Assuming that you do not have an attorney,
your primary contact will be either your employer or what is commonly referred
to as a claims or insurance adjuster. The adjuster's job is to stay informed of
your medical condition, working condition, and to ensure that the interests of
their company is protected. As a matter of practicality, they work for the
insurance company and they are not going to be able to tell you your rights or
explain what is to your advantage. Your responsibility is to be aware of your
rights and to assert them.
A good relationship with your insurance
adjustor is important and it is likely that you may have one or several
adjustors who work on your case. The adjuster is the one who will decide when
and whether or not you get benefits to which you may be entitled and,
obviously, it is important that you have a good relationship with them.
Remember, working with an insurance adjuster is a two-way street and just as
they need to be cooperative, polite, etc., you need to be the same.
While the insurance adjuster has the
primary responsibility to handle your claim, provide benefits and deal with you
in good faith, many times the adjuster has information supplied by the employer
or they may suspect you of trying to receive benefits to which you are not
entitled. While the insurance adjuster has a duty to deal with you in good
faith, they do not have a duty to advise you in matters which are in your best
interest. If you do decide to hire an attorney, remember that it is your
attorney's job to deal with the adjuster and you should not talk with the
adjuster after you hire an attorney.
Your first contact with the insurance
company will probably be by letter or by a phone call from your adjuster. The
letter will advise you generally whether the insurance company is accepting or
rejecting your claim or whether it needs additional time to investigate the
claim. Adjusters usually contact the injured worker as soon as possible and try
to take a statement from the worker concerning the facts of the accident and
what other information they might feel is relevant. Whenever the insurance
company or adjuster takes a statement, the most important thing is to tell the
truth. As long as you stick to the truth, you will not have to worry about
giving conflicting statements, nor give the insurance company a reason to
suspect that you are not telling the truth.