If everything has been smooth sailing for your business so far, then that’s great! We don’t want to be the bearers of bad news but we have to remind you that things can go wrong. Which is why you have to maintain your commercial insurance policies. It could be a major mistake to believe that you will likely never have to use your insurance policies or that the cost of premiums is not worthwhile. Insurance claims are more common, and costly, than you might expect.
Burglary And Theft
Almost every commercial business has been the victim of theft by either customers or employees. The majority of all insurance claims filed annually are for burglary and theft. In fact, a recent survey revealed that 54% of small business owners have reported theft. Every business has something that can be stolen, whether it’s money, supplies, data, etc. It is not surprising that this is the most common insurance claim for businesses.
Water And Freezing Damage
The second most frequent insurance claim is for water damage and subsequent freezing due to pipes bursting or flooding from storms. Thankfully the cost of this type of damage can be covered by commercial property insurance. You also need to consider the cost associated with repairing structural damage. Keeping up with snow and ice removal can lower the risk of freezing damage. And maintaining a suitable indoor temperature can prevent pipes from bursting. If you plan to be away from the business for more than 72 hours, such as for an expected snow storm, turning off the water can lower the chances of pipes bursting and causing damage.
Wind and Hail Damage
During severe storms, the wind can become so strong that it actually brings trees and branches down onto buildings. Hail can damage roofs and windows, whereas a tornado can completely demolish your building. Sounds intense, right? Wind and hail damage can cost your business thousands of dollars in repairs. A sufficient commercial insurance policy will help cover the costs of hail and windstorm damage.
Fires
Both small and large businesses can be severely affected by fires. If your business has suffered fire-related losses or damage, you can file a claim for commercial property insurance to cover your financial losses. In some instances, business may be required to replace damaged equipment and reconstruct portions of the structure. If your company’s operations are temporarily halted as a result of fire damage, you can rely on business interruption insurance to compensate for any lost revenue.
Customer Injury and Property Damage
Customer injury and property damage are precisely what they sound like. On your property, accidents are inevitable, however, your general liability insurance policy will cover any customer injuries or property damage. These two insurance claims are commonplace in the majority of industries from construction to retail. If a customer or someone from the general public slips and falls while visiting your business, or if a vehicle crashes into the front of your store, causing severe property damage, your business will need insurance. 10% of businesses file claims for injuries caused by slips and falls. However, if medical costs, legal fees, or repairs start to build up after a customer injury or property damage claim, your general liability insurance can help.
Product Liability
If any products you sell or make are defective, or fail, there is a good chance you will be held liable for any damages, injuries, or illnesses the failure results in. This frequent insurance claim typically happens in the retail, manufacturing, and distribution industries. You will be held responsible for any medical expenses, legal fees, and wage lost. Not to mention the cost of a product recall if your company does not have the appropriate insurance policy. General liability insurance and product liability insurance can protect your business from the risks associated with product liability claims.
Reputational Harm
If a client or another business decides to sue your company for causing them reputational damage, you may be held responsible for the damage. Reputational damage can also result from an event that causes your company’s reputation to be questioned or damaged. These claims are most common in businesses that store customer data, such as banks, retailers, and media companies. General and professional liability insurance policies can help protect you from reputation damage claims.
Auto Accidents
If your company uses commercial vehicles then you’ll need appropriate coverage from vehicle damage, property damage, and injuries associated with car accidents. A commercial auto insurance policy can protect your company, employees, and your vehicles in the event of an accident.
Struck By Object
Customers, employees, and the general public can be struck by random objects while on your property. Which can cause some serious problems if you don’t have enough business insurance. In one of the more unusual cases of business insurance claims, a British travel insurer offered additional coverage against people being struck by falling coconuts while on vacation. It just goes to show that you can never predict what can happen.
How The Business Insurance Claims Process Works
In the event that your business is affected by one of the above problems, filing a claim for business insurance is pretty straightforward. Your first step should be to contact your insurance company. You have to inform them immediately to get the claim started. You’ll need to give them a list of any items that were damaged or the specifics of a customer’s complaint. Some insurance companies will require you to call them on the phone to file a claim. While others will let you file online. When you file a liability claim, your insurer will conduct an investigation to verify the circumstances.
Next, your broker will examine your insurance policy to determine what is and is not covered. Additionally, your insurer may suggest contractors who can assist you with any necessary repairs. Once the investigation and policy review are complete, your claims adjuster will let you know when you can anticipate receiving payment for your commercial insurance claim.
What Happens If My Insurance Claim Is Denied?
Unfortunately, not all commercial insurance claims procedures are straightforward. Your claim may be rejected for a variety of reasons. For example, if the insurance company suspects fraud, if the claim is not covered by your policy, or if you did not submit the claim quickly enough, it could be denied. There are, however, alternatives to filing a lawsuit in this situation. If your claim is denied, you can write a response letter to your insurance company explaining why you believe the denial was incorrect. To do this, you have to maintain accurate records of all pertinent information before and after the incident. If you require additional assistance, do not hesitate to contact a state insurance regulator for direction.
Additionally, it never hurts to follow up with an insurance company regarding a pending claim or to request an explanation as to why the claim was denied. Most of the time, you’ll want to avoid having to go to small claims court over a dispute with an insurance company. Hiring an attorney will only cost you more money. Additionally, there is no assurance that you will win the case. Consider reaching an agreement with the insurance company, even if a state insurance regulator is required. Going to court should almost always be a last resort for small businesses.
Types of Business Insurance You May Need
There’s a long list of insurance policies you should consider for your small business. All of these protect different portions of your business and are equally important.
