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Workers' compensation is a necessary safety net for employees who are injured as a result of their job. But, as experienced workers' compensation attorneys, we have seen every shady trick that workers' comp adjusters try to pull. This article will discuss some of the common tactics we have dealt with and how you can avoid them.
Summary of the Key Findings
- Insurance companies train workers' comp adjusters to minimize claim payouts.
- Adjusters use tactics to pressure injured workers into accepting lower settlements.
- An experienced attorney can help you fight back and secure your rightful compensation.
Workers’ Comp Adjusters: The Tactics They Use & How to Beat Them
Workers' compensation is meant to protect employees who suffer injuries on the job. Unfortunately, insurance companies often prioritize their bottom line over fairness, using aggressive tactics to reduce or deny claims.
According to a report from the National Council on Compensation Insurance (NCCI), more than half of workers' compensation claimants receive lower settlements than expected [1]. Many fall victim to common adjuster tricks, costing them thousands in lost benefits.
This guide will expose five common tactics adjusters use to undermine claims and provide practical strategies to protect yourself.
5 Types of Workers Comp Adjuster Tricks You Should Know About
1. Manipulative Communication Tactics
- Adjusters may call you late at night, on weekends, or when you are unprepared, hoping you will make a rushed decision.
- Some adjusters are rude and dismissive to pressure you into accepting a lowball offer. Others pretend to be friendly, gaining your trust to extract damaging information.
- Adjusters are not legally required to disclose all benefits you may qualify for, so they often withhold information to minimize payouts.
Counter-Tactics:
- Never discuss your case over the phone without taking notes.
- Do not feel pressured to respond immediately—consult a lawyer first.
- Request all communication in writing to prevent misinterpretation.
2. Medical Manipulation
- Adjusters may ask for a blank medical authorization form to access your full medical history, searching for pre-existing conditions to deny your claim.
- They may pressure you to see a company-approved doctor for an “Independent Medical Examination (IME),” where the doctor often downplays your injuries.
- Some adjusters delay or deny necessary treatments and specialist visits to force you into accepting a lower settlement.
Counter-Tactics:
- Never sign blank authorization forms—limit access only to injury-related records.
- Request an independent doctor of your choice for a fair evaluation.
- Document all denied or delayed treatments and consult an attorney.
3. Invasive Investigations
- Adjusters often monitor your social media accounts for posts that contradict your claim.
- They may request employment records to find past disciplinary actions or performance issues that weaken your case.
- Private investigators may be hired to follow you and take photos or videos that suggest you are not as injured as you claim.
Counter-Tactics:
- Set your social media accounts to private and avoid posting anything about your case.
- Be mindful of your activities in public—assume you are being watched.
- If you notice unusual surveillance, document it and notify your attorney.
4. Financial Pressure Tactics
- Adjusters may offer a quick, lowball settlement, claiming it is your only chance to settle.
- Some miscalculate your wage loss benefits, hoping you will not notice and accept lower payments.
- Delays in check payments and medical bill reimbursements are common tactics to create financial stress and pressure you into settling.
Counter-Tactics:
- Never accept the first offer without reviewing your full entitlement.
- Calculate your lost wages and expected medical costs before negotiating.
- If payments are delayed, request an explanation in writing and seek legal counsel.
5. Legal Intimidation
- Some adjusters falsely suggest your claim may be considered fraudulent to scare you into withdrawing.
- Adjusters may file unnecessary disputes to exhaust you financially and delay your benefits.
- They may intentionally stall and later claim your case is closed due to missed paperwork or expired deadlines.
Counter-Tactics:
- Keep a detailed record of all communications, deadlines, and legal notices.
- Do not let intimidation tactics stop you from pursuing your full benefits.
- If you suspect deception, consult an experienced workers’ compensation attorney immediately.
9 Tips For Dealing With An Adjuster
Dealing with insurance adjusters can be a frustrating and confusing process for an injured worker. The best way to deal with an adjuster is to be prepared. Here are some tips:1. Get a copy of the workers' comp claim form and keep it in a safe place.2. Make sure you understand all the documents you sign.3. Do not give a recorded statement without talking to a lawyer first.4. Be polite and professional when dealing with the adjuster, but do not let them take advantage of you.5. Do not sign a medical authorization form or agree to anything without first getting advice from a lawyer.6. Keep copies of all correspondence and documents related to your claim.7. Pay attention to deadlines and make sure you meet them.8. Be prepared for the adjuster's tricks, and do not let them get the better of you.9. Get help from an experienced workers' compensation attorney who can protect your rights and get you the benefits you deserve.Related Articles:
- How to Scare Insurance Adjuster
- Tips to Improve the Odds of Winning a Workers’ Comp Case
- How Can You Claim Workers’ Comp for CT Syndrome?
See all related personal injury accident lawsuits our lawyers have taken on.
FAQs
What do workers’ comp adjusters actually do?
Workers' comp adjusters negotiate settlements on behalf of insurance companies. Their goal is to reduce payouts and close cases quickly.
What should I do if an adjuster contacts me?
Do not provide any recorded statements or sign any paperwork before consulting an attorney. Adjusters may twist your words to weaken your claim.
Can an adjuster deny my claim?
They can attempt to deny it, but they must provide valid reasons. If you feel your claim was unfairly denied, seek legal representation immediately.
Know What You Deserve
Workers' comp adjusters are skilled in getting the most favorable outcome for their company. However, with the proper preparation and knowledge, you can stand up to them and get the benefits you deserve.If you are an injured worker, Schmidt & Clark, LLP experienced disability attorneys can give you a free consultation to make sure you are treated fairly.
References:
- https://www.ncci.com/Articles/Pages/AU_SOTL-Report-Metrics-Show-Strength-of-WorkersComp.aspx