Inside the mind of the insurance company

What you need to know about the investigative process and how workers’ compensation claims get disputed in Michigan.

Insurance companies have various strategies and tactics when it comes to saving money on workers’ compensation claims in Michigan. Getting through the investigative process can be a real challenge. Sometimes the bureaucracy itself causes unnecessary delay.

Did you ever wonder what is actually happening? Let’s go inside the mind of the insurance company. Here is a snapshot of the investigative process and what the claims examiner will be doing.

1. Force you to give a recorded statement of events.

2. Discuss “red flags” with your employer and interview any witnesses.

3. Ask for your signature on a HIPPA compliant medical authorization.

4. Get medical records including years prior to the workplace injury.

5. Review medical records for conflicting statements or preexisting conditions.

6. Send you for an “independent” medical examination.

7. Confer with staff attorney regarding potential legal defenses.

8. Decide whether to issue a Notice of Dispute.

9. Mail first wage loss check 30 days after it was due.

10. Hire a private investigator to conduct video surveillance and activity checks.

11. Review all social media postings for evidence against you.

12. Send a nurse case manager to all of your medical appointments.

13. Attempt to have your work restrictions modified or eliminated.

14. Speak with your employer about getting you back to work.

15. Force you to volunteer at a charity.

16. Require you to meet with a vocational counselor.

17. Ask vocational counselor to prepare transferable skills analysis and labor market survey.

18. Reduce weekly comp based upon Post Injury Wage Earning Capacity (PIWEC).

19. Demand that you submit weekly job search logs.

20. Delay payment of medical bills for no apparent reason.

21. Ignore telephone calls and have poor attitude when discussing your concerns.

22. Send you back to the insurance company doctor.

23. Stop payment of weekly checks.

24. File Notice of Dispute.

25. Offer a small amount of money for settlement.

Michigan Workers Comp Lawyers never charges a fee to evaluate a potential case. Our law firm has represented injured and disabled workers exclusively for more than 35 years. Call (855) 221-2667 for a free consultation today.

Related information:

Injured at work? Advice from a Michigan workers comp lawyer

Photo courtesy of Creative Commons, by Kevin Dooley.

Tags: ,
Injured On The Job: A Guide to Michigan Workers Compensation Law Injured On
The Job
A Guide to Michigan Workers Compensation Law Free Book
Free Consultation
  • This field is for validation purposes and should be left unchanged.