My Workers’ Comp Adjuster Won’t Return Calls or Authorize Medical Treatment. What Should I Do?

I cannot begin to tell you how many times I’ve gotten a call from an injured worker who needed a lawyer because the insurance company adjuster would not return phone calls or simply seemed to stop all forms of communication.

Not only is this offensive, but it’s just plain rude.

We’ve dealth with an insurance adjuster who waited months before responding to an injured worker. When we got involved and reached the adjuster, she made light of the fact that she had ignored our client, and said she would make a decision in two weeks. Two weeks?*

In workers’ comp, we trade stories like this all the time. In our experience, some adjusters will sit on cases just to keep our clients waiting, hoping to wear them out. Unfortunately, this type of “avoid and delay” approach does wear some people out until they just give up. And that’s why some insurance companies do it.

Here at our firm, we know their approach. We’ll fight that approach.

These injured workers are usually people in need of medical treatment or disability payments. Payments they may be entitled to. Payments that may make a huge difference between deciding to pay their rent or pay their utilities, or even whether to buy food in some cases. Or payments that may mean the difference in continuing to get the medical care they need.

Injured workers can too often experience unnecessary pain and financial hardships just because some adjusters ignoring their pleas for help!

What to Do If an Insurance Adjuster Won’t Return Your Calls

Directions on what to do if an insurance adjuster won't return your phone calls.

My professional observation over the 23+ years I’ve been an attorney is that insurance companies do not hire enough adjusters to manage the number of cases they have.

Sadly, the reason they don’t, in my opinion, is likely related to money. Most insurance companies are for-profit businesses. The less people they hire, the less money they have to spend. And as we’ve seen day in and day out, it seems that some insurance companies hope that the injured workers will just give up and go away. Many of them do go away. But this type of treatment is not fair or appropriate under our workers compensation laws.

If you find yourself in a situation in which the adjuster won’t return your calls, here’s what I suggest.

  • Sometimes, it’s simply a function of the “squeaky wheel gets the grease.” Call the adjuster often and leave messages every day reminding them that you need medical treatment in order to return to work, or that you need your disability check so that you can pay your bills.
  • Call the adjuster’s supervisor as frequently as you feel you need to. While frustrating, we have found that this approach often works.
  • If you need follow-up medical care, try calling the doctor’s office that the carrier sent you to and ask them to schedule an appointment and ask that they get approval from the adjuster.
  • In other words, be a pest.

But if you don’t want to go through all that rigmarole, or if you don’t have the time to follow up every day with letters and phone calls, hire an experienced workers’ comp attorney from the start.

North Carolina Workers’ Comp Lawyers Can Help You…

7 ways NC workers' comp lawyers can help.

  • Communicate with the adjuster and others
  • Try to get your payments started, or continued in some cases
  • Keep your case moving along
  • Try to negotiate a higher settlement than you may be able to on your own
  • Try to obtain medical benefits the insurance company is denying
  • Fight for a measure of job security if, for example, the insurance company forces you to go back to a made up job, which may be disguised as “light duty,” “modified duty,” or “restrictive” employment. (These jobs are sometimes eliminated later.)
  • Give you added peace of mind knowing you have someone who is championing your rights

And many other things, depending on your situation. Think you can’t afford legal help? Think again. Most workers’ comp attorneys work on a contingency fee basis set by the state of North Carolina.2 The standard fee is 25%, and it usually comes out of any payments your attorney helps you collect from the insurance company. This 25% set rate affords you the peace of mind of not having to worry about a particular lawyer or law firm being “too expensive.” And it allows you to choose a law firm you feel is best suited for your situation – without having to worry about fees.

Get a FREE Case Evaluation from North Carolina Workers’ Comp Attorneys

If you feel you’re getting the run-around, or that your insurance company may not have your best interests at heart, contact us or call 1-866-900-7078.

Let one of our workers’ comp attorneys  – six of whom are North Carolina Board Certified Specialists in workers’ compensation law – evaluate your situation for free.

 

* This is a specific example of an experience we had with an insurance company and adjuster. This does not necessarily represent any industry as a whole. The description of events are based upon the recollections of individual staff members.