In this video, we’re going to address the question of why employers fight workers’ compensation claims in California. My name is Matt Eason. I’ve been practicing workers’ compensation and employment law for over 25 years here in Sacramento, and we’re regularly asked by injured employees, “Why is my employer fighting my workers’ compensation claim?”
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To really answer that question correctly, I think it takes a slight modification of the question. Is it the employer fighting your workers’ compensation claim, or is it the employer’s insurance company that’s fighting your workers’ compensation claim? We’re going to answer both of those in this video.
Understandably, we will have an employee coming to our office who has worked for their employer for 25 years. They never missed a day at work, a diligent servant to the employer, loves their job, loves their employer. They are completely frustrated that their employer’s personality turned against them when they filed a clear and obvious valid workers’ compensation claim and wants to understand why.
From the employer’s perspective, we would like to believe that they feel compassionate towards their employees and they want their employees to get better, and they want to support their employees during this time off.
Their workers’ compensation rates are typically based on their industry. Those rates are then modified based on the losses that they’ve suffered from workers’ compensation or a good safety record. An employer’s workers’ compensation rate could be very similar to, for example, your car insurance rate. If you have a long history of being a safe driver, you will see a discount on what the average driver in your situation would pay.
For example, you might pay 85% of what someone just like you would be paying who just went to that company for the first time. In contrast, if you’ve got points on your record from causing an accident from speeding tickets, well, you’re going to pay more for your car insurance than someone just like you because you’ve had exposures to your policy.
Workers’ compensation from the employment perspective is very similar. If an employer goes for a significant amount of time without any claims or only very small claims, they may get a reduction in their premium such that they actually may get a discount.
In contrast, if an employer has claim after claim or a particularly large claim that costs the insurance company a large amount of money, then they’re going to pay a higher premium. Because of that fear of paying a higher premium and arguably greed based on wanting to make more money at your expense, employers often will fight employee claims when they really should not.
With respect to your employer’s insurance company fighting your workers’ compensation claim, that’s pretty simple. Insurance companies, by and large, are businesses or run like businesses. As a business, they want to make a profit. And how do you make a profit? You increase premiums, and you decrease expenses, and no matter how justified your claim is, how right is your injuries are, you’re an expense, and if they can reduce that expense, they have a better bottom line, and that’s why they’re doing it.
While it’s unfortunate that employers and insurance companies fight valid workers’ compensation claims, the reality is that they do. Hopefully, this video addressed some of the reasons they do so, and that gives you an understanding of what you’re dealing with. Again, my name is Matt Eason, and if you have any questions about your workers’ compensation claim, I hope you contact my firm or me. The firm name is Eason & Tambornini.
