Workers Compensation is governed by state law, yet each state is surprisingly similar to most other states with respect to the fundamental legal principles behind their respective work injury claim systems. This makes the overall structure and operation of the Workers Compensation system less difficult to navigate.
Why Workers Comp Insurance Companies Challenge Claims
The workers compensation insurance company is concerned with return on investment by selling more policies while reducing the amount paid on workers claims. Insurance companies have been aggressive in recent years and workers who have sustained injuries are feeling the pain.
Insurance companies defend their aggressive claims practices by claiming that payment of workers claims contribute to the high cost of insurance premiums which adversely affects businesses of every kind. According to Workers Compensation insiders, the reason for the cost of insurance premiums rising is because indemnity costs keep rising ahead of them, and in some instances by as much as 50 percent. Add to this nearly a 100 percent rise in medical costs over the past decade, and insurance companies find themselves doing serious battle with the claimant. Sadly, more often then not, it is the worker who gets unfairly exploited under a system, the rules of which have been written by insurance company lobbyists.
How Workers Compensation Insurance Companies Fight Back
Industry executives know that containing costs means containing the value of paid claims. The most effective approach of these companies has been to heighten the level and intensity of investigation into what they consider soft claims.
Most other insurance carriers have figured out ways to reduce payouts on Temporary Total Disability claims through the use of legal and administrative technicalities such as refusing to pay because the worker missed a statutory deadline or submitted their paperwork incorrectly.
With this kind of leverage and sophistication from insurance companies, the injured worker is at the mercy of the skills and dedication of her lawyer. The cards are clearly stacked against the worker and insurance companies are happy to have it that way.