The more employees file workers' compensation, the higher the premium costs for the employer to pay. Worker's compensation insurance premiums rise due to the following reasons: more workers actually file claims than the estimated number and; when an expensive claim is being filed which was not expected. An example of this is a back surgery, this is a particularly expensive claim.
Employers and their insurance companies always hire the services of investigative agencies to watch the daily activities of their employees who have filed these workers' comp claims. They want to make sure that the employee is really suffering the illness they claim to rule out fraud and determine if he or she deserves the claim.
Insurance agencies' employer bias
Many employers think that some injuries being filed are not valid or serious. They assume that employees are not really honest and truthful and are just "malingering". Some employers hold the belief that employees who suffer from carpal tunnel syndrome or a lumbar back injury are just feigning sickness for the purpose of financial gain.
Insurance companies have employer bias in cases when an employee suffers injuries or pain that can't be verified by medical examinations or laboratory tests. Some medical conditions are not easy to objectively verify and this doesn't mean that the employee is malingering.
Reasons to deny a claim
Sometimes, your employer or the insurance company denies your claim or a part of it. A written notice should be given to you. The most common reasons are: not suffering a serious injury; injury wasn't within the scope of employment; no need for a medical treatment for the injury suffered; and no need to take a sick leave or be absent from work due to the injury.
Battling against the insurance company
1. When you receive a notice of the denial of benefits or claims, phone or send a letter to your company's workers' compensation insurance carrier.
2. If it doesn't solve the problem, hire a worker's compensation lawyer as he knows the workers compensation law and can help you in requesting for a hearing with the workers' comp board.
The main point is, employees who have been sick or injured resulting from doing their job should file for workers' compensation benefits to protect themselves. If the insurance company denies it, they should fight by seeking one who is knowledgeable of workers' compensation law -- a workers' compensation lawyer.