When an employer or compensation insurance company decides to deny a worker’s compensation claim, it may seem like that entity has an unreasonable objection to that particular claim. However, many claims are initially rejected in order to limit the costs of compensation payouts, especially in instances when the worker has fraudulently filed for assistance. By understanding the basic cost drivers of compensation, a worker can be more informed going into the claims process as to what employers and insurers read as fraudulent or unnecessary claims.
Perhaps the most obvious part of compensation that may cause a claim challenge following a work accident is the compensation for medical bills. These expenses can be extremely high depending on the injury, causing either the insurer or the employer to lose a substantial amount of money on paying for the employee’s recovery. In addition to problems with even legitimate claims, employers may need to watch out for insurance fraud on the hospital’s behalf, as unnecessary charges can quickly prove costly.
As well as paying for medical bills, employers are also expected to provide employees the costs and effort needed to reintroduce that employee into the workforce. This can include paying for transportation to and from follow-up treatments and therapy and adapting the workplace in case of a debilitating injury. Whether redesigning a workspace, changing job descriptions to work with a disabled laborer, or providing new instruments to reduce future injuries, these costs can drive up the bottom line for a compensation claim.
Working with an insurance company may have its own costs, which can lead to claim denials in order to keep premiums down. If a company works with a compensation insurer, the process can be complicated, costing an employer both time and money.
To learn more about creating a claim that is less likely to be approached as fraudulent, contact a workers’ compensation attorney.