If you are questioned about your case, it is imperative to understand that you do not have to handle your claim on your own. In fact, it is generally not a good idea to do so.
In the state of Missouri, if any business owner has more than five employees (or if they are in the construction industry), then they are required to carry something called workers’ compensation insurance.
Workers’ compensation coverage seeks to ensure that if someone is injured while they are at work, their employer has the means to cover the cost of their damages.
Not based on fault, many workers who are hurt while working think that they do not need a lawyer. After all, since they don’t have to prove that anyone was negligent, it should be a simple open and shut case. Right?
Not necessarily. Unfortunately, for many workers, that is not the case. Often workers need the help of a workers’ compensation lawyer to defend their eligibility and get what they deserve.
Who Determines Which Workers Are Eligible?
Workers’ compensation insurance is like any other insurance in the respect that the insurance company is first and foremost a business. Like any other business, workers’ compensation insurance companies operate to turn a profit.
That means that they try hard to limit what they pay regardless of the high premiums companies pay to ensure that their workers have access to everything they need.
There are many ways that an insurance company will try to either limit their liability for a workers’ compensation claim or to deny it altogether. If you are questioned about your case, it is imperative to understand that you do not have to handle your claim on your own. In fact, it is generally not a good idea to do so.
Reasons an Insurance Company May Deny a Workers’ Compensation Claim
Although you can be entirely responsible for your injuries and still receive compensation, some things can disqualify you. To be eligible to collect benefits you have to be engaged in a work-related activity.
If you are being asked at all about what you were doing while injured, it is essential to understand that if the insurance company can prove that you were doing something that wasn’t under the scope of your employment when you were hurt, they might have the right to deny your claim.
The insurance company also has a right to demand that you have an independent medical examination. If they suspect that your injury didn’t happen the way that you claim, it isn’t as extensive as you say, or that you were not injured at all, they can require you to see another physician to try to prove you wrong.