Worker's Comp does not insure the employees, it insures the employer.
InsTeacher 8)
Posted: Fri Nov 05, 2010 08:59 pm Post Subject:
It protects the employers but insures employee?
I guess the real question is who is an insured under the WC policy. I think an employee is considered an insured.
This is as close as I want to get to a WC policy.
Posted: Sat Nov 06, 2010 02:45 am Post Subject:
No. The employer is the insured and purchases the policy for the benefit of the employees. Considered the employees the third-party here. Workers Comp is, in essence, a liability policy that adheres to the absolute/strict liability doctrine.
This whole Workers Comp things started like this- employees, when they were injured or became ill due to a job-related incident, were suing their employers left and right through the liability laws on the books a million years ago. It became a real problem, and so to address the problem, they came up with the idea of Workers Comp. They made a deal.
In exchange for you not suing us if you get sick/hurt on the job, we'll make sure that all of your medical bills are paid, that you receive wage-loss, that we rehabilitate and retrain you, and that if you die- we'll take care of your family. So, WC was born. That's the deal you made.
Workers Comp, as you see, is a liability issue and actually a P&C product, not a life and health product. There are a myriad of laws that vary both slightly and vastly from state to state and confuse the hell out of most people. WC doesn't cover a lot of things and will not be assumed for egregious violations of the employer.
InsTeacher 8)
Posted: Sat Nov 06, 2010 03:10 am Post Subject:
So by definition and employee is not considered an "insured" under the WC policy?
Posted: Sat Nov 06, 2010 10:28 pm Post Subject:
So by definition an employee is not considered an "insured" under the WC policy?
Correct. As InsTeacher has clearly taught, the EMPLOYER is the INSURED, the employees are COVERED PERSONS. The so-called "blanket disability" policies that are used by campgrounds and amusement parks, among others, are similar in nature. The business is the insured and the persons who suffer injuries or illnesses are covered by the policy.
It can be a bit confusing on the surface, but when you think of WC as it truly is -- a form of NO-FAULT LIABILITY insurance (the employer must accept liability for lost wages, medical expenses, rehab, death/survivors benefits due to work-related injury or illness) -- then you should clearly realize that the employees are the THIRD PARTIES whose claims are covered (same as the driver/vehicle which is the "victim" of the collision caused by a negligent driver -- the kinds of claims you handle, tcope). The employer is protected from the risk of financial loss for those expenses in the same way as the negligent driver is protected. Except that in WC, no one has to prove who was negligent.
Additionally, the EMPLOYER'S LIABILITY section of the policy covers the "damages" of non-employee third parties due to the covered injury or illness of the employee (spouse's loss of consortium, children of a single worker who need a caretaker, are just two that come to mind) which would not customarily be a claim asserted against the business' general liability policy.
In his synopsis on the history of WC insurance, which will celebrate its 100th birthday next year (Wisconsin wrote the first set of laws that survived the scrutiny of the courts), InsTeacher did not fully explain the reason employees had to sue their employers for on-the-job injury losses for WC laws: determining negligence and the common law defenses to negligence.
If a business owner could prove that the injury was due to one of the employee's fellow workers, or that there was an "assumption of risk" ("you knew it was a dangerous place in which to work"), and, last, but not least, the old contributory negligence defense -- if the employee was just 1% at fault, they could not collect anything.
Initially, if employers refuse to buy the insurance, they were forced to give up their reliance on the common law defenses, but if they bought the insurance, they could still use the defenses. Because it still resulted in an "adversarial" environment, the whole business of the common law defenses was soon eliminated in favor of no fault liability for their employees' injuries.
Only problem is . . . thanks to all the lawyers . . . the laws have never eliminated the lawsuits as envisioned. Go figure.
Posted: Fri Nov 05, 2010 08:39 pm Post Subject:
Worker's Comp does not insure the employees, it insures the employer.
InsTeacher 8)
Posted: Fri Nov 05, 2010 08:59 pm Post Subject:
It protects the employers but insures employee?
I guess the real question is who is an insured under the WC policy. I think an employee is considered an insured.
This is as close as I want to get to a WC policy.
Posted: Sat Nov 06, 2010 02:45 am Post Subject:
No. The employer is the insured and purchases the policy for the benefit of the employees. Considered the employees the third-party here. Workers Comp is, in essence, a liability policy that adheres to the absolute/strict liability doctrine.
This whole Workers Comp things started like this- employees, when they were injured or became ill due to a job-related incident, were suing their employers left and right through the liability laws on the books a million years ago. It became a real problem, and so to address the problem, they came up with the idea of Workers Comp. They made a deal.
In exchange for you not suing us if you get sick/hurt on the job, we'll make sure that all of your medical bills are paid, that you receive wage-loss, that we rehabilitate and retrain you, and that if you die- we'll take care of your family. So, WC was born. That's the deal you made.
Workers Comp, as you see, is a liability issue and actually a P&C product, not a life and health product. There are a myriad of laws that vary both slightly and vastly from state to state and confuse the hell out of most people. WC doesn't cover a lot of things and will not be assumed for egregious violations of the employer.
InsTeacher 8)
Posted: Sat Nov 06, 2010 03:10 am Post Subject:
So by definition and employee is not considered an "insured" under the WC policy?
Posted: Sat Nov 06, 2010 10:28 pm Post Subject:
So by definition an employee is not considered an "insured" under the WC policy?
Correct. As InsTeacher has clearly taught, the EMPLOYER is the INSURED, the employees are COVERED PERSONS. The so-called "blanket disability" policies that are used by campgrounds and amusement parks, among others, are similar in nature. The business is the insured and the persons who suffer injuries or illnesses are covered by the policy.
It can be a bit confusing on the surface, but when you think of WC as it truly is -- a form of NO-FAULT LIABILITY insurance (the employer must accept liability for lost wages, medical expenses, rehab, death/survivors benefits due to work-related injury or illness) -- then you should clearly realize that the employees are the THIRD PARTIES whose claims are covered (same as the driver/vehicle which is the "victim" of the collision caused by a negligent driver -- the kinds of claims you handle, tcope). The employer is protected from the risk of financial loss for those expenses in the same way as the negligent driver is protected. Except that in WC, no one has to prove who was negligent.
Additionally, the EMPLOYER'S LIABILITY section of the policy covers the "damages" of non-employee third parties due to the covered injury or illness of the employee (spouse's loss of consortium, children of a single worker who need a caretaker, are just two that come to mind) which would not customarily be a claim asserted against the business' general liability policy.
In his synopsis on the history of WC insurance, which will celebrate its 100th birthday next year (Wisconsin wrote the first set of laws that survived the scrutiny of the courts), InsTeacher did not fully explain the reason employees had to sue their employers for on-the-job injury losses for WC laws: determining negligence and the common law defenses to negligence.
If a business owner could prove that the injury was due to one of the employee's fellow workers, or that there was an "assumption of risk" ("you knew it was a dangerous place in which to work"), and, last, but not least, the old contributory negligence defense -- if the employee was just 1% at fault, they could not collect anything.
Initially, if employers refuse to buy the insurance, they were forced to give up their reliance on the common law defenses, but if they bought the insurance, they could still use the defenses. Because it still resulted in an "adversarial" environment, the whole business of the common law defenses was soon eliminated in favor of no fault liability for their employees' injuries.
Only problem is . . . thanks to all the lawyers . . . the laws have never eliminated the lawsuits as envisioned. Go figure.
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