Workers' Compensation Insurance
Workers' Compensation Insurance is a type of small business insurance that is mandatory in most states, and covers employees for work-related injuries. A typical "workers comp" insurance policy pays lost wages and medical expenses incurred due to a work-related accident or injury, while also protecting the employer against accident-related lawsuits.
What About Dishonest Worker's Comp Claims?
Unfortunately, there are dishonest people in this world, and there are times when a Workers’ Compensation claim should be denied, such as when the employee isn’t hurt on the job or it’s an old injury.
As many states begin taking a closer look at denials of workers’ compensation claims, now is a good time to evaluate how your company is handling workers’ compensation claims.
Workers' Compensation Claims Processing Tips
While state laws vary, there are some important best practices to follow:
- Keep detailed written documentation about the incident.
- Understand the claim forms, timelines, and the correct state agency to send the paperwork to.
- Ensure that all information on those forms is accurate.
- List a specific legal reason explaining why the claim is being denied and the basis for that denial.
- Provide instructions to the employee about steps he or she can take if they disagree with the denial.
Here are some practices to avoid:
- Don’t simply state, “The injury did not take place. Denied.”
- Don’t disclose Protected Health Information (PHI) without written permission to do so or if required by law.
No One is Perfect. If a mistake is made, here are some best practices to follow:
- Don’t ignore the mistake. Correct it.
- Cooperate with state agencies.
- Provide complete and detailed responses.
- Continue to keep detailed written documentation.
- Pay close attention to timelines.
- If you aren’t sure about something, consult an attorney.
No business wants to pay penalties for Workers’ Compensation claim denials, so following these best practices can help your business avoid or minimize those penalties.
How to Get a Great Deal on Worker's Comp Insurance
American Insuring Group, Ltd. offers cost-effective worker's compensation insurance from a great variety of competing insurance companies, enabling you to get a great deal on high-quality WC insurance.