Insurance Company Mandate: Bring Down Claims Through Any Means Necessary

July 27, 2016 | Attorney, Matthew Dolman
Insurance Company Mandate: Bring Down Claims Through Any Means Necessary An insurance company's interest in diminishing the value of a claim, or finding a means to deny a claim, has been around since the dawn of the insurance industry itself.  Whether you have been injured on the job through a work related accident, exposure to a toxic substance, or from repetitive trivial trauma, the workers compensation insurance company is likely to use a number of methods to investigate your claim.  If you've been injured on the job before, you're probably aware of the degree of scrutiny a workers compensation insurance carrier is likely to employ.  Workers compensation carriers seek to minimize the amount of benefits they pay through any means available.  Such a focus is not unique to workers compensation carriers.  Minimizing exposure is a goal shared by all insurance companies.  Conducting a thorough investigation of the claimant or plaintiff is one method involved in seeking to minimize exposure.  The process of conducting a thorough investigation includes, but is not limited to:
  1. Determining the severity of your injuries.
  2. Considering the details of your accident.
  3. Interviewing witnesses and any managers or supervisors.
  4. Confirming that your accident and resulting injuries are covered under workers compensation.
  5. Determining what treatment you are likely to require.
  6. Setting a monetary amount in reserves to pay for your lost wages and anticipated treatment.
  7. Evaluating potential defenses to use in refusing to authorize treatment or pay lost wages.
  8. Conducting video surveillance of your activities.
  9. Reviewing any and all social media websites to determine what comments you're making and what activities you may be engaged in.
  10. Considering whether any such activity conflicts with information you've relayed to an authorized treating physician, provided in a recorded statement, or testified to in a deposition.
  11. Reviewing your medical history for evidence of any pre-existing conditions or prior accidents.
  12. Determining whether you failed to provide information concerning a prior accident or pre-existing condition.
  13. Determining whether any work injury or condition can be argued as pre-existing or idiopathic.
  14. NEW METHOD – If you use one of today's self – tracking devices [1], a recent insurance industry article [2] suggests seeking information from fitness trackers, smart watches, heart rate monitors, blood sugar monitors, GPS trackers, smart phone fitness applications, and other wearable devices to review for the purpose of determining whether any such information could be used to deny or otherwise minimize the costs of your claim.
Though the use of fitness tracking device data is offered as a possible source of potentially crucial, “smoking gun,” information, there are barriers an insurance company would need to overcome before such information would be considered admissible.  First and foremost, do you actually own and use a fitness tracking device or application?  It is understood that more people are using wearable technology and self – tracking devices.  An increase in the availability and access to such technology resulted in a greater number of consumers.  However, those who use such technology would have to do so in a consistent manner and the tracking technology applied would have to be advanced to the degree that any related data was both accurate and reliable.  One of the most predominant complaints from consumers regarding wearable technology is inconsistencies and inaccuracies regarding the information provided by whatever device or application in use.  As of July 2016, the use of data from wearable technology, self tracking devices, or smartphone applications is not a likely area from which relevant, material, information will be located.  However, we are aware that the use of social media in injury claims was not entirely foreseeable.  We are keenly aware of the fact that insurance companies work almost as we do.  Staying one step ahead is one factor that sets our firm apart; allowing us to be successful in a claim where other firms fail.  We take pride in our work ethic and the resulting benefits; not the least of which is awareness of information which other injury law firms remain uninformed of. The fact that insurance claims professionals sift through social media for any clues regarding claimants or plaintiffs has been known for some time.  We advise all of our clients to take certain precautions regarding their use of social medial.  Moreover, we do not advise clients to exaggerate the significance of their injuries or otherwise make false statements.  When we undertake representation of an individual injured on the job or otherwise, communication between our client and the insurance company goes through our office.  Such assistance during the pendency of an insurance claim is appreciated by our clients; regardless of whether we're representing someone in a workers' comp claim or representing someone in any of the other numerous areas of law we handle.  Having the option of calling and speaking with your workers comp attorney regarding any and all aspects of your claim provides a degree of relief during an otherwise stressful time.  Consultations with our office are free.  There's nothing to risk by contacting us to ask any questions you may have. We represent individuals throughout the state of Florida. Our offices are located in New Port Richey, Clearwater, and St. Petersburg, Florida, covering all of The Bay Area. Keep in mind that workers compensation insurance carriers are not the only insurance companies that commit time and resources towards the investigation of a claim.  Auto insurance companies, companies providing coverage for slip and falls, and any other type of insurance company that provides coverage for accidents and injuries is one that would seek to determine the extent of their potential exposure.  Potential exposure can be defined as the reasonably foreseeable costs associated with an accident, resulting injuries, and damages related thereto.  There are significantly different factors concerning the determination of damages in a workers compensation claim compared to another type of personal injury claim.  Part of our job is to help ensure that your potential recovery in any type of injury claim is not diminished.  If you've been injured on the job or suffered an injury through any other means, consultations with our office are free.  You can reach us by calling 727-451-6900 or visiting Dolman Law Group Accident Injury Lawyers, PA 800 North Belcher Road Clearwater, FL 33765 727-451-6900 References: [1] [2]  Make that Fitbit a lie detector


Matthew Dolman

Personal Injury Lawyer

This article was written and reviewed by Matthew Dolman. Matt has been a practicing civil trial, personal injury, products liability, and mass tort lawyer since 2004. He has successfully fought for more than 11,000 injured clients and acted as lead counsel in more than 1,000 lawsuits. Always on the cutting edge of personal injury law, Matt is actively engaged in complex legal matters, including Suboxone, AFFF, and Ozempic lawsuits.  Matt is a lifetime member of the Million Dollar Advocates Forum and Multi-Million Dollar Advocates Forum for resolving individual cases in excess of $1 million and $2 million, respectively. He has also been selected by his colleagues as a Florida Superlawyer and as a member of Florida’s Legal Elite on multiple occasions. Further, Matt has been quoted in the media numerous times and is a sought-after speaker on a variety of legal issues and topics.

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