The Hartford's explanation of the following is intended to provide a general overview of coverages. Only the insurance policy can give actual terms, coverages, amounts, conditions and exclusions.
While the coverage included in any Workers' Compensation policy is largely mandated by state statute, The Hartford distinguishes its policy by going beyond those requirements to expand coverage in several key areas. Better yet, we complement those expanded coverages with claims handling and a variety of cost containment services.
In general, the current Workers' Compensation system represents a compromise between employers and employees regarding employment-related injuries or illnesses. Basically, employees relinquish their right to sue employers if they suffer some job-related injury or illness. In return, employers agree to provide state-mandated benefits if such injuries or illnesses occur.
To ensure employers will have the money to pay these mandated benefits, some states require that employers demonstrate that they have the financial ability to pay any claims that may arise. Typically, this financial ability is demonstrated through the purchase of Workers' Compensation insurance.
Most Workers' Compensation insurance policies actually provide two types of coverage:
In general, Workers' Compensation insurance is designed to provide benefits for your employees. However, the individuals that are defined as employees is determined by state law. And in Workers' Compensation cases, courts have typically been very liberal in their definition of employees, so as to provide injured workers with broad protection under the state's Workers' Compensation laws.
The Employer's Liability insurance included in your Workers' Compensation policy can also provide damages to injured workers separate from their Workers' Compensation benefits. Family members and other third-party claimants may also receive benefits under this coverage -- if they prove the employer's legal liability.
Typically, your Workers' Compensation policy will pay for:
Work-Related Injuries
If one of your employees is accidentally injured while on the job, your Workers' Compensation policy will pay for a wide range of services to aid the injured worker's recovery and return to productive work. These services can include the cost of medical care, compensation for lost wages, and rehabilitation therapy.
If your employee is accidentally killed while on the job, your policy will also provide death benefits -- including burial expenses and partial replacement of the worker's weekly wage.
If some condition in your working environment actually causes one of your employees to become ill or contract a work-related disease, your Workers' Compensation policy will provide a wide range of benefits to help treat this illness and speed the employee's recovery. These benefits will typically cover the cost of medical care, compensation for lost wages, and other required therapy.
If your employee dies from this disease, your policy will also provide death benefits -- including burial expenses and partial replacement of the worker's weekly wage.
Coverage for Employees Not Subject to Workers' Compensation Laws
Some Workers' Compensation policies only provide benefits for those employees your state specifically identifies as subject to workers' compensation laws. But The Hartford's policy goes beyond this requirement. It automatically extends bodily injury coverage to employees who aren't expressly covered by your state's Workers' Compensation laws -- such as volunteers. (Not available in Wisconsin and New Jersey.)
Liability Suits Related to an Employee Injury
To recover benefits under your state's Workers' Compensation law, your employees don't have to prove you were somehow responsible for their employment-related accident or disease. But if they can prove you were liable for their accident or illness, they may be able to successfully sue to recover damages beyond the Workers' Compensation benefits.
If so, you'll be comforted to know that the Employer's Liability portion of your Workers' Compensation policy can pay for the damages awarded to your injured employee -- as well as the legal expenses involved in such a suit. This coverage may also provide certain benefits if you are ever sued by a third-party affected by a workplace injury, such as a family member of the injured worker.
Expenses You Incur as Part of a Workers' Compensation Claim
If you are ever involved in a Workers' Compensation claim, proceeding, or suit, The Hartford's Workers' Compensation policy will pay for any reasonable expenses you incur at our request to participate in these proceedings or help prepare your defense. In fact, we'll even pay for any earnings you lose because of these activities -- a benefit some standard Workers' Compensation policies do not offer.