General Liability – General liability insurance, also known as commercial general liability insurance, protects your business against claims of bodily injury and property damage. This type of policy can be purchased separately or as part of a business owner’s policy.
Professional liability – Professional liability insurance, also known as errors and omissions insurance, covers a portion of the costs associated with negligence claims and lawsuits. Professional liability will cover you if you or an employee make a costly mistake, such as providing poor advice or improperly handling confidential information.
Commercial property – Your company’s physical assets are protected with commercial property insurance. It protects against damage from fire, explosions, burst pipes, storms, theft, and vandalism. Typically, earthquakes and floods are not covered by commercial property insurance unless they are purchased as an add-on for the policy.
Cyber liability – Cyber liability protects against threats associated with that technology. These threats, which include hacking and data leaks, can be devastating to your business.
Commercial auto – Any costs associated with injuries, deaths, or property damage caused by your business vehicle are covered by commercial auto. This policy is necessary because a standard auto insurance policy will not cover you if you use your vehicle for business purposes.
Business Owners Policies – A business owner’s policy (BOP) combines property and liability insurance into one easy policy. NOP insurance protects your business financially against fire, theft, bodily harm, and property damage.
Working With EZ
Regardless of the type of business insurance policy you need, EZ can help. Our agents work with the nation’s leading insurance providers to ensure that your business and its employees have the best coverage available. In fact, we can save you hundreds of dollars annually by finding the best coverage within your budget. Simply enter your zip code into the box below to get started. Or feel free to contact us at 877-670-3538 if you have any questions.
Workers’ compensation insurance is designed to protect you and your employees financially in the event of a workplace accident or unjust. Workers’ compensation insurance isn’t just a good idea, depending on your state it may be a legal requirement. When it comes to workers’ comp claims, the majority of them are approved because workers’ compensation is considered “no-fault”. Meaning that employees do not need to prove that their employer was at fault for their injury.
As long as the employee files their claim on time, has witnesses to their accident, and seeks medical treatment for their injury, the employee will receive benefits. There may come a time, however, when one of your employees files a claim that you find questionable. In this case, you do have options, including the option to contest the claim. Below we’ll look at how you can fight a questionable claim. As well as the impact workers’ compensation claims can have on a business.
Reasons To Dispute A Workers’ Comp Claim
You can’t fight a workers’ comp claim for no reason, you and your insurance company must have a legal basis for disputing any claims. Here are some of the reasons you could have for disputing a claim:
Your employee missed the deadline to file a claim
The wrong paperwork was used to file a claim
The injury didn’t happen at your company
Your employee quit before filing a claim
The injury happened while the employee was at work but was not working
The injury was intentional
Always File The Claim
Even if you suspect the workers’ compensation claim is false. You have to file it when the employee comes to you with it. You can be penalized if you fail to report a work-related injury with a full report of all related details as soon as possible. The insurance claim adjuster’s job is to determine whether or not the claim is valid or not. You are paying premiums to your insurance company so that they can handle these matters. If your report is thorough and you work closely with your adjuster, there is a good chance the adjuster will catch the fraudulent claim and deny it anyway. So, delaying or not filing a report because you think it’s invalid could backfire on you, best to just let the adjuster do their job.
Work With The Claims Adjuster
Once you’ve filed the workers’ compensation claim with your insurance company, an adjuster will be assigned to the case. They will contact you and the employee personally, as well as review all documents associated with the case including medical records. The adjuster ultimately decides if the claim will be denied, but at this point you will have more information about the claim than the adjuster. If you have reason to believe the employee lied, or was injured outside of work, now is the time to gather all information that supports why you think it’s invalid. Document, date, and save everything that indicates why you think the claim is fraudulent. Most importantly, inform your adjuster immediately that you believe the claim to be questionable. Indicating in your initial report that you believe there are reasons to deny the claim serves 2 purposes.
First, it lets the adjuster know they may need to file an extension early, since workers’ compensation claims have to be completed in a certain time frame, and disputing a claim will take more time to investigate. Secondly, marking your claim as questionable from the beginning will actually make your adjuster pay closer attention. They will spend more time looking through the paperwork, medical records, and searching for warning signs that otherwise may have been missed. Finding one of these red flags doesn’t necessarily mean anything, as accidents and coincidences do happen. But if an adjuster notices that more than one exists, they will look into it further to make sure if the claim is or isn’t fraudulent.
Warning Signs
A new hire who immediately filed a claim after being hired
An employee who has immediately hired an attorney after the injury
Claims from an employee who may have been “disgruntled”
Employees with poor attendance, poor work records, or financial issues
Injuries with no witnesses, or that happened in an area the employee isn’t assigned to normally work
Injuries that occur late on a Friday or right when they return to work on Monday
Learn Your State’s Procedure
While workers’ comp is mandatory in almost every state, each state has its own laws and procedures for dealing with claims. Including disputing them. You can call your insurance provider and ask about what you need to know about local procedures. So you don’t accidentally make a misstep and cause trouble for yourself or your company.
You have the option to dispute even if the adjuster doesn’t deny the claim after the investigation. In some states, such as Texas, you have to submit a form or attend a hearing to dispute the claim in front of a judge. In other states, such as New York, or Tennessee, you may have to appear before a judicial panel or speak with a state-assigned workers’ compensation arbitrator. However, regardless of the state your company is in, you will most likely have to defend your position orally, in writing, or both. You will also need to provide all of the evidence you gathered when you first filed the claim and informed the adjuster of your concerns. Remember the “document, date, and save all information” part? This is where that step comes in handy.
