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Workers' Comp Archives - Harbor America

Benefits of Workers’ Compensation Insurance

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Did you know that while non-fatal workplace accidents are decreasing, fatal workplace accidents are increasing?[1] Workers’ compensation offers your business protection from work-related injury, illness, or death. Because workers’ compensation insurance is to protect businesses against workplace health and safety liability, it is imperative to find a workers’ compensation policy that best covers your business’s needs.

Here are some benefits that workers’ compensation insurance can provide your business:

  • Medical expenses. If an employee sustains a work-related illness or injury and needs medical attention, workers’ compensation insurance can cover the medical expenses for treatment. Medical expense coverage may include hospital visits, medical procedures, and prescriptions.
  • Lost wages. If an employee misses work due to illness or injury, workers’ compensation insurance can offer compensation to replace lost wages.
  • Disability and rehabilitation. More severe work-related illnesses or injuries may require an employee to seek recovery services. Workers’ compensation can help cover short-term disability and rehabilitation expenses.
  • Accident and life. If a work-related accident occurs that results in death, workers’ compensation insurance can offer benefits to the employee’s family members.
  • Compliance. While regulations vary from state to state, most businesses are legally required to have workers’ compensation insurance.
  • Liability. Workers’ compensation insurance can alleviate attorney fees, court costs, and settlements or judgments if your business is sued for negligence that resulted in a workplace injury or illness.

If you’re looking for a workers’ compensation policy that can be customized to your business needs and flexible payment plans, contact Harbor America. From pay-as-you-go workers’ compensation to full coverage and access to multiple carriers to no down payments and a team of dedicated workers’ compensation specialists, Harbor America is equipped with resources and diverse policies to assist businesses of all sizes to promote healthy and safe workplaces. Contact Harbor America for a free consultation today!

 

[1] Workplace Injury Statistics – 2019 Year-End Data for Workplace Accidents, Injuries, and Deaths

Partner Post: Helping Small Businesses Understand Workers Comp

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Workers’ compensation, the insurance that safeguards employers from liability if employees are injured in the workplace, includes coverage for medical bills, lost wages, and ensures the employer will not be sued for injuries or illnesses related to the workplace. A great additional level of coverage for any employer, workers’ compensation underlines an employer’s role in taking responsibility for the safety of employees in the workplace.

Small business owners are not exempt from employee injuries or workplace safety, however, many states require businesses to carry workers’ compensation insurance for their employees. (Check your state’s workers’ compensation laws or contact us at Harbor America.) Regardless of the severity of the employee injury, workers’ compensation will ensure the injured employee, the employer, or a customer receives the care that is necessary to address their medical needs.

However, not all small businesses understand the basics of workers’ compensation. Here is what small business employers need to know:

1. Workers’ compensation coverage is purchased separately from business insurance. We recommend choosing an insurer who is not only familiar with workers’ compensation claims in your state, but that is also well versed in the coverage you need for your specific business.

2. If your business requires employees to work with or around occupational hazards or illnesses related to your industry, it is a good idea to obtain coverage.

3. Employee health insurance isn’t the same as workers’ compensation insurance. These are two separate and, in fact, very different policies.

4. Physical injuries or illnesses obtained while on the job qualify for workers’ compensation coverage. However, if an employee was using a piece of equipment against manufacturer instructions or were acting dangerously even after receiving proper training, the claim could be denied.

5. Independent contractors are typically ineligible for workers’ compensation coverage.

6. Workers’ compensation typically does not cover injuries or illnesses obtained while not on the job, injuries that occurred while the employee was committing a crime or as a result of violating company policy, or self-inflicted injuries.”

Protecting your employees, yourself, and your customers is an important aspect of making sure your business runs smoothly—especially for a small business owner. Workers’ compensation, in addition to employer liability, can help pay for legal fees, court costs, and settlements the employer may be required to pay in the event of a lawsuit. Learn how to best protect your business by contacting Harbor America.

 

As seen originally on insured Solutions Blog: August 13, 2019.

