Adjuster X

Claim With a Kick

By: | August 3, 2015

This column is based on the experiences of a group of long-time claims adjusters. The situations they describe are real, but the names and key details are kept confidential. Michelle Kerr is the editor of this column and can be reached at [email protected]

The first report of accident appeared pretty straightforward, if vague. Pete Lanto, 27, injured his right foot while working at Carl’s Custom Motors. No details on how he hurt it.

First stop was a visit with Lanto’s supervisor. “How exactly did Lanto injure his foot?” I asked. The supervisor shrugged, “Not really sure. Told me he banged it into something. Didn’t say what. He was limping pretty bad and obviously in a lot of pain.”

The incident occurred around 10 a.m. I asked about breaks and was told Lanto had 15-minute breaks at 10 a.m. and 2:45 p.m.

About a dozen guys were having a kick hockey game with a flattened can being used as the puck

“Anyone witness the accident?” I asked. The supervisor said, “I’m not sure, but Cal Smith and Mike Nardi work next to Pete. I didn’t even think to ask them.”

I introduced myself to Smith and asked if he witnessed how Lanto had injured his foot. Cal looked down at the floor and said, “I, ah … don’t recall.”

“It was only two days ago,” I pointed out. “I just need to know — the accident report is vague.” Cal replied, “You’ll have to ask Pete.”

Nardi was next, but his reply was about the same. “I don’t remember … Pete can tell you.” Both Smith and Nardi were in their 20s. Faulty memory wasn’t likely an issue. Something was off.

I drove to Lanto’s home. Pete was on crutches with an Ace bandage on his right ankle.

After gathering the basics, I asked, “How exactly did you injure your foot?” Pete slowly replied, “I hit it on the side of the dynometer. There was something on the floor and I used my right foot to sweep it out of the way. I hit the machine with my foot.”

“Huh,” I said. “Must have been a pretty hard sweep to sustain this kind of result.” Pete said, “Yeah, guess so.”

I decided to return to the work site and met with Pete’s supervisor again. “What do you do on break?” I asked him. He looked quizzical and said, “Usually go and grab a cup of coffee in the break room, and read the paper for a few minutes, if I’m not involved in work that requires me to skip break.”

“Mind if I stay until the 10 a.m. break?” I asked. “I want to observe Pete’s area.”

“Sure,” said the supervisor, “but I’m not sure what you’re going to see as the guys will be on break.”

I silently approached the work area, keeping out of sight. At first I didn’t hear anything, but then there were some slightly raised voices and the sound of something metallic sliding across the concrete floor.

The voices became louder. It was cheering. I peeked around the corner.

About a dozen guys were having a kick hockey game with a flattened can being used as the puck. Mike Nardi and Cal Smith were involved. I whipped out my phone and took several photos of the match. The game soon ended and everyone went back to work.

I walked back to the office and explained my theory about Pete Lanto’s injury to his supervisor. I suggested he put an end to the kick hockey game. Then I drove back to Lanto’s home.

He looked surprised to see me. I asked, “How did you injure your foot?” Lanto said, “I already told you that.”

“Well,” I replied, “you left out the part about kick hockey and how you hurt your foot kicking the flattened can puck. Tough when that thing winds up in the corners.”

Lanto’s eyes went wide, “Who told you about that?”

I shook my head. “I saw it for myself and put two and two together. Oh, by the way, that’s called ‘horseplay’ and it’s not covered under workers’ compensation.”

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