Term
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Definition
| This defense placed all the risk on the employee as being responsible for knowing the work conditions prior to employment |
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Term
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Definition
| Removed the employer’s negligence if a fellow employee contributed in any way to the loss |
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Term
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Definition
| Used to argue that the employee was partially at fault and therefore was not eligible to recover benefits from the employer |
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Term
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Definition
- workers’ compensation benefits are mandated by state law
- If the provisions of a policy do not comply with the state law, the insurer is required to provide all legally mandated benefits
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Term
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Definition
- workers’ compensation benefits are not mandated by state law employers have the choice to accept or reject state workers’ compensation laws
If rejects:
- employee may then file a claim or lawsuit against the employe
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Term
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Definition
| Workers’ Compensation insurance is only available through a state fund |
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Term
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Definition
- Workers’ Compensation insurance is available through private insurers
- And any state fund that may exist
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Term
employer-employee relationship exists if the employer: |
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Definition
- Retains the right to direct the way work shall be completed
- Supplies the necessary equipment to complete the work
- Determines the work hours
- Determines the end results of the work to be completed
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Term
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Definition
- employers are not required to cover independent contractors
- is not required to withhold taxes from any compensation
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Term
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Definition
Workers’ compensation statutes require employers to provide benefits to all employees unless an employee is exempt.
Examples:
- Agricultural workers
- Domestic employees
- Independent Contractors
- Sole – Owners, Partners, and Corporate Officers.
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Term
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Definition
| Covered injuries are those that arise out of, and in the course of, employment. |
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Term
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Definition
| An occupational disease must arise out of the course of employment and be caused by conditions that are particular to that employment. |
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Term
| Federal Workers' Compensation Laws |
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Definition
federal laws governing certain types of employees:
- The Federal Employers Liability Act (FELA) applies to interstate railroad workers
- The U.S. Longshoremen and Harbor Workers’ Compensation Act applies to workers who load, unload, build, or repair ships (but not to the crew of the ship).
- The Jones Act or Merchant Marine Act of 1920 applies to sailors injured by the negligence of others.
- The Federal Employees Compensation Act applies to all U.S. civilian employees
- Defense Base Act applies to workers on military bases outside the United States.
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Term
Benefits Provided (Determined by State Law)
Medical Benefits |
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Definition
| Unlimited coverage for all necessary medical (including hospital) expenses related to the covered injury that occurred during the policy period. |
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Term
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Definition
- expected to recover and return to work
- BUT can't do with W/O recovery
- Benifits-In most states, it is 66 2/3%.
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Term
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Definition
- Can't work for rest of life
- Benifits- paid for life
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Term
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Definition
- Can do some work
- BUT can't earn normal wages till recovered
- Benefits- as a percentage of the difference in the wages
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Term
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Definition
- able to do some work, but will never fully recover
- Can still earn a wage but not as much as he/she would have earned
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Term
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Definition
- applies to specific permanent partial(such as a dollar amount for the loss of an eye)
- These benefits are usually paid in addition to other benefits.
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Term
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Definition
- pays compensation on behalf of an employer to an employee who has already suffered a prior disabling injury
- employer is responsible only for compensation that would have been paid had the second injury occurred
- designed to encourage employers to hire people with disabilities by limiting their liability for subsequent injuries
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Term
| policy workers’ compensation contains the following parts: |
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Definition
- General Section
- Part One – Workers’ Compensation Insurance
- Part Two – Employers Liability Insurance
- Part Three – Other States Insurance
- Part Four – Your Duties if Injury Occurs
- Part Five – Premium
- Part Six – Conditions
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Term
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Definition
- The Policy
- Who is Insured
- Workers’ Compensation Law
- State
- Locations
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Term
| Doctrine of Dual Capacity |
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Definition
| which applies when an employee is injured by a product the employer manufactures |
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Term
| Workers’ Compensation Policy |
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Definition
| contract between the employer, who is the insured, and the insurer; and the terms of the policy may not be changed or waived, except by endorsement. |
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Term
| injured employee is entitled to |
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Definition
| benefits in the state where the injury occurs |
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Term
| Workers’ Compensation Policy Provisions |
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Definition
- include prompt notice, bankruptcy of the insured, insurer liability, jurisdiction, policy conformance, and conflicting terms
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Term
| Voluntary Compensation endorsement |
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Definition
| This endorsement is used when an employer wishes to provide Workers' Compensation benefits to employees even though the law does not require the employer to provide that coverage. |
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Term
| Which Workers' Compensation benefits do not have a limit |
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Definition
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Term
| primary objective of Workers' Compensation |
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Definition
| To provide a payment of benefits to employees for injuries that arise out of their employment |
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Term
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Definition
Insurers who write Workers' Compensation Insurance in the voluntary market in the state must participate in the Assigned Risk Plan.
Offered ti employers unable to purchase coverage in the voluntary market |
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Term
| Employers Liability insurance (Stop Gap Coverage): |
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Definition
| Covers actions brought against the insured in a capacity other than as an employee |
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