Workers' Compensation Insurance

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What is Workers’ Compensation?

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 AM Best, AmTrust Financial always seeks to deliver superior services at a rate that’s both fair and affordable.

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Workers' Compensation FAQs
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.
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.
What are 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
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 HR 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.

Policyholders should file all claims regardless of whether they think the employee injury is work-related. The injured employee’s social security number and the description of the injury is needed to get started.
To file a workers’ compensation claim with AmTrust, complete a workers’ compensation ACORD form, First Report of Injury or Illness, and include it with your email or online submission.

Phone: (888) 239-3909
Email: WorkersCompClaimReport@AmTrustGroup.com
Online: Log in to AmTrust Online
 
How can you 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.
What are the 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. Every state has laws that require employers of certain sizes to provide workers’ compensation coverage to their employees, and in the vast majority of states, having workers’ comp insurance is mandatory. Regardless of whether the coverage is required by law, however, it’s recommended that all employers obtain coverage to protect their workers and their business.

Almost every state has exceptions to what workers’ comp covers based on the type of employee. For example, in Arkansas, workers’ compensation will not cover casual employees (an employee with no specific amount of hours or set hours), farm laborers, inmates or state employees. In Mississippi, Maryland, Texas and a few other states, workers’ comp doesn’t provide coverage for independent contractors.

It's important for business owners to understand their state’s workers’ compensation laws to ensure they have the proper coverage that keeps them protected.
How do I determine my workers' compensation rates?
Workers' compensation quotes should depend on the amount of risk associated with the industry that your business operates in as determined by the class code. 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.

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