Meeting with Insurance Companies During a Rock Hill Workers’ Compensation Claim

Obtaining workers’ compensation benefits after suffering an on-the-job injury can be a lengthy and complicated process. If it is necessary to file an appeal after receiving a denial from an insurance company, you may need to request a formal hearing with the South Carolina Workers’ Compensation Commission.

However, formal hearings over workers’ compensation benefits disputes are rare. You and the insurance company have the ability to participate in informal mediation sessions to attempt to settle the claim before it gets to a formal hearing.

Even so, meeting with insurance companies during a Rock Hill workers’ compensation claim can be a risky endeavor. While these sessions are not binding in a legal sense, talking with the insurance company may serve to expose the weaknesses in your case and provide fresh reasons for the insurance company to deny your claim.

When may Talking with the Insurance Company be Appropriate?

Disputes over workers’ compensation benefits are adversarial in nature. Put another way, a claimant for benefits is attempting to force an insurance company to provide payment, and the insurance company is trying to find any excuse possible to avoid payment.

While both sides have the right to ask the State to intervene, it may be beneficial to attempt to come to a settlement before requesting a formal hearing. Indeed, it is always possible to contact the representative who is working on a claimant’s case to ask for an explanation as to the reason for a denial or to bring more evidence to their attention. However, this approach can be risky.

Insurance companies often record all conversations that take place over the phone. This means that if a claimant admits that their injury is not work-related, provides conflicting statements about how the incident occurred, or downplays the severity of their injury, this is grounds for the company to deny the claim. In general, the only appropriate time to talk with the insurance company is under the supervision of the State’s hearing agency.

What to Expect When Meeting with the Insurance Company

While participating in an informal meeting with the insurance company prior to a formal hearing is never required, it can come with benefits. Especially if a claimant has the help of an attorney, these sessions can result in settlements that leave all parties satisfied.

An informal session can help both parties to understand the perspective of the other, to present evidence in a simple way to find common ground, and to negotiate their case before asking a judge to make a binding decision. Working with a lawyer in Rock Hill during these sessions can help people make a compelling argument, properly present their evidence, and avoid making any statements that may weaken their claims.

A Rock Hill Attorney Could Represent You in Meetings with Insurance Companies

In many ways, workers’ compensation insurance disputes are much like other civil claims. This means that a court will only get involved if the two parties cannot come to a settlement on their own. As a result, it may benefit you to talk with the insurance company before the case gets to a formal hearing.

However, doing so is not without its risks. Any statement you make is not official in the eyes of the law but may give the insurance company more evidence to deny a claim or a new strategy in court. It may be best to avoid talking with the insurance company without an attorney.

A Rock Hill lawyer could help to protect your interest during every phase of a workers’ compensation claim. Specifically, during informal talks, they can help to frame your argument, organize your evidence, and make your demands for payment in a persuasive manner while leaving room for negotiation. Contact Schiller & Hamilton today to see how they could help during talks with the insurance company.