Workers’ Comp Insurance

clock February 15, 2023

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10 Questions to Ask Before Finalizing Your Workers’ Comp Insurance

Owning a business has many responsibilities. One of the biggest concerns is workplace injuries. In 2020, 2.6 million nonfatal workplace injuries and work-related illnesses occurred within the private business sector. 

For this reason alone, you don’t want to bypass having Workers’ Comp insurance. As an employer, it’s also critical to know everything about your state’s workers’ compensation laws.

Employees have a level of expectation if they ever experience a work-related injury. Falls in the workplace, an injury sustained while moving office furniture, or having an accident while away from the office on company business can become the employer’s responsibility.

Workers’ Compensation insurance can help safeguard your company and its employees. Keep reading to learn the ten most frequently asked workers’ compensation questions.

1. Workers’ Comp Insurance: What Is It?

You may have heard it referred to as workman’s compensation or worker’s comp. All variations refer to worker’s insurance used to cover workplace personal injury claims. It helps workers avoid the potentially devastating costs of injuries at work.

Workers’ Compensation Insurance also helps keep businesses and their employees from losing money when an employee gets injured on the job

Imagine an employee getting injured on the job and being responsible for their medical care. This scenario would most likely lead to the employee suing their employer.

Workers Comp insurance helps shield employers from potential losses that could lead to bankruptcy for the company.

2. How Do I Get Workers’ Compensation Insurance?

Workers’ compensation insurance can be purchased in person, over the phone, or online. Workman’s compensation policy requirements are determined by the state where your business is located. The coverage you require and the amount you will pay for workers’ compensation could be affected by a variety of factors.

Before purchasing a policy, you should be aware of the following:

  • How many employees require coverage
  • Total number of employees
  • Positions and duties
  • Size of your payroll

Business owners can purchase workers’ compensation insurance from private insurance companies or state-funded programs.

Note that not all insurance companies provide business owners with direct access to this coverage. It’s only available through agents for some providers.

Choosing a company that provides the best protection for your employees is vital. National Workman’s Comp Solutions can provide you with the solutions you need to help you focus on business and not risks. 

3. What Does Workers’ Compensation Cover?

Workers’ compensation insurance coverage is another frequently asked question. In the event that an employee becomes ill or hurt due to work-related activities, workers’ compensation insurance pays for things like:

  • ongoing physical therapy
  • disability benefits
  • medical bills
  • prescription drugs
  • lost wages
  • funerals
  • and other benefits

The laws governing workers’ compensation for businesses in each state are set by that state. Here are some examples of Florida Workers’ Comp Insurance laws

Travel costs to and from a pharmacy or approved treatment center. Wage replacement that is equivalent to two-thirds of your prior wage.

Disability benefits are for employees that suffer an injury or workplace illness resulting in permanent physical, mental, or functional impairment. When an injury renders the employee totally and permanently unable to work, they are entitled to total and permanent benefits.

Death benefits cover funeral costs and benefits for dependents. These benefits pay when a workplace accident results in the death of the employee.

Benefits for lost wages under workers’ compensation begin after a set number of days. The clock starts when the injured worker is first unable to work. The wage replacement benefits will typically be equivalent to two-thirds of the employee’s weekly wage.

4. What Does Workers’ Compensation Not Cover?

In the event of a covered loss, Workers’ Comp insurance can assist in safeguarding your company and employees. However, there are some workplace incidents that are not covered by the policy. These, too, are governed by state laws and also vary from state to state.

The majority of workers’ insurance plans do not cover the following:

  • injuries sustained during a fight
  • injuries sustained while intoxicated in the workplace
  • injuries sustained by an employee on purpose
  • work-related mental health crisis

In some states, for workers’ insurance to cover an employee’s mental health claims, the crisis must result from a workplace injury. However, there may be other instances where an employee can show the workplace was an overwhelming contributor to their stress.

5. Can You Provide Market Quotes?

A business owner should never settle on one quote. It’s easy to think all workman’s insurance is priced the same. You should work with a company that provides quotes from multiple companies. 

You should also under what it means to work with captive agents or direct writers. These are individuals who only write policies for one company.

6. Do You Recommend Programs, Vendors, and Consultants?

Employees filing a claim for workers’ insurance don’t have the option of choosing medical providers in some states. Other states may allow for it after a set amount of time. It’s important to discuss what programs, vendors, and consultants are available.

Employees can file lawsuits against a company based on how the company handles its personal injury claims. It’s best that companies provide their employee with the services needed for a full recovery. 

7. Is Workers’ Compensation Insurance Required of Me?

In most states, any business that employs at least one person is required to have workers’ compensation insurance. Texas is the exception.

Large employers can get insurance on their own, but they have to apply to their state and meet strict requirements for self-insurance. Agricultural businesses, construction companies, charitable organizations, and some others are not eligible for other workers’ compensation exemptions.

