Work Related Diseases Are Not Covered Under Occupational Accident Insurance}

Submitted by: Ed Sneineh

Occupational Accidents insurance refers to coverage for work associated accidents that come about in the course of a individual’s occupation. Occupational accidents insurance may not cover any diseases that are not affiliated with accidents.

Occupational accidents account for over 90% of occupational disabilities in America. In most cases the injured staff is allowed for compensation under state laws. Workers compensation is a coverage that is mandated by law for all wage paying employers which hire people as ’employees’ ‘independent contractor’.

Workers compensation and occupational accidents coverage typically deals with the following details:

– All medical payments for medical care that are reasonably needed to remedy or soothe the injury.

– Temporary Total Disability (TTD): Pay for benefits while the insured staff is in recovery.

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– Temporary Partial Disability (TPD). Pay for benefits when the insured worker is not completely cured but is performing some light tasks.

– Permanent Partial Disability (PPD). Provides income payments to an injured employee who incurs a permanent disability but can perform light functions.

– Permanent Total Disability (PTD). Provides income payments to an injured worker who is ruled to be incapacitated to work completely.

– Survivorship Benefits including death benefits for surviving spouse and family members.

– Vocational rehabilitation to enable the injured staff get gainful vocation through rehabilitation programs to improve employment skills or education or vocational training.

Similarities and differences between workers compensation and occupational accidents insurance.

Workers compensation is a coverage that is required by law. Workers compensation policies are created with certain minimum limits and coverages pertaining the matters listed above. The coverage along with provisions, conditions, and exclusions of the policy are closely observed by certain governmental bodies in each state. Also the government observe very closely, and does intervene in the claim paying practices. Workers compensation insurance companies work within strict legal and competitive environments. Occupational accident insurance, on the other hand, is not mandatory and its terms and provisions related to the above factors are dictated by competitive forces, not legal requirements per se.

Workers compensation insurance covers both work related accidents and work related diseases. Occupational accident coverage covers only accidents.

Rating for workers compensation coverage is based on class code (degree of risk involved with the job), insurance limits and estimated annual payroll. However, rating of occupational accident insurance is based on class code and coverage limits. Wage is not a factor in a factor in deciding rates for occupational accident policies.

Rationale for occupational accident insurance.

In situations where companies are not mandated to have workers compensation and where the class of job is too risky and where projected yearly wage is too high, some businesses may find it beneficial to get occupational accident policies instead of workers compensation. A leading example is a trucking company that recruits independent owner operator truckers. Occupational accident for truckers can be challenging in some states because some jurisdictions have ruled those as “employees” that must be covered under a workers compensation policy, not under an occupational accident policies. For that reason, occupational accident policies may not be helpful to cover independent contractors who can be looked at as ’employees.’

Some insurers give valuable enhancement to their occupational accident policies such as ‘Contingent Liability”. In occupational accident insurance, contingent liability kicks in when and if the employer is sued for accidents covered under their occupational accident polices, but it was decided later that workers compensation was mandatory to cover the case. In that case the occupational accident policy will provide coverage tantamount to workers compensation.

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