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A recent study on distracted driving from in-car data collection and analysis showed that drivers spend more than half their time focused on things other than driving.

There are a variety of activities that count as distractions, and it’s estimated that these distractions contribute to more than 5,000 traffic fatalities each year. 

Here are some of the most common driving distractions, any of which can result in higher workers compensation insurance rates if they occur while on the job:

• Talking on a cell phone
• Texting
• Eating and drinking
• Attending to child passengers
• Grooming
• Reading, including maps
• Using a navigation system
• Watching a video
• Adjusting a radio, CD, MP3 or temperature controls

Your Business and Your Workers Comp Insurance Rates

When your workers are behind the wheel on your company’s behalf, their safety is your business. And since texting takes your drivers’ attention away from the road for almost five seconds (the equivalent of driving the length of a football field at 55 mph blindfolded), it is important that you prohibit them from texting in your commercial vehicles.

“It is well recognized that texting while driving dramatically increases the risk of a motor vehicle injury or fatality.” Explains David Michaels, Assistant Secretary at Occupational Safety and Health Administration (OSHA). “We are asking employers to send a clear message to workers and supervisors that your company neither requires nor condones texting while driving.”

Your Legal Responsibility to Safeguard Drivers at Work

As a business owner or manager, your legal responsibility under OSHA is to safeguard drivers at work. And it makes no difference whether they drive full-time or only occasionally to carry out their work, or whether they drive a company vehicle or their own. When OSHA receives a plausible complaint that an employer requires texting while driving or organizes work so that texting is a necessity, they will investigate and issue citations and penalties where necessary.

Your cooperation can minimize the danger to your business

Building a workplace culture of safety requires clear, explicit policies and sound practices. OSHA, which enforces worker safety laws, has joined with the Transportation Department, other agencies, key associations and organizations to enlist the help and cooperation of businesses of all sizes in a nationwide outreach, education, and enforcement effort to stop the dangerous practice of texting while driving.

Here are a few of the recommendations for employers to follow:

• Prohibit texting while driving. OSHA encourages employers to declare their vehicles “text-free zones.” Also, emphasize that commitment to their workers, customers, and communities.
• Establish work procedures and rules that do not make it necessary for workers to text while driving in order to carry out their duties.
• Set up clear procedures, times, and places for drivers’ safe use of texting and other technologies for communicating with managers, customers, and others.
• Incorporate safe communications practices into worker orientation and training.
• Eliminate financial and other incentive systems that encourage workers to text while driving.

Millions of Americans drive on the job every day, and this deadly behavior, texting while driving, has put them at risk. And that risk continues to grow as texting becomes more widespread. OSHA believes that by improving our understanding of how mental and physical distractions impair your company drivers and by educating them about avoiding distractions, we can eliminate these needless deaths and make our businesses safer while lowering commercial vehicle insurance and workers compensation insurance costs.

For more information about safe driving, commercial vehicle insurance, and workers comp insurance, contact us online or call (800) 947-1270 or (610) 775-3848.

Problems can occur when workers covered by Medicare Advantage Plans sustain workers compensation injuries and use the plan to pay for medical care.    

Congress created the original Medicare program (Parts A and B) in 1965. It was designed to offer older and disabled Americans access to affordable health insurance. With the Balanced Budget Act of 1997, Medicare Part C was born with the intention of giving beneficiaries a choice: opt for original Medicare or choose the newly created Part C plans, better known as Medicare Advantage Plans (MAP).

These plans, with coverage provided by private insurers, cover all Medicare services and offer additional benefits such as prescription coverage, dental, and vision. However, problems can occur when workers covered by these plans sustain workers’ compensation injuries and use the plan to pay for medical care.    

                                                  

Medicare and Workers' Compensation Insurance

If a worker is receiving Medicare benefits and is hurt on the job, workers’ compensation insurance (WC) is the primary payer. An insurer or workers’ compensation plan cannot, by contract or otherwise, supersede federal law--for instance by alleging its coverage is supplemental to Medicare.

WC is always the primary payer for Medicare beneficiaries’ work-related illnesses or injuries, and Medicare beneficiaries are required to apply for all applicable WC benefits. If a Medicare beneficiary has WC coverage, providers, physicians, and other suppliers must bill WC first.

In situations in which Medicare has paid for WC-claim-related care before the beneficiary has obtained a settlement, judgment, award, or other payment, those Medicare payments are referred to as “conditional payments.” They are considered conditional payments because Medicare pays under the condition that it is reimbursed when the beneficiary gets a WC settlement, judgment, award, or other payment.

