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Understanding CLAIMS INVESTIGATIONS: Workers’ Compensation claims

Information for employers and employees who are struggling with a claim.

For employees

Worker’s compensation claims literally re-injure the employee all over again, and in some cases the family unit is hurt as well. Not only does the injured worker have to endure the physical and or emotional pain of his or her injury, they may have to deal with a long drawn out worker’s compensation claim as well as the litigation that, in many cases, go along with it. You are not alone, and getting an attorney may be the best thing that you can do.

Look for attorneys who only get paid when you win your case. There are a lot of those operating across the country, and they are adamant about getting your case won. You will fair far better with a private attorney than you will trying to go it alone. It is totally worth the fees they charge, and it can literally mean the difference of thousands of dollars bring put back into your bank accounts.

Typically worker’s compensation claims are filed by the injured party through his or her employer. The claim gets escalated to the insurance carrier or an employee who is designated to handle the worker’s compensation cases and files that the employer is required to maintain. It can be a grueling process, and nothing about it works fast.

Employees filing workers compensation claims get worn out from waiting months upon months, maybe even years, to get the final settlement. They find themselves living hand to mouth on nothing more than their savings, credit cards, monthly payments or subsidies.

If the injured worker is the bread winner you can imagine the devastation on the family unit and their finances.

If you hire an attorney you won’t have to deal with the insurance companies anymore. You have to be very careful, because they will set you up to be denied. You want to let your attorney be the one speaking to them and handling the mail from them. Remove yourself from the litigations process. Your money will come more abundantly and much faster.

The companies insurance will make any claim possible to discredit a person claiming injury in the workplace. So, don’t do any difficult tasks, yard work or heavy lifting because the pictures will show up in court in a feeble attempt to prove that you can work or that you aren’t injured.

Employers have rights too.

On the other hand, many an employer has been scammed by wrong doing employees who simply want a big, a huge pay day via a workers compensation claim or a law suit against the business that they currently work for. If you are an employer wanting to make sure that your employee isn’t trying to pull a fast one then surveillance will work well to get the proof in print and or video.

Not everyone claiming they have been hurt has really been hurt. This is one reason for the high price of insurance these days, fraud! Fraud causes everyone to pay a bigger price. If you are an honest employer than can’t provide solid proof against an employee claim then hire a private investigator and get the goods on the no-good employee. It’s never ok to commit fraud. If an employee did indeed try to scam an employer and files a false claim then he or she deserves to pay the price.

The employer has the insurance companies who will investigate the fraud claims, but if that is not working then you need an attorney. However, if the claim is legitimate you will end up having to pay them their dues, so trying to fight it will only lead to your having to spend unnecessary funds. It is best to go ahead and offer them a settlement and get through the process as quickly as possible.

Seca Investigations:
Phone 61 3 9544 6865 / 61 3 9544 8279
Fax 61 3 9558 8980