How Workers’ Comp Claims Affect Businesses
Workers’ compensation claims tend to have a greater impact on smaller businesses. This is because larger companies have deeper pockets and larger payrolls, allowing them to absorb the financial cost with not much issue. Regardless of how big or small your business is though, workers’ comp claims can cause your business issues. Below we’ve detailed how claims can affect you. So, you understand why it’s important to fight fraudulent claims to protect yourself. As well as explain why doing everything you can to avoid workplace accidents is even more important.
Premium Hikes
Your workers’ compensation insurance premiums are determined by your industry, number of employees, payroll, and claims history over the last 3 years. A single claim will not necessarily result in a higher premium. But depending on the nature of the claim and the resulting medical bills and disability benefits even one claim could make a mark on your record. The more often you have workers’ compensation claims the more likely it is that your premiums will increase.
Additionally, your insurer also takes your experience modification rate (EMR) into consideration. Your EMR is how insurance companies compare your claims history to other companies in the same industry. The average EMR is 1.0, the more claims you have the higher above average you are. And then the higher your premiums will be because your company will be considered a higher risk to insure. Regular safety training and following industry-specific safety guidelines can help reduce your premiums.
Administrative Costs
Processing a workers’ compensation claim can take a lot of time. Especially if you’ve signaled that you believe it’s fraudulent. The insurance company will want to examine all relevant evidence, including the employee’s medical records. Effectively giving you or your claims specialist more work to do. Your company may also need to spend a lot of time and money to fix or check any equipment that was involved. As well as repair it if needed. Especially if the machinery involved is found to be defective after the accident. There may also be more paperwork and more hours involved in reporting the incident to state and federal regulators. Particularly if an OSHA violation is suspected. New equipment or training that stems from a regulator’s requirement can take a chunk out of your bottom line.
Legal Action Expenses
If you believe it is false, and you decide to take it to court you could also end up paying. While your attorney will advise you on whether or not you should go to court in the first place. Keep in mind if you lose the case, you will have significantly higher legal fees than you would have if you settled the claim. So, if you are planning on disputing your claim make sure your legal team agrees with the decision. And that you have absolute proof that the claim was fraudulent.
Reputation Damage
Impact on your company’s brand is difficult to predict. Your reputation can be affected by the severity of the accident. Whether it is covered by local news outlets, and whether it spreads on social media. A serious accident, repeated incidents, or OSHA fines could make it difficult to be able to hire new employees or get new customers.
Working With EZ
Workers’ compensation isn’t just about protecting your employees, it’s also about protecting your business. Nobody wants to deny a legitimate claim. But if you encounter one of those rare cases it’s fraudulent, you should know you have rights as well. And remember, EZ.Insure is here to help if you have any questions about workers’ compensation insurance. Or any other commercial insurance for that matter. We will connect you with a highly trained licensed agent. Who will listen to all of your concerns and make sure you get the best policy. To get started, enter your zip code in the box below or call 977-670-3538 to speak with an agent today.
More and more Americans are leaving their cubicles to work on their own. Well, why not? You decide how to run your business. You decide when to work. Who is on your team is up to you. Those are some great perks. So it’s not surprising that there are 15 million self-employed professionals in the American workforce right now, and that number could nearly triple in the next two years.
But there are some things you can’t control or plan for in business or in life. What if something goes wrong on the construction site and one of your clients gets hurt? Or what if you get hurt in a freak accident and can’t work anymore? Those “what if” questions are enough to turn the dream of a self-employed entrepreneur into a nightmare. So, if you work for yourself, you need insurance to protect yourself, your family, and your business. You’ve worked too hard to leave anything unprotected. But how do you know which types of insurance for self-employed people need and don’t need? Let’s look at types of insurance that will make you feel safe.
Self-Employed Business Insurance
Whether you’re a plumber or a freelance writer, there’s always a chance of something going wrong with your job. Some people are more likely to get hurt on the job, while others may be more likely to be sued. If you work for yourself, you need some kind of business insurance to cover the risks of your work. Here are the four most important types of business insurance to look into.
Liability insurance will protect you financially in the event that someone sues you for damages after slipping and falling in your coffee shop. Or breaking an expensive vase while cleaning a client’s home. Slander suits are also covered by general liability insurance. This sort of protection is available both as a separate policy and as part of a business owner’s policy.
Listen, we all have our flaws, and everybody messes up sometimes. This is where professional liability comes in handy. It’s insurance that protects you in the event that a client is harmed as a result of a service you provided or advice you gave. It is also known by its more common name, errors and omissions insurance. Professional liability insurance covers financial losses in the event of injury or damage. While general liability insurance covers injuries and damages to property.
A business owner’s policy (BOP) gives your small business protection against a wide range of claims. It does this by combining two types of coverage. Commercial general liability insurance and Commercial property insurance are both parts of its coverage.
The part of a BOP called “general liability” protects your business in case someone makes a claim against you or your business. General liability insurance protects you from lawsuits if something like a customer slipping on a wet floor. Or a faulty product causing damage to a client’s property. Or a claim that your products or services hurt someone. It can also protect you from libel, slander, and certain advertising lawsuits.
The property part of a BOP helps protect the buildings, equipment, furniture. And stock that you own, rent, or lease for your business. It helps pay to fix or replace things that are stolen, broken, or destroyed, even if they don’t belong to you but were in your care. It can also pay for things like rent, payroll, and other bills while your property is being fixed or replaced after a fire or other covered loss.
If you have employees, no matter the nature of your business, you are required by law to carry workers’ compensation insurance. Workers’ compensation insurance, also known as “workers’ comp,” is a mandatory type of coverage that will provide financial support to your staff if they sustain an injury while performing their job duties. It serves as a disability insurance pool that reimburses workers monetarily and/or provides medical care in the event of an illness or injury. If you want to learn more about the workers’ compensation laws in your state, you can visit the state by state guides on our site.