Do Medicare Advantage Plans have the same right of recovery as original Medicare?

This an evolving issue in the courts, and it continues to be discussed and debated. Courts have ruled both ways on this issue. Here are some examples:

• In a Third U.S. Circuit Court of Appeals case in 2013, Humana Insurance Company, a MAP, demanded reimbursement from GlaxoSmithKline for payments Humana had made. The Court held that Medicare Secondary Payer regulations “unambiguously provide[s] Humana with a private cause of action.” Consequently, Humana’s payments were subject to reimbursement.
  
  
• The U.S. Supreme Court subsequently denied Glaxo’s petition for review, supporting the argument that MAP’s have the same right of recovery as does traditional Medicare—at least in the Third Circuit Court jurisdiction, which is New Jersey, Delaware, Pennsylvania, and the U.S. Virgin Islands.
  
  
• Later in 2013, a Ninth U.S. Circuit Court of Appeals case ruled the other way. Here, the Ninth Circuit Court of Appeals held that a Medicare Part C Plan--PacifiCare of Arizona--did not have the right, under federal law, to pursue a reimbursement claim.
  
  
• In a recent case in Florida, Humana Insurance Company sued Western Heritage for recovery of double damages. Humana argued that as a MAP they have the same right of recovery as does traditional Medicare, including recovery of double damages. The District Court ruled in Humana’s favor.

Recent rulings have created some uncertainty for employers

There is still uncertainty among insurers and employers when settling cases with Medicare beneficiaries who have ever received benefits from a MAP. Claim management departments need to consider the recovery rights of MAP’s when settling claims. The logical starting point would involve confirming the type of Medicare coverage at issue. Determine if the claimant is a beneficiary under traditional Medicare or under a MA plan.

We Can Help

For help meeting your compliance obligations, or to obtain quality worker's comp insurance at the right price, call us at (800) 947-1270 or (610) 775-3848 or contact us onlilne.

Return-To-Work programs are instrumental in enticing employees out on a workers’ compensation claim to come back to work. Many employers struggle to manage and fill the void that is left behind when a worker is out; however, a solid Return-To-Work program will encourage employees to return to work quickly (once they are cleared to do so by a medical professional of-course), thereby contributing to lower workers compensation insurance costs.

It is extremely important that the return-to-work program is well-known and understood throughout the company. It needs to be an indispensable part of the corporate culture understood by owners, managers, and employees. If you want employees to return quickly and efficiently, it needs to be a system that everyone can follow and understand.

Five Essential Elements of a Successful Return-To-Work Program:

#1) Offer employees a transitional position

Present them with a temporary job that will ease them back into the workplace while still making them feel as though they are making a difference. If their job usually requires heavy lifting, consider offering a light-duty job instead. Make sure the job makes sense for both the employee and the company, otherwise you run the risk of further loss.

#2) Make the cost of workers’ compensation very clear to all employees

Each employee, regardless of their current position, should understand how expensive workers’ compensation claims are and how it affects the organization. Most employees have absolutely no idea that companies pay a large deductible each time an employee goes out on a claim and assume the insurance company is the only one paying. Employees may feel differently if they know it is coming directly from their employer’s pocket!

#3) Remain in constant contact with the employee

Never underestimate the power of a “get well” card! There will be many outside sources, such as friends, families, lawyers, etc., trying to tell your employee what to do. Make sure you call to check in with them frequently and keep them posted on any updates or changes within the company. In most states, the company is able to direct medical care for an employee as well, which allows them to check-in with healthcare professionals to ensure that the employee is following protocol and is not being dishonest about their care or their return to work date.

#4) Make necessary arrangements to “speed up” return time, if possible within four days

90% of all workers out on a workers’ compensation claim can return back to work within four days. Whether they are returning to a transitional job or their actual position, the quicker they return to the workplace, the less expensive it is for the employer. These four days are considered the waiting period and if you bring an employee back before the waiting period ends, the company’s workers’ compensation company may not have to pay indemnity or lost wage payments, which in turn saves the company from having to pay the claim deductible.

#5) Keep employees updated on company “happenings” while they are out

Even though an employee is unable to perform their regular duties, they may be able to continue attending trainings and meetings. If they are unable to attend these sessions in person, the company may be able to skype them in, or at the very least can provide them with a PowerPoint deck or notes from the meetings. Keeping them in the loop can encourage them to return quicker and will allow them to transition back into their position more easily when they do return.

