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Started By
Message
workers compensation question
Posted on 8/21/15 at 12:07 am
Posted on 8/21/15 at 12:07 am
My wife fell down concrete stairs at work. Her company refused to file a claim with the workers compensation carrier and made her tell the ER room it happened at home. We have high deductible insurance.
Anybody had this situation? Can they make you lie?
(The company has a video of the injury just outside the back door - they wanted to know if she was on her cell phone and fell.)
Anybody had this situation? Can they make you lie?
(The company has a video of the injury just outside the back door - they wanted to know if she was on her cell phone and fell.)
Posted on 8/21/15 at 12:09 am to matthew25
Lawyer up, with the quickness
Posted on 8/21/15 at 5:55 am to matthew25
tell them to go to hell and lawyer up because even if your wife said it happened at home and your personal insurance finds out it happened at work, then they will not pay the claim. I would find out who the company's workers comp insurance is, and by law it has to be posted with the other required posters along with the approved occupational injury clinics and call them myself and report it. I would also call your state board of workers compensation. Also it does not matter that the employee was not following safe work practices at the time of the injury (walking and talking on cellphone) the injury still happened at work while she was on the clock.
This post was edited on 8/21/15 at 5:59 am
Posted on 8/21/15 at 7:19 am to matthew25
Very much illegal. Has to be filed with the correct insurance, or, if I remember correctly, you can be subject to a fraud claim by your health insurer if they find out.
The penalty at one time was $10k and up to ten years in prison, although you would probably be able to offer restitution in lieu of prosecution.
The penalty at one time was $10k and up to ten years in prison, although you would probably be able to offer restitution in lieu of prosecution.
This post was edited on 8/21/15 at 8:17 am
Posted on 8/21/15 at 7:24 am to matthew25
quote:
made her tell the ER room it happened at home
I hope this isn't true, and if it is I hope she told the truth.
If they pulled something like that I would be looking for a better place to work.
Posted on 8/21/15 at 8:48 am to matthew25
Dude... I just can't believe a company would tell her to lie about that.
Please talk to a lawyer about this
Please talk to a lawyer about this
Posted on 8/21/15 at 8:52 am to Big Floppy TDs
quote:
Lawyer up, with the quickness
This is pretty good advice for most WC claims, but especially in an instance when the employer told the employee to commit fraud.
Posted on 8/21/15 at 8:57 am to Perrydawg
quote:
tell them to go to hell and lawyer up
Posted on 8/21/15 at 10:07 am to matthew25
they gone get loved tendahly by a lawyer. sounds like a shitty employer.
Posted on 8/21/15 at 12:59 pm to The Spleen
quote:
Lawyer up, with the quickness. This is pretty good advice for most WC claims,
it is actually the worst possible advice you could give someone.
quote:
but especially in an instance when the employer told the employee to commit fraud
absolutely get an attorney involved if there is something fishy going on like that.
p.s.... is she actually hurt? Most companies dont file comp claims for medical only issues. They may send in notice to the carrier to satisfy the provisions of the policy, but keep the cost in house. They send them to the company doc, pay the medical and keep it off the experience mod and loss run. however once a claim moves past MO, it goes back to the carrier so that the adjuster and nurse case managers can handle the case.
for those of you saying to get an attorney, all you are doing is inflating the $ amount of the claim and putting money into the attorneys pocket. A judge has to review and approve any settlements, so the injured worker is 100% protected by someone looking out for them.
$200,000 settlement with no attorney = $200,000 to claimant
$300,000 settlement with attorney = $180,000 to claimant and $120,000 to attorney
and the cost of insurance is spread around to everyone else and built into the jobs that are out there. 33% increase in taxpayer costs in the public works construction arena.
:sigh:
Posted on 8/21/15 at 1:50 pm to Mr.Perfect
Posted on 8/21/15 at 1:59 pm to Cold Cous Cous
You must be a plaintiff attorney.
Fact is everything I said is 100% true.
Fact is everything I said is 100% true.
Posted on 8/21/15 at 2:05 pm to Mr.Perfect
quote:
33% increase in taxpayer costs in the public works construction arena
link?
Posted on 8/21/15 at 2:09 pm to Mr.Perfect
quote:
You must be a plaintiff attorney.
Not at all. Unlike you I'm capable of expressing an opinion even if it doesn't directly benefit me financially.
Posted on 8/21/15 at 2:18 pm to Mr.Perfect
quote:
for those of you saying to get an attorney, all you are doing is inflating the $ amount of the claim and putting money into the attorneys pocket
As opposed to keeping the $$ in the insurance company's pockets? I'd rather have someone on my side that knows how to navigate the process.
But I'll amend and say only get a lawyer if the injuries are serious, or in this instance of fraud.
Posted on 8/21/15 at 2:31 pm to Cold Cous Cous
Hurler loss ratios = higher premium.
I would benefit from the attorneys driving up costs.
However we all lose because insurance is a pass through
I would benefit from the attorneys driving up costs.
However we all lose because insurance is a pass through
Posted on 8/21/15 at 2:33 pm to Motorboat
Boat.... my example is at 33%
Posted on 8/21/15 at 3:07 pm to The Spleen
quote:
As opposed to keeping the $$ in the insurance company's pockets?
but do you understand that ALL insurance companies are FOR PROFIT? Even the Mutuals that return dividends are returning profit to the shareholders.
Insurance is borrowing someone else's money to pay a claim.
When the loss ratios go up the rates go up. really simple.
Posted on 8/21/15 at 3:13 pm to Mr.Perfect
Sure, I used to work in insurance. I found it to be a detestable industry, and one I wouldn't want to go up against by myself if I felt I wasn't getting what I thought I was entitled to. They have deep pockets and good lawyers, and I'd be no match for them.
Maybe it's unfair to base that opinion from just one insurance company, but I've seen first hand the lengths they will go to to minimize their claim exposure.
Maybe it's unfair to base that opinion from just one insurance company, but I've seen first hand the lengths they will go to to minimize their claim exposure.
Posted on 8/21/15 at 3:13 pm to Mr.Perfect
quote:
but do you understand that ALL insurance companies are FOR PROFIT?
You'd rather an insurance company hold on to profits than pay someone what they are owed?
If the lawyers didn't hold them to a standard, the insurance companies would frick everyone.
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