Physical dangers such as injury and property loss are ever-present in the business world. However, there are dangers associated with using technology that could affect your company. Data leaks and hacking are just two examples. Information about customers’ identities or medical histories that you store on company computers is a prime target for hackers. In order to quickly recover from a data breach or cyberattack, it is crucial that your company be covered by data breach or cyber liability insurance.
If you’re in business for yourself, it’s important to have a basic understanding of health insurance. As a first step, you should enroll in a health insurance plan. If you do not have health insurance this year, you could be fined by the government depending on what state you live in. More importantly, you and your loved ones are taking a serious risk if and when a medical emergency arises.
In addition, if you have been relying on your employer to provide health coverage, you may be in for a rude awakening when you compare prices. Since you no longer have an employer to split the cost of health insurance with, you must do so on your own. The good news is that self-employed professionals can reduce their tax liability by deducting the money they spend on health insurance premiums.
How To Reduce The Cost Of Self-Employed Health Insurance
A high-deductible health plan (HDHP) is a good option for those looking to save money on health insurance premiums. A higher deductible on your health insurance plan means you’ll have to pay more out of pocket for medical care before your policy kicks in. However, the trade-off is cheaper premiums every month.
Opening a health savings account (HSA) is an option with your high-deductible health plan, making it an even better value. The funds built up in a health savings account (HSA) are exempt from federal income tax, allowing you to save tax-free for future medical expenses. It’s a good idea to consult with an EZ agent, who can explain your options and guide you toward a policy that works for your finances and your loved ones. They will assist you in locating competitive rates and suitable protection.
Self-Employed Disability Insurance
If you’re self-employed and become ill or injured and unable to work, disability insurance could help replace some of your lost income. There are both public and private options for disability insurance. The government provides some options, such as the Social Security Administration and some state programs.
When you’re self-employed, you can buy your own disability insurance policy rather than participating in a potentially more expensive group plan through your employer. You may still be eligible for a group policy through your spouse’s employer or a trade group. You may have more options with an individual policy, but the premiums may be higher. Policy features such as the waiting period, riders, and the definition of disability may be up for negotiation.
Short vs Long Term Disability Insurance
Disability coverage comes in two flavors: long term and short term. Long term disability insurance typically has an elimination period of several weeks to months and a benefit period of several years up until retirement. There may be no waiting period or one as long as two weeks before benefits begin with short term disability insurance. Although long term disability insurance that pays out until retirement age is ideal, a short term policy could be worthwhile as well. In general, shorter waiting periods and longer benefits payout periods tend to come with higher premiums.
For an additional premium, you can secure coverage that the insurance provider can’t revoke for any reason (including your failure to pay premiums) with a noncancelable policy. With guaranteed renewable policies, the insurer cannot cancel your coverage. But they can raise your premiums along with other customers in your rating class. Additional riders, such as cost-of-living adjustments (COLA), residual benefits in the event of a partial disability, premium refunds for going claim-free, premium waivers in the event of a disability, and so on, can be purchased for an additional cost.
EZ Can Help
Working independently or as a freelancer allows for more freedom and a better work-life balance. One disadvantage is that you will be responsible for arranging your own insurance. It’s essential that you do this. Since an accident or emergency can cause financial ruin if you don’t have the proper insurance. As a result, self-employed people who don’t have insurance are taking a risk by not doing so. However, EZ can help! We offer free instant quotes on business insurance and we can even help you find the best plans for you. Enter your zip code in the box below or call one of our licensed agents at 877-670-3557 to get started.
Virtually every employer has to carry workers’ compensation insurance. However, some state laws provide exemptions for particular types of employees and business structures. Only a few worker categories are occasionally exempt. This exemption also applies to certain business owners. However, even when workers’ compensation coverage is not required, it is almost always in the best interest of the employer to provide coverage. If an employee sustains an injury on the job the employer may be held responsible for medical expenses, ongoing therapy, and lost wages.
Additionally, if you as the business owner are injured on the job, a workers; compensation policy can help pay for your medical expenses and compensate you for a portion of your lost wages. Your personal health insurance provider may deny your claim if your injury or illness is work-related, leaving you again responsible for these costs. Below we’ll look at the exemption laws in each state, if you’d like more information on the other workers’ compensation laws in your state, check out our state workers’ compensation guides here.
Any business with 4 employees or less does not have to carry workers’ compensation in Alabama, whether they are full or part time doesn’t matter. Alabama employers do not need to carry workers’ compensation for farm laborers, domestic laborers, or casual laborers including temporary or part-time employees hired for only an hour or a day.
Alaska businesses with one or more employees have to have workers’ compensation coverage unless the Alaska Workers’ Compensation Board has approved the business for self-insurance.
Owners and business executives are exempt if they are:
Sole owners
Partners
LLC owners with at least 10% ownership interest in the company
Executive officer or municipal, religious, or legally registered nonprofit organizations.
Executive officers for for-profit corporations with at least 10% ownership.
As for employees who are exempt from coverage:
Part-time babysitters
Non-commercial house cleaning personnel
People who are hired to help a farm with harvest
Amateur event sports officials
Entertainers under contract
Commercial fishers
Taxi drivers under specific contractual arrangements
Anyone who has benefits through the Alaska temporary assistance program.
Professional hockey players and coaches, as long as they are covered under a health insurance plan.
Some real estate agents
Anyone defined as a transportation network company driver.
