Has your employer ever asked you to file your claim on your health insurance? At first, it might seem like a convenient way to handle medical expenses, but there could be some hidden pitfalls. It’s essential to understand the potential consequences before blindly following your employer’s instructions.
So, before you submit that claim form, let’s dive into the details and uncover what could be wrong with your employer’s suggestion.
What’s Wrong with Your Employer’s Suggestion?
Here’s a great “lawyer answer” … it depends. What we worry about is when an employer tries to avoid telling their workers’ compensation carrier about a claim. It’s sort of like getting into a fender bender in a parking lot. You may be tempted to pay the other guy $500 to get his car fixed and keep everyone’s insurance company out of it. While that works with dents on fenders it’s not so clear that it works with internal injuries on workers.
If it gets you medical treatment more quickly and efficiently than waiting around for an adjuster, we’re all in favor of putting the bill on health insurance. But if your boss isn’t reporting the claim to the adjuster this could be a big problem. We’ve seen it happen dozens of times: when the doctor takes you out of work you’ve got no income coming in. You chase down a workers’ compensation adjuster who in turn chases down your employer and asks why this wasn’t immediately turned in for handling. At that point your boss can admit he tried to handle it in house. Or he can blame you for everything.
Sadly, we’ve seen a lot of injured workers get the short end of a stick just because they tried to help the company out. You really need to think this through carefully. Our rule of thumb is that it is usually fine if it speeds up treatment and it’s your idea. We’re less thrilled by it when the employer is telling you to do it right off the bat.
Why Would Employers Ask Employees to File Claims?
There could be several reasons why employers ask employees to file claims on their health insurance. Firstly, it could be a matter of convenience for the employer. By having employees file their own claims, the employer can save time and resources that would otherwise be spent on administrative tasks related to insurance claims.
Additionally, employers may ask employees to file claims as a way to empower them and give them more control over their healthcare. By taking responsibility for their own claims, employees can choose the healthcare providers and services that best meet their needs, rather than relying solely on recommendations or restrictions imposed by the employer.
However, it’s important for employees to understand their rights and responsibilities when it comes to filing claims. They should ensure that they are aware of the specific procedures and requirements set by their health insurance provider and that they have all the necessary documentation and information to submit a claim accurately.
In some cases, employers may ask employees to file claims in order to shift some of the financial burden onto the employee. This could be a cost-saving measure for the employer, but it may also place a greater financial strain on the employee. It’s important for employees to carefully review their insurance policies and understand their coverage and any potential out-of-pocket expenses.
If an employee feels uncomfortable or unsure about filing a claim on their health insurance, it is advisable for them to consult with their human resources department or seek guidance from an insurance professional. It’s important to ensure that all claims are filed correctly and that employees receive the appropriate benefits and coverage they are entitled to under their health insurance plan.
How Do You Handle a Situation Where Your Employer Asks You to File Unauthorized Claims?
Handling a situation where your employer asks you to file unauthorized claims can be challenging, but it’s important to navigate it carefully to protect your integrity and avoid any legal or ethical issues. Here are some steps you can take to handle this situation:
1. Understand the policy
Familiarize yourself with your health insurance policy and its terms and conditions. This will help you identify any discrepancies between what your employer is asking you to do and what is allowed under the policy.
2. Communicate with your employer
Have a conversation with your employer to clarify their request and express your concerns. Politely explain that filing unauthorized claims can have negative consequences, both for you and the company. Try to understand their perspective and see if there is a valid reason behind their request.
3. Seek legal advice if necessary
If you believe that your employer’s request is illegal or unethical, it may be wise to consult with an employment lawyer. They can provide guidance on your rights and potential legal ramifications.
At Oxner + Permar Law, we understand the complexities of employment law and can provide advice and guidance to help protect your rights as an employee. If your employer is asking you to file your claim on your health insurance and you believe that it is unauthorized, contact us today for a free consultation.
