Firm-Wide blog

Insurance Company Tactics

By Burg Simpson
November 5, 2013
2 min read

I am reminded over and over again of the disadvantages the injured party has in dealing with their workers compensation case. Frequently, before I am involved, a client will say that his supervisor or a nurse case manager went to all of his appointments with him, and even came into the room when he went in there. If it is a nurse case manager they might have spoken to the doctor behind the clients back and told the doctor what the insurance company adjuster wanted the doctor to know about the case or the injury. THIS HAS TO STOP!

You can prevent the insurance company from talking to the doctor and you can get rid of the nurse case manager if you know the workers compensation laws, but the injured party rarely can do this on their own. The adjuster knows the physicians, and frequently talks to them about the injured parties care and treatment. This can be considered “directing care” if they are telling the doctor what to do, or what they will authorize and not authorize. In some cases the insurance company has nurse case managers that work directly for the company and they manage the medical side of the case. They are not there on the injured parties behalf, no matter how nice they are or what they say. As long as you are aware of this you will have a better understanding of why attorneys are needed in workers compensation cases.

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