What Is an Insurance Company’s Role in a Workers’ Compensation Claim?

If you are injured on the job, you should be able to turn to workers’ compensation and file a claim. Under this insurance, if the incident occurred while you were on the clock performing regular work duties, you are entitled to reimbursement for anything you paid to cover medical costs. The insurance may even pay the medical provider directly. However, in some situations, the insurance company may be skeptical of your claim and deny it. If this happens, you should seek legal counsel, and you may appeal the denial. If the case goes to court, the insurance company will likely investigate you to prove you are not as injured as you claim.

Hiring a Private Investigator

The thought that a private investigator is following your activities and movements can be unnerving and unsettling. However, this is generally not an illegal tactic. Many insurance companies may choose this strategy if it feels you do not have a legitimate case and want to avoid paying your claim. The insurance provider will gather evidence to show you should indeed be able to work or that the injury you reported does not affect you to the extent you say. To dig deeper into the matter and observe you closely, the insurance may hire an investigator to prove its case.

What Is Allowed and What Isn’t

As upsetting as it may feel, it is not illegal for a private investigator to follow you or watch you. The investigator may take photos of you in public places and may even talk to your neighbors. The investigator may ask people who know and see you what kinds of activities you’re involved in, whether you appear injured, or whether you are exerting yourself physically. The investigator may even take photos of you while you are in your home as long as you are visible from outside. Conversely, it is not legal for the investigator to enter your home without permission, come into your yard or hack into your email accounts or phone communications.

Be Smart

Any experienced workers’ compensation lawyer, like a workers’ compensation lawyer in Spartanburg, SC, would advise you to be careful after you have filed a claim. Don’t put yourself in a position that would raise suspicion or questions. This means you should be prudent about what you post on social media and about what you’re doing around the home and yard.

Workers’ compensation claims can involve large sums of money. If the insurance company has denied or wants to deny your claim, you don’t want to do anything that would validate its suspicions, especially when an investigator is involved.

Thanks to Poliakoff & Associates, P.A. for their insight into how insurance companies play a role in your workers’ compensation claim.