Workers' Compensation Insurance

Small businesses and agents enjoy the backing and resources of a leading workers' compensation
insurance company nationwide
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What is Workers’ Compensation Insurance?

Workers' Compensation Insurance protects your business and your workforce by providing benefits to most employees injured on the job. These benefits can address medical care and related medical costs, retraining and lost wages until the employee can return to work or compensation for permanent disability.

Choosing AmTrust for Workers’ Compensation Coverage

AmTrust and our agents recognize the importance of flexibility in today's business environment. We work closely with our agents and the small and mid-sized businesses they serve to design the specific packages they need to comply and succeed. With an A- (Excellent) rating by A.M. Best, AmTrust Financial always seeks to deliver superior services at a rate that's both fair and affordable.
6 things to know about AmTrust's Workers' Comp Insurance

Why Does Your Small Business Need Workers' Compensation Insurance?

Workers' compensation insurance is vital for small businesses because it helps them cover the cost of medical expenses and lost wages for injured workers. Small businesses need workers' comp because:
  • In most states, workers' compensation insurance is a requirement
  • A major claim can have a devastating financial effect on your business operations
  • Workers' compensation helps protect your most valuable asset – your workforce

How Does Workers' Compensation Insurance Work?

A Workers' Compensation policy from AmTrust Financial helps protect your business and your employees from a workplace injury. Here's how Workers' Compensation Insurance from AmTrust works:
  • Your injured or sick employee seeks medical help and you submit a workers' compensation claim with AmTrust, providing details of the incident and the necessary information.
  • Our claims experts review your submission and upon approval, your injured employee begins to receive benefits that cover their medical expenses, rehabilitation costs and lost wages while they are medically unable to work.
  • You get back to running your business successfully while your injured employee is on the mend, knowing we've got you covered.

How Do I Get Workers' Compensation Insurance and How Much Does It Cost?

An experienced agent, like an AmTrust Financial-appointed agent, can walk you through the buying process and help you understand the various laws, class codes and underwriting involved with workers' compensation insurance.

The average cost of workers' compensation will depend on many factors, including the number of employees, annual payroll, specific occupation and the rate classification of the business.

Examples of Workers’ Compensation Claims

A few common examples of small business workers' compensation claims include:
  • Slip and fall incidents
  • Overexertion or heavy lifting accidents
  • Falls from high areas
  • Struck by or against objects
  • Machinery accidents
  • Fires or explosions
  • Transportation incidents
  • Exposure to dangerous chemicals, substances or environments
  • Workplace violence

What Does Workers’ Compensation Cover?

The main purpose of workers' compensation insurance is to address legitimate workplace accidents and carelessness. This includes incidents that occur off the employer's premises but in the service of the job, such as injuries sustained while traveling for work or working remotely.

Workers' Compensation insurance offers five basic benefits:
  1. Medical care for the injured worker
  2. Temporary disability benefits to make up for lost wages while the injured employee is recovering
  3. Permanent disability benefits if an employee can't return to work
  4. Supplemental job displacement benefits, which pay for skill enhancement or retraining if the injured worker can't return to the job they had before the injury
  5. Death benefits paid to a spouse, children or dependents if the worker dies due to job-related injury or illness

What Does Workers’ Compensation Not Cover?

While workers' compensation is no-fault, certain claims generally are not covered, including when:
  • A worker intentionally inflicts his or her injuries or illnesses
  • The injury or illness occurs while the worker is doing something illegal
  • The employee wasn't on the clock
  • The worker's behavior was in clear violation of company policy or protocol
  • The employee was under the influence of drugs or alcohol
  • The injury occurs after an individual is laid off or terminated
Read more about what workers' compensation covers under the course and scope rule.

How Do I File a Workers’ Compensation Claim?

Step 1: The employee reports an injury to the employer.
Assess the condition of the injured worker. The employee should seek medical attention right away for a serious or life-threatening injury. If it is a non-emergency, the employee should visit a medical provider designated by the employer.

Step 2: The employer files the claim with their insurance carrier.
Upon receipt of the work injury, a supervisor (or H.R. representative) should provide the necessary paperwork to the employee and report the injury to the company's workers' compensation insurance provider. All injuries, from minor to major, should be reported within 24 hours of the incident. Learn more about reporting a claim with AmTrust.

Step 3: The insurer will either approve or deny the claim.
The workers' compensation insurance carrier will determine whether a claim is approved or denied based on the circumstances around the injury.

Step 4: Continue receiving medical treatment and monitor the status of your claim.
The employee continues receiving treatment and may follow up on the status of their claim periodically.

Step 5: The employee returns to work.
Once the injured employee is healthy enough, they will return to work (either full-time or in a limited role) unless the injury leaves them totally disabled.

How to Spot Workers’ Compensation Fraud

Here are six signs of a potentially fraudulent workers' compensation claim:
  1. You've heard employees gossip about the employee's injury
  2. You can't get a clear idea of what actually happened from those involved
  3. The injured party is refusing diagnostic procedures like an x-ray or MRI
  4. There aren't any witnesses to the injury event
  5. The claim is reported on a Monday morning
  6. The claim is reported more than seven days after the injury occurred

Individually, these signs do not conclusively mean a workers' comp injury is false, but when more than three of them are present, it might be time to take a closer look at the situation and the employee's claim.

Benefits of a Return to Work Program

Return to work programs are an efficient way for employers, employees, healthcare providers and claim administrators to manage the workplace injury rehabilitation process. In a return to work program, employees who receive approval from a physician to return to the workplace are given light-duty or transitional work by their current employer until they are fully released by the physician to get back to their regular job duties.

