What’s next?
Compensability

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Compensability

Is the Insurance Company going to take responsibility for your accident?

Once the Insurance Company receives notice that you were injured, they have to make a determination as to whether or not your claim is compensable. In other words, if they are going to take responsibility for your work accident.

The insurance company can accept responsibility for your claim, deny your claim, or choose to investigate your claim for 120 days before making a determination.

Acceptance – If the insurance company accepts your claim, then the insurance company must pay for your medicalcare and, if eligible, your indemnity

120 Day Letter – If you have received a letter which states that your claim has been “accepted” under the 120-day provisions, do not think that your claim has been fully accepted. It has not. In fact, the insurance company could deny your claim at any moment. This “120 day” provision merely means that the insurance company will pay for your claim, for now, while they investigate your case to potentially locate a reason to possibly deny your claim. Many actions taken, or not taken, in this period can have serious impacts on the extent to which you receive benefits during this period and whether the claim is subsequently accepted or denied. Be proactive during this period. At Robert Rivera Law, we can assist you in navigating through this important period of your claim.

Denied

There numerous reasons an Insurance Company can deny your claim from the outset. For example: notice, arising out of/course and scope, no accident/injury, employer/employee relationship, fraud, and major contributing cause. This list is not exhaustive but illustrates the excuses an insurance company can make to provide you with little to no benefits whatsoever.

If you have received a denial letter from the insurance company, do not accept that without a fight. Many medical injuries and conditions are only made worse without timely and proper medical care. Do not sit around and wait for the insurance company to change their mind and provide you with benefits. Do something about it. Contact us for a free consultation.