Legal Expenses in Workers' Compensation Cases
If you are protected by The Hartford's Workers' Compensation policy, you won't have to worry about bearing any legal expenses related to a Workers' Compensation or Employer's Liability claim. In fact, we will assume the responsibility of investigating, defending and settling any related claims, proceedings or suits. We will also supply the services of an attorney to represent you in any such suit. In short, we will:
Compensation for Family Members
If an injured worker's family members can prove that you were legally liable for a work-related injury or illness, they may be able to collect damages from you. In such cases, the Employer's Liability coverage provided by your Hartford policy may pay for:
Coverages for Employees While Traveling on Business
Some Workers' Compensation policies only provide coverage for the states in which you do business, as specified in your actual policy. However, The Hartford's policy extends its Workers' Compensation coverage to employees traveling outside the standard policy territory (excluding Cuba, Iran, Iraq, Kampuchea, North Korea, Libya, and Lebanon).
Accidents Over Navigable Waterways
If any of your employees ever have an accident while carrying out their job responsibilities over a navigable waterway, they may be subject to the workers' compensation benefits provided by the United States Longshore and Harbor Workers Compensation Act. Typically, benefits mandated by this act are more extensive than those provided under a state's Workers' Compensation law.
Even so, you don't have to worry about this difference -- when you're protected by The Hartford's Workers' Compensation policy. That's because our policy automatically provides all applicable benefits extended to employees who are covered by this act.
Employer's Liability in Monopolistic States (NV, OH, WA, WV, WY)
In six states, the state governments mandate that employers purchase Workers' Compensation insurance from the state fund. Referred to as "monopolistic states", these states don't even allow insurance companies to sell Workers' Compensation to employers headquartered within their borders.
Even if your business isn't domiciled in one of these states, you could still be affected by their laws. If one of your employees is injured in any of these states and decides to file a Workers' Compensation claim, that state's laws would apply. In such a situation, you'll be reassured to know that The Hartford automatically provides "employer's liability" coverage. This coverage would pay for related expenses and damages in case you are ever sued for the employment-related injury or illness. Other insurers may offer this extended coverage in these states -- but only if you specifically request that they add it to your policy.
Third-Party Suits Against the Employer
If your employees are injured in an accident, they may try to sue a "third-party" (a company other than yours) -- if they believe that party is somehow responsible for their injury. In turn, that third-party may sue you -- if it believes your company is legally liable for the accident.
For example, an employee injured while using a piece of equipment may sue the equipment manufacturer for some alleged negligence or faulty design. However, the manufacturer can then turn around and sue your company -- if they believe the accident was instead caused by your improper maintenance of the equipment.
In this situation, the Employer's Liability coverage of your policy would pay any damages awarded by the court to compensate for the bodily injury.
Failure to Notify Insurer of Potential Hazards
When you apply for a Workers' Compensation policy, you have an obligation to disclose to the insurer all known hazards. But what if you don't even know you have a potential hazard at your business site? Unlike other policies, The Hartford's Workers' Compensation policy explicitly states that we won't deny coverage if something happens as a result of that undisclosed hazard -- as long as you did not intentionally fail to notify us of its existence.
Litigation Management in Comp-Related Claims
If you are sued because of your company's alleged responsibility for an injury or illness, The Hartford will mount a powerful defense against legal expenses. If it's in your best interest, we'll dispense with traditional litigation to settle the case quickly. Even if litigation is unavoidable, our on-staff attorneys are experts at speeding the process and reducing the costs.
Investigation into Workers' Compensation Fraud
Unfortunately, fraudulent claims add to every employer's workers' compensation costs. And since The Hartford is serious about helping you control costs, we're serious about fighting fraud. Across the country, The Hartford has set up special fraud investigative units, primarily staffed with former law enforcement officials. These units are dedicated to detecting and prosecuting fraud. Our claim professionals can also coach you on how to spot and handle a potentially fraudulent claim.
Managed Care Services in Workers' Compensation Cases
To help cut the cost of employers' losses and improve the quality of employees' care, The Hartford applies proven managed care techniques to its handling of Workers' Compensation cases. Among the managed care services your small business may benefit from are: