Dealing with Insurance Companies
Illinois workers’ compensation law requires employers to provide workers’ compensation insurance for employees. Most employers self-insure, purchasing insurance policies from private providers. These providers are obligated, by law, to pay for treatment that is reasonable, necessary, and related to work-related accidents and injuries. In reality, insurance companies work for the employer, and often they are not interested in providing effective and efficient treatment for hurt workers. Insurers may subject the employee to a strategy intended to deny or delay workers’ compensation benefit payments. At Therman Law Offices, we understand the frustration and challenge experienced by workers pursuing compensation claims and dealing with insurance companies. For more than 35 years of combined experience, our Schaumburg and Wheaton workers’ compensation lawyers have fought back against insurance company tactics, helping workers secure the benefits to which they are legally entitled. We understand that it can be intimidating to deal with your employer’s insurance company, particularly when you are recovering from an accident or enduring illness. An attorney can help shoulder the burden of dealing with an insurance company.Dealing with Insurance Companies
To recover benefits as an injured worker under Illinois law, a workers’ compensation claim must show that an injury or condition was caused by work-related conditions or a workplace accident. This causal connection is necessary because according to the Illinois Workers’ Compensation Act, employers are mandated to provide specified benefits to workers who endured on-the-job injuries or illness. Employers may hire workers’ compensation insurance companies to directly pay benefits to injured workers or self-insure and pay claims directly.
Insurance companies represent their employer and often attempt to deny or minimize a claim for compensation. For example, an insurance company may argue on behalf of an employer that an employee did not file their claim within the specified time period. Or, they can contend that an accident occurred off-site, limiting the employer's legal responsibility to provide benefits.
Workers seeking compensation for an on-the-job injury should present medical documentation that attests to their condition and be able to clearly demonstrate that their job duties caused this condition. Disputing medical records is another way that workers’ compensation insurance companies may challenge a claim. By showing an inconsistency or discrediting a worker, the insurer may seek to deny a claim, or reduce benefits.Legal Duties of Insurance Companies and Injured Employees
The legal duties of an insurer as it relates to workers’ compensation include investigating the claim, confirming coverage, and ensuring medical care authorization. The insurer also determines whether compensation and medical costs will be paid, and what types of benefits should be denied, or delayed. The investigation process is critical, because insurance adjuster findings dictate whether the injured worker will be able to collect benefits. Insurance companies have a duty to investigate and accept or deny a claim within a set period of time.
An injured worker filing a claim for compensation increases the likelihood of a success by adhering to the statute of limitations. This time period requires the employee provide notice to the employer within 45 days of their injury. A claim for benefits must be filed within two years of the last payment from the employer, or three years from the date of injury. For repetitive trauma injury or illness, the date is considered to begin when a reasonable person would have become aware of their injury and knew that it was caused by employment.
For claims that are denied, an appeal may be filed with the Illinois Workers Compensation Commission. A skilled attorney can help you appeal your case and secure you the benefits to which you are entitled.Lawyers in Wheaton and Schaumburg Serving Your Needs
Hiring an attorney experienced in securing Illinois workers’ compensation for workers throughout Wheaton and Schaumburg is the first step toward alleviating the challenges of dealing with insurance companies. At Therman Law Offices, our lawyers can help you if you are beginning your claims process or have been denied a claim by an insurance carrier. We strive to provide accurate and sufficient medical records that support benefits. Our attorneys have helped employees in West Chicago, Lemont, Elmhurst, Oakbrook Terrace, Westmont, Downers Grove, Oakbrook Terrace, Clarendon Hills, Darien, Lisle, and Bolingbrook. Call our office at 773-545-8849 or reach us online to schedule a free appointment and to discuss the details of your situation.