You have filed a claim for workers’ compensation benefits, and now you must wait to find out if you will actually receive them. The good news is that they probably authorized your benefits. However, there has been an increase in the number of first claims being turned down. You should appeal the insurance company’s judgment because there is a good possibility you will win. The first step is to retain the services of a competent workers compensation lawyer in yuma.
How you handle your injuries and the claims procedure can affect the amount of compensation you receive. Mistakes can be expensive, but with the guidance of an attorney, you can avoid the most common pitfalls that cause people to lose out on their benefits. Carefully observe all deadlines and comply with all demands for information and documentation in the meantime.
The Likelihood of a Claim Denial for Arizona Workers’ Compensation
Workers’ compensation claims that insurers deny require either additional evidence or legal action.
In most cases, insurance companies will not pay out on a worker’s comp claim for the following five reasons:
- The insurance company thinks you are not hurt and capable of working.
- The insurance company doubts that your work-related injury even occurred.
- You did not give your employer the required time to learn about the injury.
- There may be missing evidence from your claim.
- Because you did not visit a specialist, your insurance company will not cover your medical bills.
Denials are possible. Researchers have shown that between 7 and 25 percent of people live in constant denial. It makes little difference that, ultimately, claims are approved. Your family will be put through a lot of stress if your claim is denied.
Commonly Rejected Insurance Claims
The likelihood of an insurance company paying out on a claim that was not caused by an accident is substantially lower. For instance, if you get a disease years after being exposed to dangerous substances at work, you may be eligible for compensation. However, your insurer may investigate the legitimacy of the link between your injury and your job. The same is true if you get a repetitive stress injury or your job aggravates an existing health problem.
If your insurance claim is denied, the company must provide a reason. You must investigate the cause and determine whether or not the insurer was in error. They could be using whatever evidence they have available to them at the time to justify their denial. The other possibility is that they are trying to make your life difficult by erring on the side of protecting their interests rather than yours. Denial of a claim is standard operating procedure for insurance companies, even if it is not in their financial interest to do so.