There are only 4 exemptions from Arizona’s workers’ compensation. Independent contractors and casual laborers do not need to be covered. As well as any employee who voluntarily chooses to not have workers’ compensation coverage. The only owners who do not have to have coverage are sole owners who have no employees. Beyond that, any business owner with one or more employees needs workers’ compensation coverage.
All employers have to carry workers’ compensation insurance for themselves and their employees. The only exceptions to this are sole owners who opt out of coverage for themselves, or employers who have approval to self-insure.
Connecticut is another state that requires all businesses to carry workers’ compensation insurance with very few exceptions. The only employees that don’t need coverage are domestic workers who work less than 26 hours a week. Sole owners, corporate officers, and partners are allowed to opt out of coverage for themselves but they must have coverage for their employees.
Farm laborers and household workers in a private home who earn less than $750 every 3 months do not need workers’ compensation insurance. Other than that every other business owner and employee needs to be covered.
Any employer with one or more full-time, part-time, permanent, or temporary employees has to provide workers’ compensation coverage. Exemptions include:
If you have a single employee, even a part-time worker, you have to purchase workers’ compensation insurance. Only sole owners, partners, corporate officers, and real estate agents are excluded.
All Kansas companies must have workers’ compensation insurance with only a few exceptions. Some agricultural workers do not need to be covered. Sole owners, partners, corporate officers, and independent contractors with no employees do not need workers’ compensation insurance.
Employers who regularly employ one or more employees for 35 or more hours per week for 13 or more weeks in the 52 weeks prior must provide coverage. Exemptions include:
Agricultural workers (fewer than three employees working less than 35 hours per week)
Domestic workers (fewer than three employees working less than 35 hours per week).
All employers must provide coverage. Exemptions include:
Sole proprietors, partners, and officers of corporations
Domestic or household employees whose typical responsibilities include house cleaning and yard work
Casual employment
Only those working for assistance or sustenance
Officials of amateur athletic competition, such as a timer, referee, umpire, or judge.
Real estate, securities, and insurance salespeople paid solely on commission with no minimum earnings guarantee
Direct sellers
Those who deliver single or multiple newspapers and have acknowledged in writing that they have no insurance coverage.
Freelance correspondents who submit articles or photographs for publication are compensated for each submission but have not confirmed coverage in writing.
Barbers and cosmetologists who have contracts with cosmetology salons.
Petroleum land specialists
Licensed jockeys participating in a horse race, from the time the jockey reports to the scale room until the jockey is weighed out after the race.
Licensed trainers, assistant trainers, exercise persons, and pony persons on the premises of a licensed horse race meet.
Non-Montana residents whose primary duties are not performed outside the state. The employer must adhere to the coverage requirements in the location where the employee resides or works.
Officers or managers of a private, non-profit irrigation ditch company, water user cooperative, corporation, or organization.
A minister who is ordained, commissioned, or licensed by a church or religious order.
Individuals who provide companionship services or respite care to incapacitated individuals. The individual providing services or care must be directly employed by a family or legal guardian.
Excluding air search and rescue volunteers, volunteer reserve auxiliary law enforcement, and volunteer firefighters, volunteer workers are defined as:
Professional athletes who compete in contact sports for a team or club
Personnel of freight brokers and forwarders
A musician whose performance is governed by a written contract
Employers with at least one employee have to provide coverage. Exemptions include:
Employment associated with entities engaged in interstate commerce that are not subject to Nevada’s legislative authority
Employment covered by private disability and death benefit plans comprising compensation payments of equal to or greater amounts than those provided in NRS 616 and in effect for at least one year prior to July 1, 1947.
Temporary employees insured in another state who are brought into Nevada if extraterritorial coverage provisions are in effect with the other state.
Casual employment in the construction industry (employment lasting less than 20 days with a total labor cost of less than $500), if the employment is not in the course of the employer’s trade, business, profession, or occupation.
Employers with at least three employees have to provide coverage. Exemptions include Sole proprietors. However, sole proprietors are counted as employees when determining whether a business employs three or more individuals.
All employers must provide coverage. Exemptions include:
Volunteers who provide their services to nonprofit organizations without compensation
Ministers, priests, and rabbis duly ordained, commissioned, or licensed; sextons; Christian Science readers; and sects of religious orders
Customers of supervised amateur athletic activities operated on a nonprofit basis, provided that such s are not otherwise engaged or employed by any person, firm, or corporation participating in such athletic activity Educators in a nonprofit religious, charitable, or educational institution
Individuals employed in a nonmanual capacity by or for a religious, charitable, or educational organization.
Persons receiving charitable aid from a religious or charitable institution who perform work in exchange for such aid, but who are not under an express contract of hire, are considered unpaid volunteers.
People who are covered for specific types of employment under another workers’ compensation system, such as those employed in certain maritime occupations, interstate railroad employees, federal government employees, and others who are covered by federal workers’ compensation laws.
The spouse and minor children of a farmer-employer, provided they are not under an express contract of employment.
Certain foreign government and Native American Nation employees
Provisions of the New York State General Municipal Law that protect New York City police officers, firefighters, and sanitation workers
People, including minors, performing yard work or casual chores in and around a single-family, owner-occupied residence or a noncommercial organization’s property.
Certain real estate salespeople who sign a contract with a broker stating that they are independent contractors are considered independent contractors.
Certain media sales representatives who sign a contract stating they are independent contractors are considered independent contractors.
Certain insurance agents or brokers who sign a contract stating they are independent contractors are considered independent contractors.
Sole proprietors, partners, and certain corporate officers with no additional personnel providing essential business services.
