In this article, you can learn about:
- Ways insurance companies delay workers’ compensation claims to gain an upper hand.
- Legal solutions for when an insurance company is unfairly denying your claim.
- Strategies for negotiating a fair settlement in light of recent trends in workers’ compensation claims.
What Are Some Of The Recent Trends In Workers’ Compensation Handling That Your Firm Is Seeing?
In the last three to five years, insurance companies have been intentionally interfering with the intent of the North Carolina Workers’ Compensation Act. The law was designed to allow injured workers to get speedy and fair relief without the need to go through lengthy litigation. Insurance companies, however, are doing their best to delay workers’ compensation claims as a tactic to get injured workers to settle for less than they deserve.
Under the North Carolina Workers’ Compensation Act, you do not have to prove that your employer was negligent or did something wrong to get compensated for work-related injuries. In fact, your employer is responsible even if they did nothing wrong.
In return for this guaranteed coverage, you only receive part of your regular pay if you are injured at work. You also sacrifice the ability to collect for pain and suffering. The intended result is a compromise that allows you to collect the money you need quickly after an injury while your employer’s liability is limited to what’s outlined in the law.
Despite the law’s intention to streamline workers’ compensation claims, insurance companies are denying claims that clearly should be approved. This delays payment to the injured employee, who may have to go months without any income or medical treatment. Due to being under enormous economic pressure, many injured workers feel they have no choice but to accept the first settlement offer they receive.
Unfortunately, the Industrial Commission is doing very little to stop insurance companies from doing this. In fact, they’re almost promoting it in some of the decisions that they’re making.
Even if you have a strong, well-documented claim, it doesn’t mean that the insurance company is going to do what they’re supposed to do. They often stubbornly fight claims that shouldn’t be disputed just to put pressure on you to give up or accept less money.
Is There A Specific Reason Behind These New Trends? Was It COVID?
Insurance companies have a lot of economic data that they use to figure out how they can save the most money. For example, they will choose to pay a $25 fine to the Industrial Commission if they believe it lowers the value of a case by $15,000.
Insurance companies used to have fewer incentives to dispute valid workers’ compensation claims because the Industrial Commission would make them pay sanctions or attorney’s fees. But the political climate is very pro-business right now. Insurance companies feel emboldened to push the lines.
In recent times, insurance companies have been known to completely disrespect or dishonor orders of the Industrial Commission if they think it will save them money. Because of the data they have, insurance companies can predict that any fine or penalty they might have to pay will be less than what they would spend if they obeyed the court’s orders.
What Advantages Do You Think These New Trends Offer To Somebody Filing A Workman’s Compensation Claim In North Carolina?
If you have a strong claim and can show that the insurance company’s defenses are nonsense, you can gain the upper hand in court. Having the proof on your side in court puts you in a very advantageous position.
During court proceedings, someone from the insurance company is going to have to explain why they made the decisions they made. When they are unable to give a legitimate reason for denying the claim, the court could order them to pay you more than you originally asked for. If the court rules that the insurance company acted disingenuously or illegally, they may have to pay you significantly more.
What Are A Few Disadvantages That These New Trends Pose?
The biggest disadvantage of these new trends is the financial strain many must suffer when insurance companies deny legitimate claims to gain an economic advantage. If you’re unable to work and dealing with medical bills, it can be tough on you and your family. Even if you’re confident you’re going to win your case in six months when it finally goes to court, you may not be able to afford to wait that long.
Wondering why your employer or the insurance company is making things so difficult can be extremely frustrating. You may have a strong claim with medical documentation and witnesses. Unfortunately, the Industrial Commission may not recognize these patterns or step in to help.
Have You Found Your Settlement Strategies Evolving In Response To These Trends?
Although it may be difficult, the best strategy is to hang in there and go the distance if you’re receiving a lowball settlement offer. Every case is required to go through a dispute resolution process known as mediation. Insurance companies often use mediation to attempt to get a deal rather than to accurately evaluate the claim. If you’re able to hold out, you may receive more money down the line.
Another settlement strategy is to catch the insurance company doing something inappropriate. When this happens, the insurance company knows the Industrial Commission isn’t going to be happy about it. You can tell the insurance company that they have gone too far in their unreasonableness or stubbornness. You can also tell them that you are going to make the Industrial Commission aware of the misconduct so that it can be considered as part of the ruling in your case.
How Do You Stay Up To Date With New Trends In The Handling Of Workman’s Compensation?
There are many things that we do here at Cardinal Law Partners every year to stay up to date with new trends. Every attorney is required to undergo what we call “continuing legal education credits.” There are also workers’ compensation seminars and other places where we listen to speakers talk about updates in workers’ compensation in North Carolina.
Furthermore, the North Carolina Court of Appeals and the Supreme Court often issue rulings that have a material impact on the workers’ compensation laws. We read those cases to find out what changes the Industrial Commission needs to make in how they handle claims. This helps us determine the best strategies for assisting clients with claims.
Additionally, we have four board-certified workers’ compensation attorneys at our firm. Each attorney has their own caseload and years of experience. We have all litigated and know this area of the law inside and out. As a result, one of the best resources for staying up to date is each other.
For more information on Recent Trends In Workers’ Compensation Claims, a free initial consultation is your next best step. Get the information and legal answers you are seeking by calling (833)444-4127 today.