Feb 15, 2021

Who is Responsible for the Payment for a Workers’ Compensation Case?

You have been injured at work and needed to file a workers’ compensation claim. There is some resistance as to whether or not you qualify for benefits. Thanks to your workers’ compensation attorney’s diligence, though, your case goes smoothly and an agreement to provide you a lump sum settlement is eventually reached. Who will the party that pays you those benefits?

Despite how your employer might have acted as your claim was progressing, they are not the party who will pay your benefits or settlement. Instead, your workers’ comp payment should come from the insurance company that sold your employer their workers’ compensation insurance policy. Your employer pays that company premiums each month to maintain the necessary coverage for all of their eligible workers, just as you do when purchasing insurance from an auto insurance company.

Employers can purchase policies from a private insurance company or directly from their state’s workers’ compensation program. In either situation, an insurer will pay your benefits or settlement. Ideally, you shouldn’t be bothered at all by who owes you what compensation because your employer and their insurer are the parties who should sort out those details.

What is Self-Insurance for Workers?

Some employers might be able to self-insure their workforce instead of purchasing workers’ compensation insurance through a state-approved insurance company or a state-run program. The concept is the same as self-insurance options for drivers, which means the employer must prove that they have ample finances that can be used to provide necessary care and wages to an injured worker. Because self-insurance effectively puts an employer’s own finances at risk, most do not use this option in the rare circumstances it is available.

In fact, Texas is the only state that allows all employers to opt out of workers’ compensation requirements, so it is rare to see a self-insured employer outside of that state. Although, if you are an independent contractor and not an employee, then you might be eligible for self-insured coverage from your employer.

Can You Sue Your Employer Instead?

Workers’ compensation makes it incredibly difficult if not impossible to sue your employer for damages after a workplace accident. If you are eligible to use workers’ compensation benefits, then your employment contract likely says that you will fully explore that option before attempting to sue your employer for negligence. Under your state’s rules and regulations, you are more than likely barred from bringing a civil claim against your employer as soon as you receive workers’ comp benefits, too.

Only in extremely rare cases can you get workers’ comp payments from an insurance company and receive additional damages from your employer’s own finances. Courts generally only make this exception when the employer commits a crime or acts with egregious, inexcusable negligence. For example, if your employer physically assaults you, then a court might allow a civil claim in pursuit of pain and suffering damages and punitive damages, which otherwise would not be paid through workers’ comp.

Who Can Help You Figure Out a Claim?

To get accurate information about how to proceed with a workers’ comp claim and who should pay your benefits, work with a local workers’ compensation attorney who knows your state’s rules by heart. If you live in Atlanta, Georgia, then you can make Hansford McDaniel – Workers’ Compensation Attorneys your first choice for legal assistance. Our attorneys focus entirely on workers’ compensation cases and related legal issues, so you can trust in our abilities to confidently and effectively guide or represent you.

To find out more from our team, request a free case evaluation today.