Employers with at least one employee have to provide coverage. Exemptions include:
Sole proprietors, partners, and officers of corporations
Some railroad personnel
Casual employees
Domestic servants employed directly by the household
When less than ten full-time, non-seasonal farm laborers are regularly employed by the same employer, they are considered farm laborers.
employees of the federal government in North Carolina
Those who sell agricultural products for their producers on commission or for other compensation, provided the product is prepared for sale by the producer.
All employers must provide coverage. Exemptions include:
Independent contractors
Some agricultural employees
Certain providers of services administered by the Oklahoma Department of Human Services who are licensed and compensated on a commission-only basis
Any employee of an employer with five or fewer employees who are all related to the employer by blood or marriage. Any employee of a tax-exempt youth sports league.
Sole proprietors, partners, and officers of corporations
Any individual who performs volunteer work and receives no remuneration other than meals, drug or alcohol rehabilitation therapy, transportation, lodging, or reimbursement for incidental expenses is considered a volunteer.
Unlike most other states, South Dakota employers do not legally have to carry workers’ compensation insurance. To avoid civil lawsuits, however, the state encourages employers to have workers’ compensation coverage.
Employers with at least three employees are required to provide coverage. Exemptions include sole owners. However, sole owners are counted as employees when determining whether a business employs three or more individuals.
Employers with at least three employees have to provide coverage. Employers with fewer than three employees who pay wages of at least $500 per calendar quarter must also carry workers’ compensation insurance. Exemptions include some farm laborers.
Employers with three or more workers must provide coverage. Employers with fewer than three workers who pay at least $500 in wages per calendar quarter have to carry workers’ compensation insurance. Exemptions include some farm workers.
Workers’ Compensation Made EZ
Most states require businesses to carry workers’ compensation insurance, which will not only protect your business but also your employees. Keeping your employees safe does not have to be an expensive endeavor for your company. There are numerous ways to promote safety routines and programs, all of which will help you reduce your workers’ compensation costs. If you use the best practices for claims management and follow them in a timely manner, your employees will be able to return to work as soon as they receive medical clearance to do so. Not only will production return to normal, but workers’ compensation costs will get cheaper as well.
Come to EZ for free, instant quotes from one of our agents if you are looking for the best workers’ compensation policy. And if you already have workers’ compensation benefits but are looking for a better deal, we can assist you. Your EZ agent will be familiar with the local laws and able to guide you as you shop around for the best policy at the most affordable price. Enter your zip code in the box above or call us at 877-670-3538 to speak with one of our agents.
Every business that has employees should have workers’ comp insurance. In fact, this type of coverage is required in most states. But even if it weren’t required to have it. You would still have a responsibility to protect your business and its employees from the legal and financial risks associated with workplace injuries.
These policies typically cover most workplace injuries and illnesses caused by workplace conditions. But workers’ compensation cases aren’t always black and white. They definitely cover things like repetitive stress injuries, traumatic brain injuries, broken limbs sustained after a fall, etc. But what are the limits? What or who is does workers’ compensation not cover?
Workers’ compensation insurance is among the simpler types of commercial insurance policies to understand. Simply put, if one of your employees sustains an injury on the job, the policy will be cover them. Employees benefit from compensation for medical expenses and lost wages, and businesses save money by avoiding lawsuits.
But in reality, though, things are not always so straightforward. Some workplace injuries may raise doubts in the minds of employers. What if, for instance, a worker sustains an injury on the job, but the incident was entirely their own doing?
In this case, you should know that workers’ compensation is no-fault. Which means that employees who are injured due to their own carelessness are still entitled to benefits. However, this still has its limits. For example, an employee’s claim will be denied if the incident that led to the injury occurred while the worker was under the influence of alcohol or drugs.
In addition, workers’ comp generally covers repetitive stress injuries like carpal tunnel syndrome and asbestosis. But when it comes to repetitive stress injuries like chronic back pain or diseases like heart disease or high blood pressure, things become a little murkier. An employee claiming that one of these conditions is from work must provide overwhelming evidence.
So, let’s clear things up a little and look a little more closely at what isn’t covered by workers’ compensation.
Examples of Injuries Workers’ Compensation Won’t Cover
Workers’ compensation insurance covers most injuries on the job or when an employee is off-site but still working. Injuries employee injuries in the workplace must be evaluated on a case-by-case basis. There are exceptions to coverage, including:
Driving to or from work – If an employee is hurt while commuting to or from work, the injury is not considered to have occurred in the course of their employment. As a result, the employee is not eligible for compensation unless they were driving specifically for their job.
Injury while intoxicated – If an employee sustains an injury while under the influence of an illegal substance or while intoxicated, and if the employee’s intoxication is the only cause of the injury, the injury will typically not be covered by workers’ comp.
Horseplay – Playing around at work, in general, does not contribute to the success of the company, which is why an injury that results from such an activity is not covered by insurance. But there is an exception to that rule. If an employee gets an injury during the incident but wasn’t directly part of the horseplay, the rule will not apply to the employee.
Intentional actions – In the event that a worker intentionally brings about their own injuries or illnesses while on the job, workers’ compensation will not cover them.
Illegal activities – Workers’ compensation won’t cover injuries of workers as a result of illegal activities on the jobsite.
Policy violations – Employees who sustain injuries while acting in a manner that is contrary to the company’s policies, procedures, or protocols are not covered by workers’ compensation.
Ex-employees – Unless the injury occurred before the employee was terminated from their position. Former employees who have been fired or laid off from their jobs will no longer be covered by workers’ compensation insurance.
Are All Employees Covered?
Workers’ compensation coverage requirements vary by state, as well as by the number of employees and their classification codes. For example, manual laborers are classified differently than office workers for workers’ comp purposes. Some states, for instance, mandate workers’ comp insurance only for businesses with a specific number of employees. In general, though, all full-time employees must be covered by workers’ compensation insurance, but the specific regulations may vary from state to state. Workers’ compensation laws for freelancers, temp workers, and interns are not standardized across the country.
