WORKERS COMPENSATION INSURANCE

WORKER’S COMPENSATION INSURANCE

Employers are legally obligated to take reasonable care to assure that their workplaces are safe. Nevertheless, accidents happen. When they do, workers compensation insurance provides coverage.

Workers compensation insurance serves two purposes: It assures that injured workers get medical care and compensation for a portion of the income they lose while they are unable to return to work and it usually protects employers from lawsuits by workers injured while working.

Workers receive benefits regardless of who was at fault in the accident. If a worker is killed while working, workers comp (as it is often abbreviated) provides death benefits for the worker’s dependents.

ABOUT

Workers’ compensation insurance is a state regulated insurance system that ensures medical bills and some lost wages are paid for employees injured on the job or who have work-related diseases or illnesses.

Employees covered by workers’ compensation receive benefits based on the type and severity of their injuries. Benefits include:

• medical benefits for medically necessary treatment of work-related injuries and illnesses;
• income benefits for a specified period of time up to a certain dollar limit set by law; and
• compensation for burial expenses for employees killed on the job;
• Death benefits for dependents of employees killed on the job.

If there is a workers’ compensation claim for benefits, an employee’s family may be entitled to pursue other remedies through the courts if the employee is killed and the death was caused by the employer’s gross negligence or intentional act or omission.

Workers’ compensation doesn’t pay for injuries that:

• are intentional or self-inflicted,
• result from horseplay or voluntary drug or alcohol intoxication,
• are inflicted by someone else for personal reasons unrelated to the job,
• result from voluntary participation in off-duty recreational, social, or sports events, or
• Result from “acts of God” (like floods or hurricanes), unless the job has a particularly high risk of such injuries.

The Texas Department of Insurance- Division of Workers’ Compensation (TDI-DWC) regulates the state’s workers’ compensation system by:

• administering the workers’ compensation law to ensure that medical and indemnity benefits are paid to injured workers according to the workers’ compensation law,
• providing a mechanism for dispute resolution of workers’ compensation claims,
• coordinating return-to-work efforts between insurance company and policyholder,
• providing workplace safety services, and
• issuing certificates of authority to self-insure for workers’ compensation to employers that qualify.

Texas doesn’t require most private employers to carry workers’ compensation insurance. However, private employers who contract with governmental entities are required to provide workers’ compensation coverage for each employee working on the public project. Some contractors may require their sub-contractors and independent contractors to carry workers’ compensation insurance.

Employers may not charge employees for workers’ compensation coverage. There are some exceptions for independent contractors and certain building and construction workers.

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