Sunset Plaza Insurance

Protecting Your Business & Employees

A large part of running a business is protecting it and making sure your employees are safe at work.

Workers’ compensation is a state-mandated insurance which has two benefits one that covers workers in the case of injury and the second benefiting the employer. The first provides medical coverage for work related injuries incurred by the employee due to the scope of his work. In addition, the employee receives a portion of the income which is lost during the employee-recovery process. The second benefit, a very important one, protects the employer from being sued by the injured workers during their course of employment.

Regardless of who is at fault in an accident, workers’ compensation will still cover the employee. In the unfortunate event a worker is killed while working, workers’ compensation will provide death benefits to the workers’ dependents.

Who needs Workers’ Comp Insurance?

California law requires that all employers have workers’ compensation insurance, even if you only have one employee. When hiring out of state employees or temporary employees you are still required to carry workers’ compensation insurance. If you are a sole owner of your business coverage is optional, speak to an agent to get further details on this.

When does Workers’ Comp Apply?

The insurance applies to any worker that has suffered an injury or developed an illness related to the person’s job. An employee typically needs to file a claim immediately after the injury occurred. Delaying filing a claim for Worker’s compensation could result in a claim denial. In the eyes of the insurance carrier a claim filed late can be red flagged due to suspected insurance fraud.

Which injuries are covered and which are not?

Workers’ compensation only covers work related injuries or illnesses. If the injury or illness is work related, in most circumstances, it will be covered under the workers’ compensation insurance. For example, if one is injured while running a work-related errand, seeing a client or some other work related function.

There are a wide range of covered illnesses that range from sudden accidents like vehicle collisions, to injuries that happen over time like carpal tunnel syndrome or illnesses that result from exposure to chemicals, like cleaning agents or back problems from lifting heavy things without a back-brace.

There are a number of things worker’s compensation insurance does not cover. Coverage may be denied in the following situations:

– injuries to contractors,
– injuries claimed after resignation, termination or lay-off,
– injuries procured during off-hours of employment,
– injuries caused by drugs or alcohol,
– employee fight or horseplay related injuries,
– felony or other illegal actions,

When company policy is violated it is still possible for a claim to be denied, this will depend on the circumstances of the situation.

Risk Control & Premiums

The most effective way to have lower premiums is to prevent accidents in the first place, before they ever take place. It takes foresight but it is well worth the time you spend working out accident-prevention plan in your company. This will result in a safer workplace and ultimately in lower premiums.