You’ve been hurt on the job or in a car accident. A few days later an adjuster with the insurance company calls you. The adjuster asks you to provide some personal information and to give a recorded statement telling her how the accident happened. She may even tell you that your claim for benefits will be denied if you refuse to give a recorded statement. What should you do?
You may feel like you have nothing to hide. Or that there is nothing new the insurance company could find out that would have a negative effect on your claim. But answering questions during a recorded statement is often a mistake. Even truthful statements can hurt you.
This article discusses:
Keep reading to learn more about giving a recorded statement after an accident.
If you have questions about your work injury case in Virginia, or are looking for a top-rated workers comp lawyer, call me today 804-251-1620 or 757-810-5614. I’ve helped hundreds of injured employees and family members in Richmond, Virginia Beach, Roanoke, Fairfax, and across the state get top-dollar workers compensation settlements. And I can help you.
An insurance adjuster will ask you to give a recorded statement after your work injury. The adjuster works for your employer’s insurance company or for a third-party administrator (TPA). A TPA is a company that processes claims for the insurer.
The adjuster decides if the insurance company accepts your workers comp claim, either in full or in part. Usually this decision is made after the adjuster has:
If the adjuster accepts your workers compensation claim based on this investigation, she should offer you an Award Agreement form. Ask an attorney to review the form for completeness and accuracy.
If the adjuster denies your claim or refuses to provide all the workers compensation benefits sought, you will need to ask the Commission to schedule your claim for trial.
The adjuster will also use the information received during the initial investigation – including anything said during your recorded statement – to set the reserve amount in your workers comp case.
The reserve amount is an estimate of how much money the insurance carrier will pay on your claim. It includes not only the cost of paying an attorney to defend your claim but also an estimate of how much the insurer may have to pay in temporary total disability, permanent partial disability, and lifetime medical benefits. The more severe the injury, the higher the reserve amount.
Insurance companies make money by collecting premiums and reducing payment of claims. To reduce payouts, insurance companies must deny claims. The recorded statement has a key role in denying claims.
How big a role the recorded statement has in denying your workers compensation claim depends on the insurance adjuster handling your case.
Some adjusters are nice and pleasant. They are interested in getting the facts. And straightforward in their dealings with injured workers.
Other adjusters are less pleasant. They will treat you as nothing more than a number whose claim, if it costs the insurance company too much money, could keep them from getting a big bonus this year. And they will go out of their way to trip you up or to make it difficult to receive workmans comp.
The problem is that you will not know what type of adjuster you are dealing with until it’s too late. And even the “nice” adjusters may ask questions in a way that hurts your claim and entitlement to wage loss and medical benefits. Unless you know what workers comp law requires of you, you may leave out a critical detail during the recorded statement.
Here are some of the ways the insurance company may use your recorded statement to try to deny or defend your claim:
1. The insurance adjuster may try to bully you into agreeing to facts that are incomplete or untrue. Or she may try to get you to admit that you aren’t 100% sure of a fact. You may answer “Sure” or “I guess” just to finish the recorded statement. These answers can hurt you in the future.
2. The insurance adjuster will compare your recorded statement to statements found in the accident report or medical records. Often there are discrepancies. This is because the supervisor or doctor writing the statement is not focused on the facts that are critical to litigation. Or they may misinterpret what you’re telling them or not listen to you completely. Though these discrepancies can usually be explained, the adjuster may use them to deny or defend your claim – especially if they indicate a different mechanism of injury. This delays the payment of benefits.
3. Defense counsel may use your recorded statement to attack your credibility and impeach your testimony at deposition and trial. If there is a discrepancy between what you said during your recorded statement and what you say at deposition or trial, defense counsel will find it. And even if you think the discrepancy is small, defense counsel will do what he can to persuade the judge or jury that this misstatement means your testimony is not believable.
After you file a workers comp claim the insurance adjuster will call your employer and find out what it knows about your accident at work. Depending on your employer the insurance adjuster may not get an accurate version of events.
