Coverage
- Disability/loss of income benefits- compensate employees who are unable to work as the result of a work-related injury or disease. These benefits are intended to replace a portion of lost income, but not-all of it.
- Medical benefits- pay for the cost of various types of medical services required because of an employment-related injury or disease. Payment for basic medical expenses are generally unlimited and do not contain deductibles.
- Survivor/death benefits- compensate a surviving spouse, children, or other relatives of an employee whose death results from a work-related injury or disease. Survivor benefits include a weekly benefit and a stipulated amount for funeral and burial expenses.
- Rehabilitation benefits include medical rehabilitation, such as physical therapy designed to improve physical functioning, and vocational rehabilitation, such as retraining for a different occupation. Workers’ compensation rehabilitation benefits pay reasonably justifiable expenses for these purposes.
Who’s coverage?
Regardless of who is at fault, workers’ compensation covers employee injury that arises out of employment. The following factors determine if the injury came from employment:
Regardless of who is at fault, workers’ compensation covers employee injury that arises out of employment. The following factors determine if the injury came from employment:
- Time- Must occur during the time work is being performed
- Place- Must occur at the place of employment
- Circumstances- Employment duties are being performed
- Occupational disease- Medical condition caused by the environment of employment (eg. black lung from coal mining)
Add on
An employer can provide coverage for excluded workers by adding the voluntary compensation endorsement to the policy
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Exclusions
- Liability assumed under contract
- Punitive damages awarded because a worker was employed in violation of the law
- Injury to a worker while employed in violation of the law with the insured’s knowledge
- Obligations imposed by any workers’ compensation, occupational disease, unemployment
compensation, or disability benefits law - Injury intentionally caused or aggravated by the insured
- Injury that occurs outside the United States, its territories or possessions, or Canada (does not
apply to residents of these areas who are temporarily outside these areas) - Damages arising out of violations of employment practices laws, such as discrimination or
harassment - Injury that is covered under a federal workers’ compensation law
- Injury to the master or member of the crew of any vessel
- Fines and penalties imposed for violations of federal or state law
Employers are not required to provide coverage fro:
- Certain farm and agricultural groups workers
- Charitable organizations volunteers
- Domestic employees and casual laborers
- Commissioned real estate agents
Covered by te government
- Ship’s crew, longshore, harbor, marine, and railroad workers