Tricks Insurance Companies Use to Deny Your Claim


Hi this is Brian Wiklendt with Garfinkel Schwartz. I’m here in Maitland Florida today in our
office here. We also have an office in Cocoa Beach Florida which is on the Space Coast. But our practice especially including the
Defense Base Act takes me all across the country and pretty much all around the world. What I’d like to do is talk to you very
practically about insurance companies under the Defense Base Act. There are only a few of them that kind of
monopolize the market. I don’t like insurance companies because
I used to be in-house counsel for an insurance company for a period of time. For a long period
of time I was outside counsel for insurance companies so I know exactly how they work
especially how they work under this law which is really, really bad. I’ve had clients say that they didn’t
get an attorney until they called me because the nurse case manager said that she was going
to take care of everything. Or the adjuster said, “hey, once you get back home you’ll
be treated like a king…blah blah blah.” The thing you should be aware of just practically
speaking is that every time an insurance company does something, they’re doing something
to try to minimize your claim. What I mean by that is if they ask for a recorded
statement, why would they need a recorded statement from you? They already know what
happened. They know that you were injured at work. They want to try to find something that they
can use against you in the future. It’s the only reason that they would want
a recorded statement from you. They have witnesses they have the company
knows what happened to you, what the injury was. They don’t, they don’t need that. Number two is why would they send you to an
independent medical exam at a doctor of their choosing? Wouldn’t that mean that they’re
trying to figure a way not to rely on your treating physician who’s telling you that
you need these things? That’s probably the only that’s the only
purpose for sending you to an independent medical examination. Is to try to get away
with not having to pay for your medical care. Third thing, they do a vocational assessment.
What is a vocational assessment? Well someone interviews you about all of your
qualifications all the things that you could possibly do physically even though you could
be partially or pretty much permanently disabled. They’ll be doing this vocational assessment
to try to find jobs for you to help you get back on your feet? No! They’re trying to find jobs they think they
can qualify you to do to send those jobs and the qualifications and the physical requirements
to send to their Independent Medical Examiner or Peer Review person to sign off and say
yeah we can probably prove to a judge that he or she can do these jobs. Well that obviously
will reduce the benefits that they pay and that’s the only reason they do it. They don’t do it for your benefit. After
the Vocational Assessment there’s what’s done a Labor Market Survey is done on you.
And that that they try to search for and find jobs that pay enough money that it will affect
your bottom line as to what your compensation rate should be in the future. Another two things the insurance companies
do to try to minimize your claim or get away with not paying you are: Number One they want you to go to a Functional
Capacity Evaluation. They’re looking for exaggeration, they’re looking for any type
of thing that they can think of to say that you’re not trying your best, doing exercises
and doing these different bending and lifting things that you may or may not be able to
do. And they only simply do the Functional Capacity
Evaluation to try to get you back into the work force under their terms and not under
your or your doctor’s terms. So be aware of the Functional Capacity Evaluation as well. Finally a lot of times if the case is really
and it looks like long-term care is going to be needed, including possible surgery,
it’s not unlike, it’s not, it’s not uncommon for the insurance company to do surveillance
on you. And that’s just another one of the tools that they have in their arsenal to try
to get you trapped up and explaining during maybe in an initial written statement or oral
statement they ask you for maybe in a deposition if you’re not represented. They’re going
to try to twist your words and say “you acted like you couldn’t do anything, and
we saw you in your yard cutting your grass, picking up your kids…blah blah blah and
then they’ll try to say that you’re untrustworthy to the judge. So those are all the things that the insurance
companies do to people regardless of you individually because you’re just simply a number to them
and they want to try to minimize the number that they’re going to have to pay you. So that’s all I do for a living I fight
for the true value of the claims for people that I represent but it’s one definitely
worth pursuing. Like I said sometimes they act like they’re
trying to help you out and doing all these things. There’s absolutely no reason why
they would do any of these things other than to try to minimize what they have to pay you. And so anytime you start to feel a little
uncomfortable about these things that they’re trying to do that’s the time you’ve got
to call an attorney. If you don’t call me, please call somebody
else that specializes in the Defense Base Act because it’s complicated, and they have
giant resources and an entire industry on their side playing these games to try and
reduce or completely cut off your benefits. So again I’m Brian Wiklendt with Garfinkel
Schwartz. I’ll come to you call me anytime 24 hours a day. Check out my website, our
website is www.DefenseBaseActLaw.com Brian Wiklendt again signing out thanks for
listening in Maitland Florida.

33 thoughts on “Tricks Insurance Companies Use to Deny Your Claim

  1. Do you represent clients that were injured in North Dakota?
    Was hurt a year ago still cannot walk and medical case manager is pressing for vocational rehab.
    Last PT appointment sent me to ER.
    Was crushed in oilfield accident year ago and had surgery again month ago.
    Nurse attends every Dr. appt I have makes appointments and calls stating I wanted to make PT appointments.
    Can see where this is headed, reason for my questions is there are so few workman's comp attorneys in North Dakota.
    Any advice is appreciated,

  2. sir,can you please help me ,i live in texas,i dont have an atty. no available atty. for me to help me on my claim in my city..

  3. I work in an ortho practice that treats a lot of WC patients and I've always wondered about the insurance side of these cases. They flood our office with requests for medical records, functional capacity questionnaires etc and it's maddening. Some of our patients have been severely injured yet somehow the insurance company can convince a judge that patient can be up roofing homes even though our patient is nearly bedridden from pain. There has to be a better way to treat injured workers.

