If you frequently handle workers’ compensation claims, you will see a disturbing trend — some companies routinely deny valid claims. In some specific types of work, it seems as if a wrongful denial of benefits is simply the normal course of action.
A recent article on an insurance industry website titled “Not to Be Denied (in Denying Inappropriate Claims)” raises significant questions. According to the article, Kelly Services (a temporary staffing company) has a claim denial rate now at 15% and suggests that 20% may be a “benchmark to shoot for.” The article quotes a Kelly official who implies that claims should continue to be denied in an effort to save money until the company begins to face litigation costs. In other words, deny claim after claim unless forced to pay in court.
In my practice, I see valid claims every day that have simply been denied in the hope that the worker goes away. These denials are wrong. The workers’ compensation system in Alabama was established to get workers the care needed to return to work if possible. If not possible, then the system is set up to provide minimum disability benefits. The choice simply to deny valid claims costs all of us greatly. We all pay when litigation costs are increased. We all pay when the costs of injured workers is shifted from the insurance carrier to our government.by Jeff Blackwell