It’s essential to keep in mind that not all employees are required to have this kind of insurance. Independent contractors, domestic workers in private homes, and volunteers, for instance, are typically not covered by workers’ compensation. When the work performed is not part of the employer’s regular business or profession, some states exclude seasonal employees.

Workman’s compensation insurance can get purchased in one of two ways. The options are programs funded by the government or private insurance companies. Only North Dakota, Ohio, Washington, and Wyoming require businesses to only acquire policies from state programs.

8. How Do I Purchase Insurance for Workers’ Compensation?

Workers’ compensation insurance can be purchased in person, over the phone, or online. The coverage you require and the amount you will pay for workers’ insurance could be affected by a variety of factors. Before purchasing a policy, remember the following data will determine the cost:

  • number of  employees requiring coverage
  • number of employees in your company
  • type of work they will be performing
  • the size of your payroll

Business owners can purchase workers’ compensation insurance from private insurance companies or state-funded programs.

9. Can I Pay Claims Directly to Employees?

The purpose of Workers’ Comp Insurance is to cover expenses of workplace injuries. States mandate that you have workers’ insurance. The insurance protects both the employer and the employee.

You are responsible for paying for the medical care and other expenses of your injured worker if you do not have workers’ compensation insurance. This rule is required by law in your state. The workers’ compensation board in your state may also impose fines and penalties on you.

10. How Do Employees Make a Claim for Workers’ Compensation? 

Employers must adhere to a few steps when filing a claim for workers’ compensation. The process begins when an injured worker does the following:

  • report an incident
  • complete the necessary paperwork
  • seeks medical attention

It is vital to initiate a workers’ compensation claim with your insurer as soon as one of your employees informs you that they were injured on the job. You should follow these steps.

Step 1

When you learn about an employee’s workplace injury or related illness, make sure they seek medical care immediately. In order for your employee to apply for workers’ compensation benefits, you should also provide them with a claim form to fill out. 

Step 2

Once your employee has completed the form, send it to your insurance company. This informs your insurance company that a new claim is prepared for processing.

Make sure you know how to file for workers’ compensation in accordance with your state’s laws. There is a deadline for workers’ compensation claims in every state. 

Step 3

When your employee returns to work, you may need to make adjustments to assist them in performing their duties. You might have to teach them a new job in some cases.

Your employee can appeal or dispute their workers’ compensation benefits even if your insurance company denies the claim. To learn what to expect in workers’ compensation cases, check your state’s claims procedure.

What Happens After the Policy is Issued?

The  10 questions we covered are the basics of Workers’ Comp Insurance. Once you receive your policy, you’ll need to understand what to do when an actual injury or illness happens. 

Let’s do a quick recap and run-through of what should happen in the event an employee has a claim.

When to submit a Workers’ Compensation claim?

If someone has an injury or illness, you should report it immediately.

Failure to file a workers’ compensation claim in a timely manner can result in your employee not receiving benefits.

What Constitutes a Workers’ Compensation Claim?

Workers’ compensation benefits are available for the majority of workplace injuries. Examples include the following:

  • Injury due to repetitive stress
  • exposure to hazardous materials
  • slip and fall injuries

Check your policy for an all-inclusive list.

Insurance Provider Requirements

In order to receive workers’ compensation benefits, your insurance company may require the employee to visit an in-network provider for non-emergency medical care. Failure to do so might delay their claim or lead to out-of-pocket expenses. 

Making a Workers’ Compensation Claim

When you submit a workers’ compensation claim to your insurance company, you must include the following:

  • Account number
  • Location code (if applicable)
  • Parent company name (or program name)
  • Policy number

Your claim form should include as many details about the incident as possible. Always include:

  • name
  • date of birth
  • address
  • phone number
  • Social Security number
  • age
  • gender
  • marital status
  • number of dependents
  • hire date
  • number of years in current position
  • current wage information

After receiving a report of the injury or illness, note the date and time of the incident. You’ll also need to show who reported the injury or illness and where the injury or illness occurred on your company property.

  • outline the type of injury or illness
  • specify which body parts that were injured
  • witness information
  • cause of the accident
  • name and location of the medical facility
  • number of days worker will miss work
  • expected return to work date.

Make sure your Workers’ Comp insurance policy includes a phone number or other method of contacting your insurance provider. Some providers will prover online forms you can upload to your company’s intranet.

How to Know a Workers’ Compensation was Accepted? 

The insurance company will let you and your employee know if they approved the claim. In order to receive reimbursement for medical care or other benefits, your employee will work with your insurance provider.

Get the Coverage You Need

Not all insurance companies provide business owners with direct access to workman’s insurance coverage. It’s only available through agents for some providers.

With National Workers’ Comp Solutions, you can rest assured that your company receives leading-edge protection for its employees. Call 786-933-7868, send an email, or get a quote online right now.

We’re here to help you find the best workers’ compensation insurance for your business and employees. If an employee gets sick or injured at work, you can rest easy knowing they can get help from our claims specialists and programs to get them back to work as soon as possible.

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