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Workers Compensation Insurance Explained

Workers’ compensation insurance is a type of insurance that provides financial and medical benefits to employees who suffer job-related injuries or illnesses. It is designed to protect both employees and employers by ensuring injured workers receive necessary medical care and wage replacement while protecting businesses from potential lawsuits related to workplace injuries.

General Coverages

Pursuant to your particular policy language, coverage provisions, and exclusions; commercial umbrella policies can include coverage for:

Medical Expenses – Covers all necessary medical costs related to a work injury or illness, such as:

  • Doctor visits and hospital stays
  • Surgeries and medical procedures
  • Prescription medications
  • Physical therapy and rehabilitation

Lost Wages (Disability Benefits) – Provides income replacement for employees who cannot work due to a job-related injury or illness. The amount varies based on the severity of the disability:

  • Temporary Total Disability (TTD): Covers a portion of lost wages while the employee is completely unable to work for a temporary period.
  • Temporary Partial Disability (TPD): Covers lost wages if the employee can work in a limited capacity with reduced earnings.
  • Permanent Total Disability (PTD): Provides benefits if the worker is permanently unable to return to any form of employment.
  • Permanent Partial Disability (PPD): Covers partial wage loss if an employee can work but has a lasting impairment.

Vocational Rehabilitation – Covers job retraining, education, or skill development if an injured employee cannot return to their previous job but can transition into a new role.

Death Benefits – If a worker dies due to a job-related injury or illness, benefits are paid to their dependents. This includes compensation for lost income to surviving family members and funeral and burial expenses.

Employer Liability Coverage – Protects the employer from lawsuits related to workplace injuries, except in cases of gross negligence. This includes legal defense costs and settlements or judgments if the employer is found liable in certain cases.

Claims Scenario

John is a construction worker employed by ABC Builders, a company specializing in commercial building projects. One day, while working on a multi-story construction site, John slips on an improperly secured scaffold and falls 15 feet to the ground. He suffers a broken leg, a sprained wrist, and a mild concussion.

John is immediately taken to the hospital, where he undergoes surgery to repair the fracture. His doctors estimate that he will need 12 weeks of recovery and physical therapy before returning to work.

How Workers Compensation Insurance Helps:

John’s hospital bills, surgery, medications, and follow-up doctor visits are covered by workers’ compensation insurance. His physical therapy sessions for rehabilitation are also covered.

Since John is unable to work during recovery, he receives a portion of his regular wages (typically 66% of his salary, depending on state laws) through workers’ compensation.

If John is unable to perform heavy labor after recovery, he may be eligible for vocational training to transition into a lighter-duty role within the company.

Contact CastleWise to discuss Workers Compensation Insurance coverage.