In some states, workers’ compensation insurance is optional for:
Farmhands
Insurance agents
Family members under a certain age
Casual workers
Business owners and partners
Real estate agents
Most state laws also list specific types of employment excluded from workers’ compensation coverage. Typical examples of excluded workers include:
Part-time domestic workers, such as maids and nannies
Part-time gardeners or maintenance workers employed in the home to perform specific work.
intermittent workers performing very little work in the course of a year.
Taxi drivers
Some agricultural workers
Workers’ compensation insurance is typically required by states, but the federal government does not provide its employees with this protection. Instead, they are protected by federal workers’ comp.
These exemptions are not universal, and you should be aware of the workers’ compensation laws in your state. Check out our state-by-state workers’ comp guides for more specific information on laws in your state.
Is There a Workers’ Compensation Claim Deadline?
The majority of the time, the rules governing workers’ compensation work in the employee’s favor. On the other hand, though, employees cannot decide to make a claim for an injury that occurred years ago.
Although there may be some exceptions to these rules. In general, a claim for workers’ compensation benefits has to be made within a certain amount of time in order to be considered. Employees usually have between one and three years from the date of the accident to notify their employer and file a complaint with the state from the time the accident occurred. This time period varies from state to state. Check out our guides to workers’ compensation in each state to get an accurate estimate of the amount of time your employees have to file claims, as well as how long the claims process generally takes.
Does Where an Employee Gets Injured Matter?
The vast majority of injuries that occur while working are covered by insurance, with a few exceptions. But is it necessary for an employee to actually be present at their place of business? In the vast majority of cases, it doesn’t make a difference where the employee is located, as long as they are working; in fact, they could even be traveling between different locations.
Take, for instance, a scenario in which your employee sustains an injury while traveling to or from work. Because they were not carrying out any work-related responsibilities, they would not be eligible for workers’ compensation benefits. Suppose on the other hand, that a contractor must travel from one location to another in order to check on worksites or deliver supplies. Because the contractor was carrying out their duties at the time of the injury, they would be eligible for coverage in the event that they were in a car accident.
Workers’ Comp Laws for Federal Employees, Railroad Employees, and Longshoremen
Workers’ compensation benefits for federal employees, railroad workers, and longshoremen (dock workers) are administered by separate systems from those administered by individual states.
Postal workers and other federal employees have access to benefits under the Federal Employees’ Compensation Act (FECA). Injury and illness on the job are covered by this law.
The Federal Employers’ Liability Act, also known as the Railroad Workers Act, provides protections for railroad workers. In the event of an industrial accident on the railroad, this law allows employees without workers’ compensation to sue their employer. they may get compensation for expenses such as medical care, lost wages, and pain and suffering.
The Longshore and Harbor Workers’ Compensation Act governs workers’ compensation for longshoremen who sustain injuries or occupational diseases while working on U.S. navigable waters or piers.
There are workers’ compensation lawyers who focus on these types of situations. If you are a federal employee, railroad worker, or longshoreman and you get an injury on the job, you should hire a lawyer who focuses on workers’ compensation law.
EZ Can Help
Every business owner should think of workers’ compensation insurance as essential to their operations. It safeguards not only the employees on whom you rely on and who are important to you, but also the hard work that you have put into building your business. But, as with any other insurance policy, there are limits to its coverage. And both employers and employees should be aware of the things that the policy does and doesn’t cover.
EZ is here to assist you with any questions you may have regarding workers’ comp coverage for your business. We will set you up with your own dedicated agent. Who will provide you with instant free quotes, answers to all your questions, and help choosing and signing up for policies, all free of charge. You already have a lot on your plate, so let us handle your insurance needs. To start, simply enter your zip code in the bar located below. Or you can call 877-670-3538 to speak with an agent right now.
As a small business owner, you care about your employees’ success. As well as their wellbeing and their safety in the workplace. But even the most conscientious employers have to face the fact that mishaps can and will occur even in the safest of workplaces. Accidents are inevitable in any workplace. So, it’s crucial that you have sufficient workers’ compensation coverage that will protect both your business and your employees. But workers’ compensation, as important as it is, can feel like a burdensome expense. And yes, it can be expensive. Luckily there are ways to save money on your premiums. So, you can have peace of mind while sticking to your small business’s budget.
Reducing Premiums
The amount you’ll pay for worker’s compensation insurance is calculated using a simple formula. The premiums for workers’ compensation insurance are calculated per $100 of your company’s payroll. That means that your rate will go up as you hire more people.
In addition, the nature of your business, and the type of employees you have, will play a major role in establishing your premium. When purchasing workers’ comp, you’ll have to give each employee a class code, based on the risks of their job. Each state provides the class codes for different types of employees. For example, a warehouse supervisor and an administrative worker will have different codes. So, there will be a big difference between the rate at a factory and the rate at a beauty supply store. In order to ensure that your business is charged a fair and reasonable rate, it is crucial that your employees are classified correctly.
Your final price will be adjusted based on a number of factors, including “modifiers.” Themodifier will be based on your claim’s history. Your insurance company will go over your claims history and assign you a modifier. The typical modifier rating is between .75 and 1.25. Modifiers of 1.0 or less are possible if your business has a documented history of successfully lowering workers’ exposure to injury risk. If there have been numerous incidents at your workplace, your modifier will be higher than 1.0. If you can get your modifier for workers’ compensation insurance down to 1.0 or lower, your premiums will go down.
