Claim Cost

Workers’ compensation insurance is designed to protect businesses and their employees if and when on-the-job injuries occur. Every state has its own Workers’ comp insurance protocol including setting its own claim cost limits on the maximum amount an employee can collect for lost wages, death, or medical expenses.

A workers’ compensation insurance policy pays the claim instead of making a business shell out money out of pocket. The value of a claim depends on the severity of their injuries, the amount of time they lose on the job, and the number of their regular wages.

Work Comp Claim Cost Considerations

Here is a closer look at what factors contribute to a workers’ comp claim cost.

Medical Expenses

Workers’ comp insurance pays the medical expenses of an injured employee up to the statutory limit. Doctor and dental visits, medications, hospitalizations, diagnostic testing, and surgery are usually covered. If an employee who is injured needs additional help, such as the use of crutches, a workers’ comp insurance policy should cover those expenses.

Additionally, depending on the state, a workers’ comp policy may pay for pain relief therapy, acupuncture, and counseling. However, workers’ comp insurance usually doesn’t cover the expenses for certain experimental therapies or procedures.

Lost Wages

Policies typically pay between 60 and 80 percent of an employee’s usual wages, but with a cap on that total amount. The lost wages paid from a workers’ comp claim are free from being taxed and include the time an employee spends receiving medical care and time lost from work. If an employee who makes a claim uses sick days or vacation time for medical reasons, that amount is also considered to be lost wages.

Pain and Suffering

Workers’ comp insurance does not cover claims related to pain and suffering. An employee may instead choose not to file a claim and move toward filing a lawsuit against the company they work for. In this case, an employee can sue to recover their medical expenses and lost wages on top of pain and suffering.

Since workers’ comp is considered a no-fault insurance, employees don’t have to prove negligence to receive compensation.

Death Benefit

If an employee ended up dying while performing their job, their surviving family members, namely their spouse and children, may be entitled to death benefits. The value of a death benefit is determined by state statutes and the wages of the employee. A child may receive benefits if they are under 18, or if they are an adult but are mentally and/or emotionally unable to care for themselves. 

About InsureMyWorkComp & Their Workers Comp Solutions

InsureMyWorkComp is a digital brokerage that helps clients find the right workers’ compensation solution for their business needs. Unlike other online platforms, we will help you to work with an agent who can provide you the right solution for your risk profile. Our staff has over 50 years of workers’ compensation underwriting and sales experience, and we are confident that we will provide you the support that you need. For more information or to get a quote, contact us today at (855) 340-9138.