NJ Workers’ Compensation Insurers’ Fraud

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

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Proving Insurer Fraud

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
• Witness testimony

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.