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Dealing with Workers’ Compensation Fraud

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Workers’ compensation is a no-fault method of paying insured workers for wage losses and/or medical expenses due to injuries or illness caused while on the job. A person has committed workers’ compensation fraud when they decide to take advantage of the insurance system for their benefit. Unfortunately, “workers’ compensation claimant fraud and medical fraud are significant contributors to our nation’s annual $30 billion insurance fraud problem.”[1] For example, a type of claim-related fraud is an employee who attempts to collect workers’ compensation benefits by deceitfully stating an injury or illness was caused at work.

Here are some tips and indicators to better help your organization in detecting possible workers’ compensation fraud.

Questionable claims are often identified by one or more of the following:

  • Be wary of injuries that happen late on a Friday afternoon but is not reported until Monday
  • The employee has a pre-existing medical condition similar to that of the alleged injury or illness sustained on-the-job
  • The employee delays reporting without providing a reasonable explanation
  • If the employee’s injury or illness takes place near their need for personal time off
  • There are no witnesses to the accident/injury
  • The employee refuses treatment to confirm the extent of the injury or illness

Perform a proper investigation that encompasses all of the elements in the TIPP mnemonic:

· Thorough; Impartial; Prompt; Preventive

Let employees know that insurance fraud of any kind, including workers’ compensation insurance fraud, will not be tolerated. Additionally, there are penalties and fees for submitting or filing false claims to which the employee would be responsible. To drive these points home, consider adding false claim information in each new hire packet, hang a poster in a conspicuous location to help employees know-how and to whom they can anonymously report potential fraud, and openly communicate about previous stories of fraud convictions to help deter repeat offenses.

In many instances, it is often better to use a third-party, such as a Professional Employer Organization (PEO) or Human Resource Services (HR) and administration provider to manage workers’ compensation and risk management within the organization. The third-party is likely able to perform an unbiased investigation. However, only a court of law can legally determine fraud—not the workers’ compensation administrator or carrier.

Fraudulent workers’ compensation claims can potentially steal millions of dollars from businesses, employees, and their families—when it comes to fraud, everyone ends up paying the price. Contact Harbor America to find out more about dedicated workers’ compensation specialists who are available to help manage your company’s claims. When it comes to workers’ compensation insurance, we know providing superior coverage at an affordable rate is one of the most important aspects to our clients.

 

[1] National Insurance Crime Bureau: Workers’ Compensation and Medical Fraud

3 Workers’ Comp Mistakes Small Business Owners Should Avoid

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As an employer, you never want to go through the nightmare of employees being injured at your workplace. Unfortunately, accidents sometimes happen at work and especially at construction sites. When they do occur, it’s important to handle workers’ compensation claims correctly.

Why It’s Important to Cover Your Employees with Workers’ Comp Insurance

First of all, if you have a small business, check to see if workers’ compensation insurance is a requirement in your state. If workers’ comp insurance is required, failing to carry it can result in severe consequences, such as having to pay out-of-pocket benefits to an injured employee. Furthermore, you may have to pay penalties that are levied by your state. Even worse, you could be sued by an employee and face criminal prosecution.

Here are a few common workers’ comp mistakes to avoid:

Not Obtaining All the Necessary Medical Evidence

One of the most common mistakes many small business owners make regarding workers’ comp claims is failing to collect all the necessary medical evidence involving a claim. In fact, having accurate medical records regarding injuries before a workplace injury occurred is just as essential as securing medical records following the injury.

When examining medical evidence, you’ll need to determine if medical records back up a claimant’s physical grievances pertaining to an injury at work. Another consideration is deciding if the medical records provide facts that aren’t consistent with how the injured employee looks or behaves. Check to see if the claimant has a history of changing doctors after being released to go back to work. Additionally, determine if the claimant has received treatment in the past for the injured area of his or her body.

Failing to Conduct a Thorough Investigation

A huge workers’ comp mistake is failing to do a thorough investigation or procrastinating in starting it. A methodical investigation needs to begin on a workers’ comp claim as soon as possible. The investigation should include facts, such as:

  • An employee’s full name. In the case of an injured female employee, the maiden name should also be noted.
  • Include any nicknames or previous names.
  • A current address, besides an employee’s previous address
  • All phone numbers
  • Social Security number
  • Drivers’ license number
  • Vehicle information, including make, model and year
  • The injured body part
  • Source of the injury, such as a slippery floor or a machine
  • The date and specific time of the injury, in addition to the date and time the injury was reported
  • Any witnesses to the accident, including their phone numbers, emails, and other contact information

Being Unprepared for a Hearing

Not being prepared for a possible hearing is another big mistake some small business owners make. Just because an injured employee doesn’t submit a particular form or retain legal counsel doesn’t mean there won’t be a hearing. Thus, it’s important you be prepared for a hearing. Keep in mind that a hearing officer needs detailed proof that’s reliable.

How a PEO Can Help with Workers’ Comp Claims

Having to manage and process workers’ compensation claims can be time-consuming and stressful. As a result, it can affect work productivity. However, this doesn’t have to be the case when a PEO (Personal Employee Organization) does the job. Not having to handle workers’ comp claims is only one benefit of hiring a PEO for your small business. These professionals can make running your small business easier, so you have more time to invest in your small business. Some of their many duties include:

  • Making improvements in workplace safety
  • Scheduling employees’ vacations
  • HR solutions
  • Compliance support
  • Commercial insurance
  • Handling payroll
  • Managing paperwork and performing other valuable services

You can do a better job of managing your business when you have a PEO on your team. Our Harbor America workers’ compensation specialists are there when you need them, providing efficient and quick claim services for both you and your workers, being sure they get the needed benefits and care they deserve. We serve small to mid-sized business owners in construction industries as well as other blue-collar industries. Please contact us for a free consultation.

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Workers’ Compensation 101

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What is Workers’ Comp?

Workers’ Compensation is a form of insurance that provides a replacement wage as well as health benefits to help workers who become ill or injured on the job. In return for receiving a workers’ comp settlement, the employee gives up their right to sue the employer. This can save the employer from multi-million-dollar lawsuits in return for providing healthcare coverage and wages while the person is out ill or injured for a predetermined amount of time.

Employers Must Understand Workers’ Comp:

It’s vital for employers to understand what the workers’ compensation requires the company to pay and when the company will have to pay for it. The following are 7 things that companies must understand about workers’ comp:

  • Hospital Bills: The workers’ comp packages will pay hospital bills that are related to the illness or injury sustained at work. Workers’ comp may also pay for rehabilitation or other services related to the illness or injury that occurred on the job.
  • Workers’ Comp Covers Most On-the-Job Illnesses or Injuries: Workers’ comp will typically cover medical expenses and lost wages relating to documented on-the-job illnesses or injuries. These may include serious illness caused by exposure to chemicals or injuries caused by equipment or actions taken on the job site. These are costs required to be covered by the company’s insurance policy.
  • Situations Workers’ Comp Won’t Cover: Some situations workers’ comp won’t cover include any injuries that are self-inflicted or injuries that were sustained while the worker was committing a crime while on the job. Workers’ comp does not cover injuries that happened while the employee was not on the job or while an employee was violating company policies, especially in regards to safety.
  • It Must Be a Problem Caused At Work: Workers’ comp does not cover long-term illnesses or injuries that started outside of work. Workers’ comp is only for illness or injury that can be directly related to something that happened on the job while working, barring self-harm, criminal interactions, or going against company policy.
  • Employees Covered By Workers’ Comp: Only some employees are covered by workers’ comp and state laws vary in each state. Coverage will depend on how many employees the company has and what type of workers’ comp insurance the company is covered by. Seasonal or casual workers may or may not be included. Sometimes only full-time employees are included.
  • Employees Seeing Their Own Doctor(s) For Injuries: In some states or instances, employees will be allowed to go see their own doctors and specialists for injuries caused by the jobs. Other states will require the employee to see a select set of doctors chosen by the company, or the insurance company providing the workers’ comp benefits.
  • Workers Can Sue: Workers have a right to not accept the workers’ comp coverage offered by an employer in lieu of suing the company if they feel their injury is caused by company negligence or lack of safety precautions. However, once an employee does accept workers’ comp benefits, they can not sue.

Workers’ compensation is a complicated subject for most business owners. Hiring a PEO to handle this task for you and ensure you remain compliant may be your best choice. For more information on workers’ comp and our other managed services, contact Harbor America anytime.