- The policy form
- An information page
- Various endorsements
Classification and Rating
Depending on the type of business you run, you will be allocated one or more classifications under a workers compensation policy. If, for instance, you run a clothing store, your business can be classified as a retail clothing store. The premium you pay in coverage will depend on your workers’ payroll, the classification used and the rate for each classification.
Your workers compensation premium can be affected by an experience modifier rate. An experience modifier is the adjustment of your premium based on the losses your insurer has experienced from you. Your insurer will gauge the past cost of injuries your workers have filed claims for and future chances of risk. The lower your experience modifier rate, the lower your premiums will be.
In the state of Massachusetts, a state workers compensation bureau will administer policy forms, classifications, workers compensation rates and other issues related to workers compensation.
Most states assign tasks like form development, statistical analysis and rate making to the National Council on Compensation Insurance (NCCI), a non-profit owned by insurers. About two thirds of states subscribe to NCCI but the state of Massachusetts is an independent state. This means they do not subscribe to NCCI. This means they allow private insurers to sell insurance.
Standard Policy Form
Most independent states use a standard workers compensation policy developed by NCCI. The policy has two basic coverages:
- Employers liability
- Workers compensation.
We shall explain in detail about workers compensation. Employers liability will be covered in another article.
Workers Compensation Coverage
All workers injured while on the job are entitled to workers compensation benefits regardless of whether they were at fault or not. This means an employee does not have to file a lawsuit in order to be compensated for injuries sustained at work. Furthermore, they are entitled to benefits even if their negligence contributed to the accident.
For instance, an employee at your restaurant slips and falls. The accident could have probably been avoided if they had wiped any spills that were on the floor as you had instructed them to do. If that is the case, they are still eligible for compensation. Below are some of the benefits that state workers compensation laws offer:
- Death benefits: These are benefits awarded to the spouses and children of the deceased worker.
- Vocational rehabilitation: This is a form of training given to workers who cannot return to their previous job because of their injury. The purpose of the skill is to enable them to learn new skills.
- Disability: This is compensation offered to workers who suffer a temporary or permanent disability due to work related injuries.
- Medical coverage: This includes compensation for physical therapy, medication, hospital care and doctor visits.
Typically, workers cannot file a personal injury lawsuit if they are covered under workers compensation but there are instances where a worker might have the right to file a personal injury lawsuit. If the workers is able to prove gross negligence, they could get more compensation outside workers compensation benefits.
For instance, if you own a restaurant and a worker continuously warned you about leaking gas, and then one day the kitchen burns down resulting in the worker suffering from severe burns, they might be awarded double compensation benefits.they would have otherwise received. Your workers compensation premium may not cover the benefits and you may have to pay a penalty. Other instances where your insurer might refuse to pay any excess benefits include:
- Intentionally condoning and promoting misconduct. For instance, insisting that the employee must continue cooking in the kitchen while the gas is leaking.
- You hire an employee against the law. For instance, you hire an employee who is under 21 years old to serve alcoholic drinks
- You do not comply with health or safety regulations
- You discriminate, coerce or discharge employees without regard for workers compensation law.
Consult with a Workers Compensation Lawyer in Plymouth
If you have been injured at work or you an employer with a workers compensation case that’s you need to be looked in to, we can help you. Contact out Plymouth workers compensation lawyers at 508-746-2700 for a free initial consultation.