Workers Compensation Coverage Guide

Transcription

1 Brochure More information from Workers Compensation Coverage Guide Description: The definitive guide to understanding Workers Compensation and Employers Liability Programs. From basic to complex concepts, this comprehensive guide covers it all in plain language. You'll learn how the coverage works and how programs are established and monitored. This valuable guide has more than 200 pages of forms and information, including discussions that are vital for complete understanding of the workers compensation system. The workers compensation system was one of the triumphs of the industrial age. The system is the cumulative result of years of strife and compromise between employer/owners and employee/labor. The struggle toward this useful social compromise began in the 1870s with the organized labor movement and came to fruition in 1911 with the passage of the first state workers compensation law in Wisconsin. In the workers compensation system, injured employees relinquish the right to sue their employers for employment-related injuries in return for a statutorily imposed mechanism that provides specific scheduled benefits. These benefits are funded, for the most part, through insurance policies that employers purchase from insurance companies. Indeed, in most states, employers must insure their workers compensation exposure or become qualified self-insurers. Employers cannot simply decide to operate without insurance. If they do, they risk being fined and still have to pay the benefits that are set by law when an employee is injured on the job. This work is a guide to the workers compensation system: how to calculate premium; how experience rating and modifiers work; and various financial plans and considerations. It also provides a detailed analysis of workers compensation and employers liability insurance by way of an examination of the standard workers compensation insurance policy. Contents: : The Workers Compensation System A Great Social Compromise Chapter 1: Policy Organization, General Section Policy Organization General Section Chapter 2: Workers Compensation Insurance To Pay Promptly When Due the Benefits Required by Law How This Insurance Applies We Will Pay We Will Defend We Will Also Pay Other Insurance Payments You Must Make Recovery from Others Statutory Provisions Chapter 3: Employers Liability Insurance How This Insurance Applies The Course of Employment We Will Pay Employers Liability Exclusions We Will Defend We Will Also Pay Other Insurance Limits of Liability

2 Recovery from Others Actions Against Us Chapter 4: Other States Insurance Notice Clauses Chapter 5: Duties After Injury Occurs/Conditions The Duties of the Insured Conditions Chapter 6: Endorsements Alternate Employer Endorsement WC A Employers Liability Coverage Endorsement WC B Joint Venture as Insured Endorsement WC Medical Benefits Exclusion Endorsement WC Medical Benefits Reimbursement Endorsement WC Partners, Officers and Others Exclusion Endorsement WC Sole Proprietors, Partners, Officers and Others Coverage Endorsement WC Voluntary Compensation and Employers Liability Coverage Endorsement WC Voluntary Compensation and Employers Liability Coverage for Residence Employees Endorsement WC Waiver of Our Right to Recover from Others Endorsement WC Workers Compensation and Employers Liability Coverage for Residence Employees Endorsement WC Domestic and Agricultural Workers Exclusion Endorsement WC Employee Leasing Client Endorsement WC Labor Contractor Endorsement WC A Labor Contractor Exclusion Endorsement WC Employee Leasing Client Exclusion Endorsement WC Anniversary Rating Date Endorsement WC Experience Rating Modification Factor Endorsement WC Premium Discount Endorsement WC or WC A Retrospective Premium Endorsement One Year Plan WC A Retrospective Premium Endorsement Three Year Plan WC A Retrospective Premium Endorsement One Year Plan Multiple Lines WC A Retrospective Premium Endorsement Three Year Plan Multiple Lines WC A Benefits Deductible Endorsement WC Chapter 7: Nonprivate Insurance Monopolistic State Funds North Dakota Ohio Washington West Virginia Wyoming Residual Markets Chapter 8: Federal Workers Compensation Coverage The Longshore and Harbor Workers Compensation Act Scope of Coverage Employer s Liability Third Party Actions Compensation The L&HWCA and the Workers Compensation Policy State vs. Federal Coverage The Jones Act Scope of Coverage Definition of Seaman Jurisdiction of the Jones Act Federal Workers Compensation Endorsements Defense Base Act Coverage Endorsement WC A

3 Federal Coal Mine Health and Safety Act Coverage Endorsement WC Federal Employers Liability Act Coverage Endorsement WC Longshore and Harbor Workers Compensation Act Coverage Endorsement WC A Nonappropriated Fund Instrumentalities Act Coverage Endorsement WC A Outer Continental Shelf Lands Act Coverage Endorsement WC A Maritime Coverage Endorsement WC A Chapter 9: Premium Manuals Classifications Remuneration Premium Payments Final Premium Records Audit Workers Compensation Bureaus Classification of Exposures Premium Basis Payroll Limitation Rates Other Factors Limits of Liability Sample Premium Calculation Extension of Information Page Chapter 10: Experience Rating General Points The Mod Anniversary Rating Date The Mod Formula Unit Statistical Plan Making the Calculation Applying the Mod Recalculation and Revisions One Risk or Two? Experience Rating Summary Schedule Rating Why is This Important? Chapter 11: Financial Plans Type of Financial Plans Guaranteed Cost Plans Dividend Plans Standard Dividend Plans Sliding Scale Dividends Estimated Dividend Display Retrospective Rating Plans Retrospective Rating Formula Excess Loss Premium How a Retro Works Optional Retro Premium Components Audit vs. Retro Calculation Retro Policy Cancellation Retrospective Rating Forms Incurred Loss vs. Paid Loss Plans Deductible Plans Option Evaluation Form Chapter 12: Cost Management Issues Managing Loss Reserves

4 A Typical Claims Review Location Coding Return to Work Programs ADA Implications Integrated Disability Management Loss Prevention Incentive Programs Premium Allocation Systems Financial Impact Chapter 13: Issues in Workers Compensation Exclusive Remedy Dual Capacity Intentional Tort Third-Party-Over Other Possible Doctrines Mental Stress Claims In the Course of Employment Relationship to Employment Employment of Minors Principals and Contractors Leased Employees Stop Gap Coverage Workers Compensation and Volunteers Various Workers Compensation Doctrines The Positional Risk Doctrine Odd Lot Doctrine Usual Exertion Doctrine Last Injurious Exposure Rule Peculiar Risk Doctrine Personal Comfort Doctrine Successive Injury Cases Appendix A: NCCI WC Policy Information Page NCCI Workers Compensation and Employers Liability Policy Form Appendix B: Sample Experience Modification Worksheet Confidential Request for Information Form ERM-14 Appendix C: Application of Workers Compensation Laws by State Residual Markets Successive Injury Funds by State Type of WC Law by State Index Ordering: Order Online - Order by Fax - using the form below Order by Post - print the order form below and send to Research and Markets, Guinness Centre, Taylors Lane, Dublin 8, Ireland.

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