got from a chatter recently. This one has to do with CCMSI and his Illinois workers’ compensation case, but it really could be with any work comp insurance company:

I was injured on the job and it has been over 6 weeks and Ccmsi has still not determined if my claim will be covered.

This like I said is not unusual for CCMSI or anyone else. You see it with Travelers, Gallagher Basset, Sedgwick, ESIS, etc.

They aren’t telling you no and they aren’t telling you yes. They say things like, “It’s under investigation,” or “We are gathering records,” or “We are gathering information,” or maybe they just blow you off and don’t get back to you. Let me tell you that it’s all nonsense and BS.

Your work injury isn’t a murder case. It’s a simple investigation. Typically talking to a supervisor and/or looking at a medical report is all that they really need to do. It’s almost always a pretty straight forward situation. A worker types all day and has been diagnosed with carpal tunnel. A worker was hit by a forklift and broke their leg. A worker lifts heavy objects all day and has a back injury.

Certainly it’s possible that there are other causes for these injuries. But it’s not probable and they can’t delay and delay until they find something. If they follow the law, they are supposed to begin providing work comp benefits. They can always stop payments if new information arises and seek to be reimbursed what they paid. Of course they don’t follow the law.

And if you don’t have a case filed with the Illinois Workers’ Compensation Commission, they can screw around with your health and life by not approving benefits. They get away with it because if you don’t have a case filed, there is no way to hold the insurance company accountable for their bad behavior.

You’d be shocked at how quickly benefits can be approved and delays end when you actually put pressure on an insurance company and file a case. There are motions a lawyer can file that can punish their bad behavior. Insurance companies quickly decide the cost of having to pay for a lawyer and penalties on your case, outweighs just doing the right thing and approving your claim.

That doesn’t mean that they won’t still try and deny your case at some point. They’ve already made their intentions clear. They do this stuff all of the time. It’s not personal to you, it’s just business to them.

The bottom line is that good cases are supposed to be covered. Delays can greatly harm your health and your life, especially if you have no money coming in. By waiting them out, you actually reward them and hurt yourself. It’s shameful how these insurance companies can act. But the great news is turning around a denial or no response is usually not that hard.