If you were hurt while on the job, you will likely need to speak with an insurance adjuster at some point during the workers’ compensation process. This conversation could be a crucial part of receiving the benefits you need. The adjuster will take detailed notes of the discussion. Couple with the evidence you submitted, the adjuster will determine how much the insurance provider will pay for your injuries.
The value of your claim could be significantly reduced if you say the wrong thing or provide an opportunity for the adjuster to question the severity of your injury or the facts surrounding your accident. In some situations, a misstep could result in your claim being denied.
Working with our experienced Springdale workers’ compensation attorneys will help you prepare for the questions an adjuster will ask and avoid many of the common mistakes claimants make. Contact our office at (479) 316-0438 to review the workers’ compensation application process.
What Does an Insurance Claims Adjuster Do In Arkansas
A workers’ compensation adjuster is a claims specialist that your employer’s insurance company employs. Their most important role is to evaluate your claim and injury to determine what your benefits should be. In nearly every situation, an adjuster is working to limit the insurance company’s liability. Before speaking with an adjuster, you should talk with our Fayetteville workers’ compensation attorneys.
A claims adjuster will gather various types of evidence and documentation to make a determination. Some of their duties are listed below.
- Speak with you to get your statement regarding what occurred
- Gather information from your employer concerning the accident and injury
- Collect testimony from witnesses who saw what happened
- Determine if your claim is accepted or denied
- Coordinate with your doctors and other healthcare providers
- Approve or disapprove medical treatments, including surgery and physical therapy
- Discuss potential settlement options
Things to Avoid When Speaking With a Workers’ Compensation Insurance Adjuster in Arkansas
First, you are not required to speak with an insurance adjuster. The information you provide could be used to reduce or deny your benefits claim. However, the adjuster will determine what the insurance company will pay, so you want to present your case. Having our Farmington workers’ compensation attorney at your side is one way to avoid costly errors or misstatements. The knowledgeable lawyers in our office know what information is important and have the ability to prevent adjusters from asking inappropriate questions.
No Recorded Conversations
You should never agree to have your conversation with the insurance adjuster. An adjuster has no authority to compel you to submit to a recording. A recorded conversation could be used to contradict later statements to reduce or deny your claim. You have the right to politely decline the request.
Stick to the Facts
A common tactic employed by insurance adjusters is to try and engage in a friendly conversation. Harmless banter and sympathetic questions create a relaxing atmosphere. If a person is relaxed, they might provide additional details or information they normally would have kept guarded. When discussing anything with an insurance adjuster, you should not deviate from the facts, such as where the accident occurred, the time, the date, and the injuries you sustained.
Be Specific
While it is important to stick to the facts and not get too expansive in your conversation with the adjuster, you still want to provide as many details as necessary to describe what occurred. You should not embellish or exaggerate what happened – staying consistent is crucial in presenting a creditable account.
Injuries Should be Fully Described
Part of the reason you are speaking with an adjuster is to review your injuries. Therefore, you want to ensure you do not accidentally omit any critical information. If you leave out an injury, the insurance company might not pay for it. You need to be inclusive in your description. For instance, if you hurt your neck in an accident, you want to explain if you are experiencing pain in your shoulder or arm. It is generally a good idea to go through every individual body part.
Be Honest About Pre-existing Conditions
You want to provide concise and clear information to the insurance adjuster. However, you also want to remain creditable. This means you need to be honest. Some people believe they need to hide a pre-existing condition during their conversation with an insurance adjuster. Workers’ compensation does not cover a pre-existing condition. However, an aggravated injury should be covered. The insurance adjuster will likely discover any pre-existing condition you might have. If you are caught hiding your medical condition, the insurance company will have a reason to deny your claim
No Family Questions
You have no obligation to answer any questions regarding your family or financial situation. All questions should be directed towards the accident or your injuries.
Do Not Sign Anything
One of the most common pieces of advice our Arkansas attorneys give injured people is not to accept any settlement without having our office review the agreement. You should also never sign any document or authorization without speaking with an experienced attorney. An adjuster might attempt to have you sign a release allowing them access to your complete medical history. In other cases, you might agree to a lump sum payment that does not cover all your expenses and losses.
Request a Panel of Physicians
If you have not been seen or treated by a doctor, you should request that a panel of physicians review your workers’ compensation claim. In many cases, having a panel of doctors review your claim rather than one doctor will increase the chances you receive the necessary benefits.
Before Talking to an Insurance Adjuster, Call Our Arkansas Workers’ Compensation Attorneys
Workers’ compensation benefits are a much-needed lifeline for many injured employees. You do not want to assume your claim will be approved or take your benefits for granted. Our Arkansas workers’ compensation lawyers represent injured workers throughout the state. If you suffered a severe injury on the job, call our law offices at (479) 316-0438.