  4. I am in search of an attorney in Colorado can you help Please. I heard you say you travel.

  5. What if you had an appointment to see an independent medical exam but workers comp cancel it 2 days before.

  6. Claim 2014-011750 in Georgia state board 6/28/2014 with out resolve the state board negligence law enforcement responsibility failure at the law by employer/ insurance A to Z intentionally

  7. State board in Georgia pleasse respond to this case with. No jurisdiction to a member's decisions first count
    Was no coverage and no panel was said in courts no evidence of compliance

  8. I Fernando Santacruz filed a complaint for the law enforcement department i need to have your response regarding my case please ejecutivo director in. Georgia state board i need the response and resolve case thank you

  9. I'm going to represent myself and try to negotiate with insurance company clearly the other driver was at fault but now they are saying we collided into one another. Should I hire someone to do an accident scene reenactment to further support my case?

  10. What can I do if the cop gave me a ticket for no insurance but in the company van. They want the company to show proof and I can’t do anything. I have been waiting for 3 weeks and nothing. They set a court day 😡
    Any ideas?
    This happen in Texas

  11. I tried to call several attorney's locally and they said because I work for Pizza Hut I made too little amount of money and they couldn't represent me.

  12. I told my insurance agent if they don't pay if my home burns down, they better sleep with one eye open for the rest of their lives. because I'm coming after their children, grand children. Then their eyes will be cut out of their fucking head after they are skinned alive. Simple as that. Their nothing but paper pushers who think the law and fancy words are going to protect them. Not where I come from.

  13. This is false. As an attorney are you saying that insurance fraud is non existent and no one ever attempts to commit it? So an insurance company should never take measures to protect themselves from fraud? Those measures are taken to prevent fraud not deny people. Insurance fraud hurts innocent and honest customers who end up paying higher premiums for people who commit fraud. By minimizing fraud they are helping their honest customers. Minimizing fraud has nothing to do with minimizing paying customers for legitimate claims. Shame on you.

  14. Yep – Insurance Companies are evil, IME doctors are evil, and some WC attorneys are evil. They will represent you -negotiate a small settlement – take a cut and leave you high and dry. That is why most people represent themselves.

  15. Attorney will not represent you, if the claimant does not have BI. Attorney just care about their 30%.

  16. I was parked in a delivery van, (on the job) and a large semi truck in front backed into me very hard and kept trying to reverse.
    After I called my employer and he had us trade insurance information. The next day my neck felt very stiff so I went to get a x ray from the hospital.

    They said my results were NO BROKEN BONES thank God! But a very intense muscle spasm is what caused the stiffness.. more than likely caused by the forward impact in the accident.

    So I got an attorney and went after the truck drivers insurance, (not workman comp) now over a week later I'm doing chiropractor visits and my lawyer called to say the insurance company of the third party wants to investigate the claim before accepting liability..

    What does this all mean?

  17. iluvdmusic07
    I saw your video too late. My lawyer never give me any single advice what to do and not to do prior to my Doctor's appointment. Although, I did not lie with my work related injury, but a words of advice would definitely help. No proper communication at all no call, no notice. I am so disappointed. Very stressful. If only it is easy to switch a lawyer. Nevertheless, it is nice to know some useful information from you.

  18. How but I'm waz car accident and oder side have farmers insurance and farmers incurace refuse send adjuster too look my car and my car is not drive able and be 30 days is farmers incurace adjuster dident show up and tell me we send you tomarow but is dident show off can I'm ask what can I do I'm lost my job becuz I'm fired for can go work on the time incurace company is sucks and farmers incurace is scam

  19. Thank you Mr Brian. I really enjoyed your video. But I have a question , I got hurt last week . and my boss didn't find a place to take where workers compensation I'd handle. So she told me to go dos ever I needed to go to be attended ,cause I was bleeding from my finger , she said find closest hospital from you're house.

    Well My son took me to the ER write away. That was on Friday 1st afternoon. Was filled out the worker compensation paperwork I waited over the weekend ,'till Monday I went back to The ER for a follow up as I told by the doctor. Anyways, later, I called my boss, and with sarcastic laugh s she was saying that she wants to handle this matter the cheapest way not to involved workers compensation because she can no even afford it , hearing that my I got frcket out my self. . please, give an advice !

  20. So glad you posted this video and your 100% right about everything I been fighting my BWC claim for almost 2 years and the insurance company is doing everything they can to stop my treatment every time I try to get treatment from a doctor they file a C9 and the BWC stands by them and stops me I have 2 tears in my shoulder and a fraying tear and the only doctor they would let me see was a chiropractor 2 times a week and now they once again put a stop to that with a C9 and once again the BWC turned me down this has been pure hell for me now I have to go to yet another hearing at the BWC which takes forever so if your reading this post don't listen to the people saying do this on your own that's pure BS you will lose well unless you went to law school you might have a chance don't let them throw you under the bus like they are trying to do to me pick up the phone and call this attorney or any attorney like Brian said and most attorneys you don't have to pay anything unless you win.

  21. The insurance company that are treating people poorly by loopholes and inhumane traing will have to answer to GOD for their wrong deeds of deception the insurance company needs to beg GOD for forgiveness and repentance for causing people to suffer needlessly behind their tactics of Delay and Deny God sees all the wrong these companies do to innocent people GOD sits high looks low and misses nothing because He keeps the records Amen

  22. Can I get a service in NC if I need ?? I am suffering from disc herniation and they sent me back to work without MRI.Again I am having pain over leg and back after 12 hours of continuous work and lifting, bending

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