As the lawyers for injured workers in California, we at Pacific Workers’ often see the important role that insurance adjusters play in the workers' compensation claims process. Workers' compensation is a type of insurance that provides medical and financial benefits to employees who are injured on the job. In California, most employers must carry workers' compensation insurance to protect their employees in the event of a work-related injury or illness.
When an employee is injured on the job, they must report the injury to their employer as soon as possible. The employer is then responsible for reporting the injury to their workers' compensation insurance carrier, who will assign an insurance adjuster to the claim. The adjuster's job is to investigate the claim and decide whether the injury is covered under the employer's workers' compensation policy.
The insurance adjuster plays a crucial role in the workers' compensation claims process. They handle gathering information about the injury, including medical records and witness statements. They will also review the employee's job duties and any safety protocols in place to decide if the injury was a result of the employee's own negligence or if it was caused by the employer's failure to provide a safe work environment
Once the insurance adjuster has gathered all of the necessary information, they will decide on the claim. If the adjuster determines that the injury is covered under the employer's workers' compensation policy, they will begin the process of providing medical and financial benefits to the injured employee. This may include payment for medical bills, lost wages, and any permanent disability or disfigurement benefits.
However, not all workers' compensation claims are approved. If the insurance adjuster determines that the injury is not covered under the employer's policy, they will deny the claim. In this case, the injured employee may have the option to appeal the decision, but it is important to have experienced legal representation to navigate the appeals process.
At Pacific Workers', we have extensive experience representing injured workers in California. We understand the complex workers' compensation claims process and how insurance adjusters play a key role in determining the outcome of a claim. If you have been injured on the job and your workers' compensation claim has been denied, we can help. Contact us today for a free consultation.
In addition to the role of insurance adjusters in the workers' compensation claims process, employees need to understand their rights and responsibilities when reporting a work injury. California law requires that employees report their injury to their employer as soon as possible, but no later than 30 days from the date of the injury. Failure to do so may result in a denial of benefits.
Employees also have the right to choose their own treating doctor for their work-related injuries. In California, the employer and their workers' compensation insurance carrier are required to provide medical treatment to the injured employee, and the employee has the right to choose their own doctor from a list of approved medical providers.
Employees need to understand their rights and responsibilities when it comes to reporting a work injury and pursuing a workers' compensation claim. At Pacific Workers', we are dedicated to protecting the rights of injured workers in California and ensuring that they receive the medical and financial benefits they are entitled to. If you have been injured on the job, contact us today for a free consultation at (800) 606 6999.