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Tips on how to best navigate the worker's compensation process
BIO:
Tim Gaspar is the owner of Gaspar Insurance Services.
TRANSCRIPT:
Hello. My name is Tim Gaspar with Gaspar Insurance Services. We are an insurance agency specializing in insurance for small and medium-size business owners.
Today, we are going to talk a little bit about workers compensation insurance and some of the things you should know about filing a claim and the claims process. In some states, workers' compensation insurance is the law. If you hire even one employee under your supervision or on your payroll, you have to have workers compensation insurance. The fines for not having it, depending on your state, can be very substantial.
Even if you do not have any employees, if you hire subcontractors, and they don't have their own workers' compensation insurance, depending on your state, there's a pretty good chance that you might have to go ahead and get a workers' compensation policy to cover them.
A workers' compensation policy generally covers any injuries your workers sustain while on the job. Now the first thing you want to do when you get your workers compensation policy is that you make sure and find the workers compensation claims kit. This is typically sent to you by the workers compensation insurance company, and will usually be clearly labeled as the claims kit. Make sure that you have this somewhere it is readily accessible and that you know where it is because for most businesses, you are going to need it at some point.
Now in the event of a claim, you want to make sure that you get medical attention for the employee first and foremost. This could mean calling 911 or if it is not as serious it could mean calling your insurance agent or calling the workers compensation carrier for a nearby clinic, and going ahead and sending that person over to get checked out just to be absolutely safe.
After you have gone ahead and made sure that your employee is okay, and that they are healthy and that they have gotten adequate medical attention, you want to go ahead and fill out that workers' compensation paperwork to go ahead and file the claim. These can be pretty lengthy at times, so you might want to call your agent just to get some assistance in regards to how to fill it out. Once you have it filled out, there is typically going to be a fax number or an email address to go ahead and send that paperwork in to get the claims process started.
Typically, the insurance company will assign a claim's person to the case within 24 hours or so, assign a case number, and get the process started for you. Now in regards to the workers' compensation claim, there's a couple of different directions it can go.
If it is a relatively small claim like, let's say, a chef cuts his finger in a restaurant and it requires a stitch or two, and he or she is eager to get back to work, the claim can be closed relatively quickly. The workers' compensation insurance company can go ahead and cut the check to the company or the hospital that did the stitches pay for the claim, the employee goes back to work, and everybody is happy. This would be a relatively small claim, relatively quick to take care of, within a week or two.
However, if an employee has a serious injury, where they are seriously injured or let's say they can't work for a while, the claim can drag on for quite a while. Now if you have a situation where a claim stays open for more than a year, or let's just say that it seems like an unreasonable amount of time, or you even think that fraud is involved, you definitely want to get your insurance agent involved at that point so they can go ahead and address it accordingly.
I'm Tim Gaspar with Gaspar Insurance for Business.com making sure that you have the right business insurance coverage for the right price.
Workers' compensation:
• Covers injuries to workers on the job
• Is required in most states
• When accidents happen, file a claim
• Follow up on lengthy claims
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