What to Do When Denied a WC Claim by AIG*

If you have been injured or become ill while at work you may be able to claim workers’ compensation. This type of insurance is normally a requirement of most, but not all employers, in most states. Typically, a successful claim covers medical costs and at least a percentage, usually around two thirds, of earnings that might be lost because of absence from work. Some claims are denied for a variety of reasons and this can be a good reason for contacting a workers’ comp. attorney for legal help.

AIG – Company Profile

If your employer has workers’ compensation insurance cover with the AIG it will be one of very many companies worldwide that uses this insurance corporation for a variety of reasons. The American International Group (AIG) has 88 million different customers in over 120 different countries. The group is made up of three separate businesses, AIG Property Casual being the entity that deals with employers’ workers’ compensation coverage. The AIG group of companies employs around 65,000 people itself and has its U.S. corporate headquarters based in New York.

Tips for What to Do if Your Workers’ Comp. Claim is Denied

If your workers’ comp. claim has been denied, it is not necessarily the end of your claim. You may be able to appeal the decision. Here are some tips to help you decide the best course of action to take if you get a denial letter from your state board.

Denied by an employer's insurance company

  • Tip no. 1. Read the denial letter carefully to find out the stated reason for a denial. It may be something you can do something about or it may be due to legitimate refusal, typically because you did not notify your supervisor about the accident / injury or illness on time or make a claim within the stipulated time period.
  • Tip no. 2. If you think that some mistake has been made, make an appointment to talk to your employer’s representative and someone from the AIG if this is your employer’s insurer. The denial may be due to a simple administrative error on the part of the insurer or your employer.
  • Tip no. 3. Failing this, contact a workers’ comp. attorney to discuss your claim and the stated reasons for the denial. The attorney will be able to assess the circumstances and advise you whether it is sensible to appeal the decision.
  • Tip no. 4. If an appeal is suggested by your attorney, you will need to request this within a specified time period after receipt of the denial letter. The appeal is usually to the state workers comp. board.
  • Tip no. 5. You will need to prepare for an administrative hearing, in which any supporting evidence for your claim that’s accepted will be examined. The exact nature of the documentation will depend on the reasons for the denial. Reasons include: your employer did not accept that the injury was a legitimate workplace-related one, you had no medical report showing what your injury was, you did not provide a time sheet copy showing that you were at work at the time of the accident or insufficient evidence of medical costs claimed etc.

How a WC Attorney Can Help You With a Denied Claim

If your claim has been denied, unless the denial has been due to a simple error which you can rectify by talking to your employer’s AIG representative or your employer, you will have to appeal the decision. This is not an easy process to do on your own and you should ensure you get legal advice before you go about requesting an appeal.

A workers’ comp. attorney can decide whether there are strong enough grounds for an appeal and help you prepare the extra documentation you may need to convince the compensation board that you deserve the payment you originally claimed for.

*The content of this article serves only to provide information and should not be construed as legal advice. If you file a claim against AIG, or any other company, you may not be entitled to any compensation.