Workers' Compensation Discussion Forums

Will your private insurance cover you if you see your pcp for a work comp injury ? or do you have to see the work comp doctor ?

most exclude coverage of work related injuries.

What if in my case I had to use my private insurance co. to pay for my medications yesterday due to the IC denying my meds? I called the adjuster and he is sending me a letter of denial to have on hand in case the IC questions it. Do most private insurances cover your meds of a workers comp. claim denies?

I have BC&BC and they have covered all of my work comp meds.

Last week I received a pharmacy card from work comp, this was 3 weeks post surgery.

In my case WC denied my claim. My personal health insurance paid sor everything UNTIL I won my claim Now they won't pay for anything that has to do with my WC claim. Sparkey in your case along with a letter of denial I don't see why you would have a problem.


CAP

Private insurance will cover your injury if WC denies your claim.

Yes, in VA at least, if you are denied something from w/c, your private insurance will cover it.

Your primary insurance will cover your expenses until the time that they discover that it is a Comp Case. Then they might "pull payment". What that means is anything that they have paid on you behalf they will withhold payment in the equal amount on ANOTHER patient. This has happened to me. Your health care provider gets understandably very upset about this.

Just because Comp denies a claim doesn't mean that they are not responsible for it. When this happens, it often takes going to Court to have a judge determine which insurer pays.