If an employer directs you to deny a claim that you know is compensable, what is the proper course of action?

• A. Ignore the employer
• B. Deny the claim
• C. Deny the claim based on information from the employer
• D. Pay benefits if they are due

Answer: (D)

Paying benefits if they are due is the proper course of action because it aligns with the ethical and legal obligations to ensure that compensable claims are addressed appropriately. Even if the employer instructs otherwise, the obligation to protect the rights of the claimant and adhere to the rules governing workers' compensation remains paramount.

In scenarios where a claim is deemed compensable, there is a responsibility to act in accordance with established laws and regulations. Denying valid claims, regardless of employer instructions, can expose the employer and the claims handler to significant legal repercussions, including penalties and damage to reputation.

Choosing to ignore the employer or denying the claim based only on their direction undermines the integrity of the claims process. Additionally, denying a claim based on direction from the employer without validating its compensability does not uphold the necessary standards of care and due diligence required in these instances. Thus, ensuring that benefits are paid when they are legitimately owed ensures compliance with legal standards and ethical responsibilities.