Insurance plays a vital role in the modern world in providing compensation when various forms of loss or damage occur. Many people have multiple types, including health insurance, car insurance and homeowners’ insurance.
Workers’ compensation programs are another key part of this modern societal infrastructure. They provide a way for injured workers to be compensated for injuries or illnesses suffered on the job.
In Colorado, as in other states, this means that the insurance company plays a key role in workers’ compensation cases. In this post, we will discuss some of the considerations involved when the insurance company fails to respond to a workers’ comp claim or denies a claim.
As an injured worker, you don’t have to sit passively by if your employer’s workers’ comp carrier denies your claim. You can, for starters, get in touch with the adjuster for the insurance company and engage him or her in dialog about the decision.
Sometimes, all that’s needed to get a workers’ compensation claim back on track is providing more information to the insurance company. In other cases, more investigation may be necessary in order for a claim to go forward.
Of course, sometimes insurance companies take the position that a claim is not warranted because the injury or illness is not work-related. That is a factual question and you should be prepared to provide sufficient documentation of your injuries.
Obviously there can be a lot of money riding on such determinations. Given the escalating costs of medical care in recent years, it is important to have as much of those costs covered by insurance as is possible. If workers’ comp is not available, the next question would be whether a health insurance policy of your own applies.
Source: Colorado Department of Labor & Employment, Division of Workers’ Compensation, “Frequently Asked Questions – By Employees,” Accessed Feb. 25, 2014