Beware of Insurance Company Adjusters Playing Doctor

When you suffer an on-the-job accident, you will not deal with your boss or employer as you seek some sort of compensation for your damages. Instead, you will be in direct communication with an insurance company adjuster. It probably comes as no surprise but insurance adjusters do not have your best interests in mind; they are there to save their parent company as much money as possible. In an effort to give you as little compensation as allowed, some adjusters choose to “play doctor” and deny necessary treatments based on their own discretion.


An insurance company adjuster that is dead set on cutting your compensation and saving their employer money may start to cite a medical degree or medical training that they don’t even have. The moment you are told you are denied some sort of treatment, probably in the form of a determination letter, you need to start questioning who made that decision. You could be shocked to find the trail leads back to the insurance adjuster, who has no background in the medical profession, and no one else.

The danger of dishonest denials is widespread and alarming. You could see several doctors for a work-related injury and have all of them say you need a particular treatment, and still get denied that treatment due to an adjuster’s whim. It is also possible that your doctor has prescribed a treatment for your injury, but you don’t even know about it because an insurance adjuster shut it down before the information could reach you.


If an insurance adjuster denies your treatment – for whatever reason – your only remedy is to file an appeal, wait for your court date, and hope the court sees things in your favor. Also, if the court does rule in your favor, the insurance company has another month or so to comply or attempt another denial through a higher appeal. Does this sound fair to you? Probably not because it isn’t.

At Gump & Faiella, our Moberly personal injury lawyers believe that a good defense is a strong offense. Rather than letting your personal injury case devolve into a battle with an insurance adjuster, retain our legal services from the beginning to let your opposition know you mean business. With us at the helm of your case, it might be possible to “scare the adjuster straight” and prevent them from trying to unjustly deny you needed treatment and compensation. We can also remove stress from your shoulders by speaking with insurance adjusters on your behalf, letting you focus on recuperation. No matter what direction your case turns, you can rest easy knowing we have your back.

Contact us online and request a free consultation to learn more about our personal injury law firm and services.

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