AIG Admits to Mishandling Workers’ Compensation Claim
American International Group (AIG) is in the spotlight after the NBC4 I-Team revealed that the mishandling of a claim could have significantly impacted the health and well-being of an injured worker.
Ramon Contreras, a forklift operator at Epmar Corp, suffered injuries to various parts of his body on April 27 including his head, chest, abdomen and upper extremities. Contreras’ physician requested that modifications be made to his home, including a wheelchair ramp, bathroom renovations, a new bed, and a lightweight wheelchair. A utilization review physician, however, stated that the improvements were not medically necessary.
Contreras’ requests were denied by AIG.
AIG Failed to Address Worker’s Needs
After further investigation AIG admitted that they had focused too closely on the workers’ compensation process and that they failed to properly address Contreras’ urgent needs. The statement went on to say that the insurance company did not show sensitivity and flexibility when handling the situation.
AIG stated that they would immediately address the injured workers’ home modification requests.
What to Do If Your Claim Is Denied
If part or all of your workers’ compensation claim is denied, you have every right to appeal that decision. You can obtain and file an “Application of Adjudication of Claim” yourself, or you can seek additional legal guidance from an attorney experienced in workers’ compensation law such as Turchin Law.
Once you contest the denial of your claim, you will receive a notice confirming that the application has been filed and you can then file a “Declaration of Readiness to Process” to have a hearing before a judge. Throughout the hearing the judge will discuss the case with you, your attorney, and the claims administrator, and will attempt to reach a resolution of the disputed issues.
What Happens If a Settlement Is Not Reached
If you do not reach a settlement during the hearing, you will need to then prepare documents, names of witnesses who will testify, and other information which will help prove your case. After the trial, the judge will issue a written decision typically within 30 to 90 days.
Should you or the claims adjuster disagree with the judge’s decision, you can then file a Petition for Reconsideration.
How Turchin Law Can Help
Turchin Law has devoted its legal practice to helping injured workers with their workers’ compensation claims. Whether you have questions about the process or have had your claim denied, we are here to help.
To arrange for a free legal consultation with a workers’ compensation lawyer in the Los Angeles area, we invite you to call (818) 230-3110.