Ten Things Your Workers’ Compensation Insurance Company Might Not Tell You

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  • It is the adjuster’s job to explain all the benefits available to you under your coverage.  Most people have little idea of the benefits available to them under insurance.  The insurance representative is trained in these benefits.  It is their job to help you.
  • You have the right to choose the doctor you receive treatment from.  However, some self insureds have the right to designate your treating physician for the entire course of your treatment.  If in doubt you may ask the ICA ombudsman, or an attorney.
  • If you return to the carrier/employer’s designated physician for a second visit, this counts as your election to make that your treating doctor.  Now, to see your own doctor, you will have to go through special procedures.
  • An independent medical physician may not be acting in your interest.  Insurance companies often get IMEs looking for ways to limit the payment of benefits.
  • The insurance company has a duty to promptly and thoroughly investigate all relevant information you provide them for payment of your claim.
  • Your insurance company is not entitled to your private medical information concerning conditions unrelated to the pending industrial claim.
  • If the insurance carrier requires you to travel an extraordinary distance for purposes of a medical examination, they should provide you transportation, lodging, and meal expenses, as well as a reasonable time to complete the trip.
  • The insurance company has 21 days to investigate your claim for acceptance or denial, after they receive notice of your claim from the Industrial Commission.  If they do not issue a notice of acceptance of denial within that 21 days, they must pay medical and disability benefits as if the claim were accepted until such time as they issue a notice of denial.
  • If the insurance company denies your claim without conducting a complete investigation, that is bad faith.
  • It is not good faith to conduct an investigation designed to deny benefits.


Arizona Workers’ Compensation Attorney

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