Unit 20: Workers' Compensation Flashcards
Common Law Defenses
Assumption of Risk
- employee knew of job risks
- employer not at fault
Common Law Defenses
- if employee partly at fault, considered to be totally at fault
- employer not at fault
After states passed workers’ compensation laws - no fault
- employer agrees to pay regardless of fault
- benefits of the law are the employee’s exclusive remedy
Workers’ Compensation Benefits
- medical
- disability
- survivor
- burial
- rehabilitation
Injury or Disease
- injury must occur in the course and scope of employment
- disease must be caused by a specific type of employment
Compulsory or Elective
almost all states require employers to comply with the provisions of the law
in an elective state, the employer does not have to comply
- can be sued
- cannot claim common law defenses: assumption of risk, contributory negligence, fellow servant
Funding of Benefits
- private workers’ compensation insurance policy
- monopolistic: insurance bought from the state
- competitive: insurance bought privately or from the state
- self-insurance: employer has savings to pay claims
- group insurance: members of the same group
Part One - Workers’ Compensation Benefits
- pays the workers’ compensation benefits of the state law
- no dollar limit unless in the law
Part Two - Employers Liability
pays when the employer is sued outside of the workers’ compensation law
- policy limit per accident
- policy limit for all bodily injury claims by disease
- policy limit per employee for bodily injury by disease
does not pay workers’ compensation benefits
Part Three - Other States
pays the workers’ compensation benefits of state island
Part Four - Your Duty if Injury Occurs
the insured’s obligations
- provide medical services required for the injured party
- report the injury to the insurer
- cooperate with the insurer in the investigation and settlement of the claim
Part Five - Premium
explains how the cost of the policy is determined
Part Six - Conditions
- subrogation
- inspection
- cancellation