We have some of the most experienced professionals in workers compensation. Hands down. We understand how to effectively install a healthy workers compensation process so each year results are successful. We know how to position our clients at renewal with carriers and most importantly what a long term safety culture should be within the organization.
Unfortunately injuries happen, workers’ compensation insurance provides medical care and other benefits to employees who are injured while on the job. Workers’ compensation is a “no-fault” system. Employees who are legitimately injured as a result of their work receive benefits as set by law, regardless of who is at fault. The process of closing a claim takes a lot of time and can impact your business for years.
Workers’ compensation covers three categories of injuries or illnesses:
- Injuries or illnesses that result from a specific work-related accident
- Injuries or illnesses that occur over a period of time that are directly related to employment (e.g. cumulative trauma)
- Occupational diseases (e.g. exposure to toxic substances used in the workplace)
Under employers’ liability, the policy may provide defense and indemnification to a policyholder for a civil lawsuit (outside the jurisdiction of workers’ compensation) alleging damages for an employee’s work-related injury.
Who needs workers’ compensation insurance?
Workers’ compensation laws and requirements vary by state, but generally any business that has employees must have it. In many states, it is common for the following people to be exempt from coverage:
- Business owners
- Unpaid volunteers
- Independent contractors
States can levy penalties against businesses that fail to meet their workers’ compensation regulations.
- The false information is spoken or put in writing.
- The person who gives the information knows it's false.
- The false information is meant to prove, validate, affirm or deny a claim for injury or loss payment, or to obtain insurance coverage.
- The false information must be given with intent to defraud.
- The false information must relate to the case (i.e., change the way the claim was handled, investigated, evaluated or settled).
- Medical fraud: Medical provider bills for services not provided, intentionally inflates charges for services, or bills for services provided by non-licensed or unqualified personnel.
- Premium fraud: Employer intentionally underreports the number of claims, the number of employees or amount of payroll, or misclassifies employees to affect the price of coverage.
- Employer fraud: Employer denies benefits to an employee by not reporting a claim or encouraging employees not to report a claim.