Some employers are concerned that when an employee is injured on the job it will result in an increase in the cost of workers compensation premiums. This leads to an increase in the tendency to misrepresent the facts surrounding your work accident and the extent of your injuries, so that your claim will be denied and the employer’s insurance premiums won’t rise.
Next the adjuster will call you and ask to take a recorded statement.
Though I’ve helped many injured workers overcome false information provided by an employer, the recorded statement usually isn’t the time or place to do so. Why? Because it’s unlikely that the insurance carrier will accept your version of events of your employer’s version, especially when accepting the employer’s version allows the insurance carrier to deny your claim and save money. You’re better off proceeding with litigation.
But if you agree to give a recorded statement the adjuster will turn on her recording device. She will again introduce herself, state the date of the phone conversation, the date you were injured, and the claim number the insurance carrier has assigned to your case. This claim number is different from the claim number assigned by the Workers Compensation Commission. She’ll also confirm that you have given her permission to record the conversation about your work injury.
The adjuster will then ask you questions about the following:
As you can see, the workers compensation statement can be invasive.
The adjuster is looking for a way to deny your claim – either because of a preexisting condition, a failure to report your accident to your employer in time, or how the injury happened. The adjuster is also looking for clues as to whether your financial situation is desperate enough that delaying payment or denying the claim, even though it is valid, could result in you accepting a low-ball settlement offer.
No.
In my opinion you should never give a recorded statement for the following reasons:
1.There is a possibility that you will make a statement that hurts your case.
2. There is a possibility that you will volunteer information that can hurt your case or reduce its settlement value.
3. The adjuster may twist your words or ask confusing and misleading questions that could result in an answer that harms your case.
4. The insurance carrier will have an opportunity to take your deposition and cross-examine you at trial. It is also allowed to force you to attend an independent medical examination (IME). There is no reason to subject yourself to another examination by the insurance company by giving a recorded statement. Trying to recover from a workplace injury is stressful enough.
5. There is a possibility that you will leave out a detail that the Commission would find important in deciding your case but that you may not. For example, we have helped injured workers who did not identify the exact substance that caused them to slip and fall or left out the height of step from which they fell.
6. If the insurance adjuster has not accepted your claim based on statements from your employer, accident reports, or medical records, it is unlikely that your recorded statement will convince the adjuster to accept the claim.
7. If you have a strong case there is no reason to waste time and not move forward with litigation. This keeps the insurance company on its toes. Do not allow the insurer to delay payment with false promises that it will accept the claim after the recorded statement.
So you understand the risk of giving a recorded statement to the workers comp insurance adjuster but want to give one anyway? Then follow these tips:
1. Tell the adjuster that you are willing to give a recorded statement but are not available to do it right now. Schedule an appointment for one week later.
2. Hire an attorney. Or at least pay for an in-depth consultation with an attorney so that you understand your burden of proof under the Workers Compensation Act. For example, many employees are surprised to find out that not every injury at work is covered by workmans comp. You must prove that a specific risk of the employment caused your injury.
3. Offer to give a written statement to the insurance adjuster instead of a recorded statement. This allows you to take your time to draft the statement and include all the details you want.
4. Do not offer information that isn’t asked for.
5. Never try to guess the answer to a question. If you’re not sure of something, tell the adjuster that you will need to think about it and review your notes.
6. Do not make off-the-cuff comments or jokes. No matter how nice the adjuster is, this is just business to her.
7. Make your own recording of the conversation. In discovery the insurance company will ask you to verify that a transcript of the recorded statement is correct. If you have your own recording you can point out discrepancies in the recorded statement transcript and get them corrected.
Though a recorded statement may seem like the perfect opportunity to tell the insurance company your story and why you’re entitled to workers comp, it is often used as a trap.
If the insurance adjuster called and asked for a recorded statement, call me for a free consultation: 804-251-1620 or 757-810-5614.
I’ll discuss whether it makes sense to give a recorded statement following your work injury, provide an overview of the workers compensation claims process, and tell you what steps to take after an accident to give you the best possible result. I’ve handled cases against just about every workmans comp insurance carrier and claims adjuster in Virginia – and I can help you win.