Is Workers' Compensation Insurance Mandated?


Workers' comp insurance for the general public is state-mandated, meaning that every state has its own workers' compensation laws and programs. The U.S. Department of Labor's State Workers' Compensation Officials has a handy map explaining the workers' comp insurance by state. It is important to remember that most states explicitly prohibit employers from firing workers who plan to make a workers' compensation claim, and employers cannot tell workers not to file.

States like Georgia, Arkansas, and Michigan require workers' compensation insurance for three or more employees, while states like Missouri, Tennessee, and Alabama require it for five or more. In Texas, workers' compensation insurance is not required unless a company is contracting with a government entity.


What Workers' Compensation Laws Apply to Me?


The most basic law is whether or not you are required to carry workers' compensation insurance. Every state other than Texas requires businesses to carry workers' compensation insurance if they employ a certain number of people.


How Do State Laws Differ for Workers' Compensation?


Workers' compensation laws are dependent on each specific state.

Some states, like California, are "no-fault," meaning injured employees don't need to prove that their injury was the fault of someone else to receive benefits. In "fault" states, it's necessary to demonstrate who was to blame for an accident, making the claim resolution process longer and more arduous.

In Illinois, for example, employers are obligated to inform the workers' compensation insurance carrier if an employee is out for three days due to an injury. Other state requirements are different. In Georgia, an employee must be out of work for seven or more days before the employer is required to notify the Board of Workers' Compensation.


How Do I Determine My Workers' Compensation Rates?


Workers' compensation quotes should depend on the amount of risk associated with your company's tasks. The more risk, the more expensive your coverage will likely be. Those risks can be mitigated through comprehensive risk management practices that increase safety and drive down the number of injuries or illnesses.

Premium rates determine the rates from each employee classification code, annual payroll, and the experience modification factor. Adding the annual premiums for all class codes will give you the estimated cost of annual workers' comp insurance for your entire staff.

Agent Information

As an AmTrust agent, you'll help your clients with ongoing services, including evidence of coverage and any changes to their policy, as well as provide advice about adhering to workers' comp laws. In the event of a claim, you'll be there to help guide them through the process.

Preferred Classes & Industries

While not all-inclusive, our workers' compensation coverage is particularly well-suited for the following classes:
For our preferred classes, we strive to provide a policy priced in a way that the policyholders and our agents are satisfied. Learn more about understanding workers' compensation underwriting guidelines.

The industries AmTrust covers include:

Financial Institutions
More than 2,000 community banks and other financial institutions nationwide rely on our insurance products and services, and we are endorsed by the American Association of Bank Directors.

With access to our extensive portfolio of competitively priced nonprofit specialty insurance products and services, AmTrust agents are uniquely able to address the unique challenges that nonprofits and government employers face.

Restaurant Insurance
Address restaurant business owners' issues quickly and provide them with a decision on their insurance application in a timely matter. Learn more about reducing restaurant injuries.

AmTrust understands the challenges the retail industry faces. New and inexperienced employees are at a greater risk of injury and need proper training. Learn more about the most common retail worker injuries.

What Are Workers’ Compensation Requirements

To ensure efficient processing, please supply all requirements listed below for workers' compensation submissions.
  • Complete ACORD application including insureds' FEIN, description of operations and description of the exact nature of work performed
  • A premium schedule from our website with the premium you need
  • A completed questionnaire
  • Any appropriate narrative clarifying the operation and experience of the risk
  • Loss runs described in further detail below

Prior Experience/Loss Runs Requirements

  • New ventures/no prior coverage or less than three years prior coverage
  • Must have at least one full-time employee other than owner(s)
  • Targeting fewer than 12 employees, unless part of a franchise program
  • Eligible business operations
    • Professional office exposures: doctors, dentists, lawyers, accountants, insurance agents, computer/programmers/consultants
    • Beauty and barber shops/salons
    • Retail stores: Sale of new merchandise, not open after 9 p.m., and no delivery
    • Restaurants: Liquor receipts less than 50% of total receipts, not open after midnight, no delivery, and minimum premium of $1,000 in N.Y.
    • Laundry/dry cleaners with no vehicle exposure

Businesses with Prior Coverage and Other Risks

For retail stores, professional office exposures, motels, restaurants, laundries and beauty shops:
  • Our preferred submission guidelines require that the current year, plus the past three loss runs are submitted
  • If the "preferred submissions" information is not available, we will accept the following:
    • Premiums under $5,000
    • Current year loss run
    • Loss statement for prior years if loss runs not available
    • If bureau promulgated merit credit, please provide current year loss run
    • Premiums between $5,000 and $25,000
    • If experience modification is less than 1.00, current year loss run
    • If experience modification is greater than 1.00, current year and prior three years' loss runs or current year loss run and experience modifications worksheet
For all other risks:
  • Consideration will be given for risks in business a minimum of three years with prior coverage
  • Loss runs for current year and three prior complete years
  • Loss runs for current year plus the experience modification worksheet

Meeting the Needs of our Workers’ Comp Agents

When you choose to become an insurance agent with AmTrust, you'll become part of an organization focused on generating steady, stable and positive growth. Your career as an agent will prosper with our multi-tiered carrier approach, giving a competitive advantage with pricing flexibility. We are committed to ensuring that our agents and policyholders have the service and support they need to succeed. Our workers' compensation coverage is available nationwide, including in California, Florida, Illinois, New York and Texas.

Workers' Compensation Insurance Information Center

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