What is the role of the insurer in my workers comp claim?
The insurer makes decisions in regard to approval or decline of a workers compensation claim The insurer is required to contact all staff with new claims where they have medical recommendations for restrictions to their duties at work. The insurer makes decisions regarding what treatment is approved for each claim based on the medical advice available and what they consider to be reasonable. The insurer may choose to send staff to independent medical examinations to assist in clarifying the progress in injury recovery and to review treatment needs. Attendance at these insurer medical examinations is compulsory. The insurer may also choose to appoint an independent investigator to a claim to conduct factual interviews with various key parties. This is commonly the case with claims for psychological injury or illness. This type of factual investigation is aimed at assisting the insurer in determining their acceptance or decline of the claim.
