NJ Workers’ Compensation Lawyer Holds Workers’ Comp Insurers Accountable for Fraudulent and Deceptive Handling of Injured Worker Claims
In New Jersey, the workers’ compensation system is intended to provide employees who suffer workplace injuries and occupational illnesses with certain defined financial benefits, regardless of who may have been responsible for causing the employee’s injury or medical condition. These benefits are usually paid by an employer through a workers’ compensation insurance policy they have purchased. Unfortunately, insurers sometimes engage in wrongful or fraudulent behavior in handling workers’ compensation claims to avoid paying benefits in an effort to maximize their profits. At Camili & Capo, PA, we can help you when your road to recovery from a work injury or occupational disease has been disrupted by NJ workers’ compensation insurers’ fraud.
Facing legal obstacles is no small task. Seeking accountability and justice can be a confusing, time-consuming process. You deserve to keep your focus on your medical treatment and rehabilitation. If you have been the victim of fraud or wrongful conduct by your employer’s workers’ compensation insurer, get the legal help you need to hold the insurer accountable and secure your rights to workers’ comp benefits. Reach out to Camili & Capo, PA for a free initial claim review to discuss what our firm can do to assist you in pursuing justice and the full financial compensation and benefits you deserve under NJ workers’ compensation law.
Types of Fraud That Workers’ Compensation Insurers Commit Against Claimants
Examples of fraud that workers’ compensation insurers may engage in include:
For insurers who offer other types of insurance products besides workers’ compensation insurance, placing workers’ comp insurance premiums in the general liability fund to avoid paying surcharges required for premiums deposited into the workers’ compensation fund.
Intentionally or recklessly failing to remit temporary or permanent disability benefit payments to workers, or underpaying disability benefits
Intentionally delaying payments to workers or healthcare providers
Intentionally or recklessly providing inaccurate benefit notices or otherwise misrepresenting the terms of workers’ compensation coverage
Intentionally withholding from workers information about their rights under workers’ compensation law, such as the right to permanent disability benefits or vocational rehabilitation services when a worker becomes eligible for such benefits
Intentionally altering or destroying claim evidence for the purpose of denying or terminating a claim for workers’ comp benefits or reducing the benefits paid to a worker
Paying bribes, kickbacks, or other improper incentives to healthcare providers, including treating physicians and independent medical examiners, to induce providers to deem a worker fit for duty and not permanently disabled
Accepting bribes and kickbacks from medical providers in exchange for injured worker referrals
Proving that a workers’ compensation insurer has engaged in fraud in the handling of your workers’ comp claim may require relying on evidence such as:
Your pay stubs and income statements, which can be used to calculate your correct average weekly wage
Check stubs or direct deposit statements of the disability benefits you received
Originals of evidence from the scene of the workplace accident, including accident scene photos and video or surveillance footage
Correspondence from the workers’ compensation insurer
Metadata from electronic records, which can show alterations to those records
Medical records from the treatment and rehabilitation of your work injury or occupational illness, along with independent medical expert testimony, which may establish if your treating workers’ comp provider made a medically unsound diagnosis
How a Workers’ Compensation Lawyer with Camili & Capo, PA Will Pursue Justice for You When Your Claim Has Been Wrongfully Denied
You should not have to shoulder the financial consequences of a work-related injury or illness. If a workers’ compensation insurer is attempting to wrongfully or fraudulently deny you the full benefits you are entitled to by law, Camili & Capo, PA will go to work on your behalf to make sure you are not victimized by NJ workers’ compensation insurer fraud by:
Aggressively investigating any allegations of fraud or bad faith denial of your claim or certain benefits, recovering evidence we can use to show that workers’ comp benefits have been wrongfully withheld from you
Documenting your expenses and losses that you may have had to cover on your own that you should have received benefits for
Sitting down with you to discuss your legal options for holding the workers’ comp insurer accountable for their conduct
Standing by your side when you choose to report fraudulent conduct by an insurer to state authorities
Fighting for your rights and the compensation you deserve in formal workers’ compensation hearings or in court if necessary
Contact Our Firm for a Free Case Evaluation to Learn More About Your Legal Options If You’ve Been the Victim of NJ Workers’ Compensation Insurers’ Fraud
Do not wait to reach out to Camili & Capo, PA if you have been denied workers’ compensation benefits due to insurer fraud. Contact us today for a free, no-obligation consultation to speak with a NJ workers’ compensation lawyer about your legal rights and options under state law.
Frequently Asked Questions about NJ Workers’ Compensation Insurers’ Fraud
What are my legal options if the workers’ compensation insurer fraudulently or wrongfully denied my workers’ comp claim?
If you believe that you have been wrongly denied workers’ compensation benefits by your employer’s insurer or that the insurer has engaged in fraud in handling your workers’ comp claim, you can file a formal claim petition with the state workers’ compensation division within two years of the date that you were injured on the job or within two years of the last date that you received workers’ comp benefits. A state workers’ compensation judge can issue a ruling ordering the payment of benefits that you deserve under the NJ workers’ compensation system.
Can I report a workers’ compensation insurer for fraud?
You may also have the option of reporting your employer’s workers’ compensation insurer to the New Jersey Division of Banking & Insurance if you suspect that the insurer has engaged in fraudulent activity in the processing of your workers’ comp claim, including intentionally withholding benefit payments or altering claim evidence to deny your claim or terminate your benefits.