Workers Compensation Cost Reduction Strategies
The following are some simple things that you can do right now to cut down on your workers’ compensation costs:
Choose the Right Policy
It is essential to do some comparison shopping in order to find the best workers’ compensation insurance policies. In the same way it is when choosing the best auto or health insurance policy for yourself. If you live in a state that has a competitive market, which the vast majority of states do, it is in your best interest to speak with multiple insurance companies about the premiums they are willing to offer you and your business.
And once you have a policy in place, you should continue to shop around at least once every few years, since insurance companies will periodically change their prices in an effort to woo customers away from their competitors. Unfortunately, if you live in a state that does not have a competitive market, you won’t have the option to shop around. But there are still other steps you can take to lower your premiums.
Follow Claims Management Best Practices
Perhaps the single most important thing you can do to keep your workers’ comp costs under control is to make sure you’re handling claims with best practices for claims management. “Best practices” include simple tasks like keeping in touch with the employee and possibly medical personnel. This can mean staying on top of any possible issues that may pop up, such as coverage not kicking in on time or money not coming through.
If you need help, an adjuster can make the process go smoothly and save you money by doing things like making sure all paperwork is filed on time, verifying coverage, and keeping a daily diary of all work completed on the claim. This may cut the payout amount by as much as half.
Create Strong Safety Protocols
Creating a safe workplace environment can do wonders for employee morale. As well as help save money on workers’ compensation claims. It’s less difficult than you might think to establish a culture of safety. In fact, you’re probably already doing some of this work already.
First, make sure your staff has access to the tools and information they need to stay safe on the job.
If you don’t do so already, schedule periodic safety inspections.
Use daily safety checks to constantly remind workers to be cautious whenever they are at work.
Plan weekly and/or monthly in-depth inspections.
Putting an emphasis on safety will not only reduce accidents and injuries among workers and help lower your workers’ compensation premiums but will also demonstrate your concern for their well-being.
Know What to Do in Case of Injury
Having a strategy ready in the event of a workplace injury is an important part of fostering a culture of safety. Managers, coworkers, and the claims adjuster would all have immediate tasks to perform in this scenario. For this to go smoothly, each person involved needs to know what they are responsible for.
Having a plan in place gives workers the opportunity to make choices that lessen the severity of injuries on the job. In the event of an accident, they will feel more at ease knowing that everyone around them is prepared to help.
Offer New Hire Incentives
Incentive programs are a great way to motivate employees, especially new hires, to follow the safety procedures in place. You can offer more experienced workers incentives to teach newer workers about your business’s safety culture.
Utilize Return-To-Work Programs
Workers’ compensation costs tend to be lower for businesses that utilize return-to-work programs. Which encourage injured workers to return to some sort of duties as soon as possible. Doing so will help with the indirect costs of an employee’s injury. Including overtime pay for workers who do the injured worker’s work, a drop in productivity, the cost of hiring and training new workers. As well as the time that managers or supervisors have to take away from their administrative duties to help out. So, the sooner an injured worker returns to work and starts making money again, the less you will have to pay.
Look for Discounts
Find out if your state offers workers’ compensation discounts to businesses that implement safety programs. For instance, some states reward businesses that promote drug-free workplaces with tax breaks. Since workers who use drugs while on the job are more likely to get injured. So, showing that you promote a drug-free environment by doing things like requiring regular drug testing for employees can get you a tax break for being proactive.
Be Aware of Employee Classifications
As noted above, not only will different companies have varying overall workers’ compensation rates. But the costs associated with various categories of workers will also vary. A sheet metal worker, for instance, will have a different classification code than a bookkeeper. Who spends little time in the factory. This means that it’s extremely important to verify that each worker has been assigned the appropriate classification. You can save a lot of money by following this one piece of advice.
Check for Safety Rewards
It is possible that the number of accidents that take place at work will decrease after you begin putting some of these ideas into action. Check with your insurance company to see if they will reduce your premiums in recognition of the fact that your business has been safer for the past year. These kinds of safety rewards are typically distributed after a period of one year during which there were fewer claims filed. These rewards are not guaranteed. So, it is important to check with your insurer to determine whether or not safety rewards are currently being offered.
Working With EZ
Most businesses are required by law to carry workers’ compensation insurance. Doing so will not only protect your business but will also protect your employees. Keeping your employees safe, though, does not have to be a financial burden on your business. There are a lot of different ways to encourage safety routines and programs. All of which will help you cut down on the amount of money you have to spend on workers’ compensation. Your employees will be able to return to work as soon as they are medically cleared to do so if the best practices for claims management are implemented and adhered to in a timely manner. Not only will production return to normal, but also the costs associated with workers’ compensation will decrease.
If you’re looking for the best workers’ comp policy, come to EZ for free instant quotes from one of our licensed agents. And if you already have workers comp benefits but would like to shop around, we can help you look for a better deal. Your EZ agent will be well-versed in the regulations in your area. They will be able to advise you as you shop around for the best policy at the most affordable price. To get started, simply enter your zip code in the box above. Or give us a call at 877-670-3538 to speak with one of our licensed agents.
Even if you suspect the workers’ compensation claim is false. You have to file it when the employee comes to you with it. You can be penalized if you fail to report a work-related injury with a full report of all related details as soon as possible. The insurance claim adjuster’s job is to determine whether or not the claim is valid or not. You are paying premiums to your insurance company so that they can handle these matters. If your report is thorough and you work closely with your adjuster, there is a good chance the adjuster will catch the fraudulent claim and deny it anyway. So, delaying or not filing a report because you think it’s invalid could backfire on you, best to just let the adjuster do their job. 
Dispute The Claim
