What your Workers Comp Adjuster won’t tell you – #1 The insurance company is in the business of making money

North Carolina’s Workers Comp Statute and Rules are complicated and difficult for a normal person to understand without the assistance of a lawyer.  Insurance company adjusters know this and will hold back information from you to accomplish the #1 goal of the insurance company – to make money.  This is the first in a series of posts that will outline specific things that the adjuster for your Workers Compensation claim doesn’t want you to know.

As I just mentioned, topping this list is the fact that – your adjuster doesn’t want you knowing that the insurance company is in this business to make money, not to make sure you get the best treatment possible.

How does the insurance company make more money?  There are several ways:

  1. By increasing premiums – (Although they are not likely to do this, because the employer will just find another carrier).
  2. By paying out fewer claims
  3. By paying out less money with each claim they do pay out
  4. By denying claims
  5. By getting your back to work as soon as possible (thus stopping your Workers Comp checks)

When you talk to the insurance adjuster, they will probably be very nice to you.  They will do everything they can to reassure you that they will take care of you and that you will get the benefits you deserve.  In so doing, they will ask you to give a recorded statement – just so that they can “document their file” and authorize your benefits.  They will tell you that this is just routine, and that they aren’t trying to trick you with any of their questions.

What they don’t tell you is that they have scripted the questions they will ask you in such a way that you will give the answers they need so that they can deny your claim.  They are very sly about this, and most ordinary folks don’t even realize what is happening.

I don’t want to give the impression that these adjusters aren’t nice people – many of them are.  But they have a job to do just like anyone else, and their job is to make sure that the insurance company doesn’t pay out any unnecessary benefits.