One of the keys to keeping the cost of workers’ compensation in check, is to get employees back into their position as quickly as possible. This doesn’t happen by accident; it’s important for companies to take a proactive approach.

We'll Help You Save on Workers Compensation Insurance

For more information about saving on workers’ compensation costs, contact us online or give our experienced agents a call at (800) 947-1270 or (610) 775-3848. 

The National Council on Compensation Insurance (NCCI), a national insurance rating and data collection bureau, specializes in workers’ comp data. Annually, it collects statistics covering over four million workers compensation insurance claims and two million policies. It uses this information to provide, among other things, information on trends in workers’ compensation throughout various industries, which enables them to make insurance rate and loss cost recommendations.

A favorable outlook for workers’ compensation insurance rates

The results so far from this fiscal year’s rate filing cycle, which began in July 2015 and will continue through June 2016, indicate that there could be a good pattern for policyholders moving forward. Of the 32 filings from the NCCI, 23 have been for decreases, 8 have been for increases and one—Illinois—was amenable to a no filing. 

The Federal Reserve’s policies are contributing to lower insurance rates

Although these numbers have not been fully validated, many in the field of workers’ compensation believe that if these numbers hold, results similar to the 2015-2016 filing cycle can be expected for 2016-2017. According to a recent NCCI report, “The economic recovery in the United States remains on track, and continues to progress much as it has for the past several years. In our view, the Fed’s decision to stand pat on the federal funds rate was motivated first by the absence of observed inflation in the US economy, and, second, by a desire not to commit prematurely to interest rate tightening while there remains the possibility of international economic contraction instigated by China and while important sectors of the US economy remain soft, particularly the residential housing market.”

Workplace accidents have been less frequent and less severe

At its last annual meeting in 2015, NCCI offered its opinion that conditions have improved in the workers comp environment with premiums growing nationally in the workers’ compensation systems. Insurance executive Donna Urben says: “This is approximately the third-plus year of consecutive loss cost decrease, for a majority of the states,” and the accompanying lower rates “are driven by frequency and severity trends.” Overall, losses have been moderate and frequency trends have been in decline for several years.

The economy is aiding workers’ comp insurance pricing

Because payroll is used as the exposure base, the economy has a significant effect on workers’ comp pricing. As the economy continues to improve, more people are employed, resulting in more premiums for workers compensation carriers. Add to that an abundant capacity among these carriers to write workers’ comp policies, and it becomes evident that there is a competitive atmosphere, which will give options to consumers, policyholders and insured.

Low inflation, fewer and less severe work accidents, and a relatively strong economy, with falling unemployment and modest wage inflation, all point to a competitive workers’ compensation environment in 2016.

Contact Us For All Your Workers Comp Insurance Needs

It’s a buyer’s market for businesses shopping for workers’ compensation coverage—at least for the foreseeable future. For a competitive quote, contact us online or call (800) 947-1270 or (610) 775-3848.

Hearing loss may be a compensable work injury leading to increased workers compensation insurance costs. Taking steps to reduce the risk of hearing loss is easier than you might think.

Loud noises in the workplace can damage your employees’ hearing. It’s estimated that 22 million workers are exposed to potentially hazardous noise levels at work. The National Institute for Occupational Safety and Health (NIOSH) recommends that workers should not be exposed to noise at a level that amounts to more than 85 decibels for 8 hours. In an effort to create a safer workplace by reducing noise levels, NIOSH suggests an approach that implements controls based on a hierarchy of effectiveness.

Control Workers Comp Premiums by Adopting the Hierarchy of Hazard Controls

Occupational health and safety professionals apply the following actions, listed from most effective to least effective, to reduce or remove a noise hazard:

1. Elimination: Physically remove the hazard
2. Substitution: Replace the hazard
3. Engineering Controls: Isolate workers from the hazard
4. Administrative Controls: Change the way employees work
5. Personal Protective Equipment: Protect workers with special clothing and equipment

Low-Noise Tools

Purchasing low-noise tools and machinery, reducing vibration where possible, providing barriers to isolate workers or loud equipment, and maintaining machinery with proper lubrication are effective methods for reducing noise in the workplace.

In addition, the Occupational Safety and Health Administration (OSHA) requires employers in general industry to maintain a hearing conservation program whenever noise exposure meets or exceeds the eight hour time-weighted average of 85 decibels. Baseline and annual audiograms, employee training, and hearing protection must all be included in the program.

But even with controls and programs in place to eliminate or reduce noise hazard on the job, some employees will experience work-related hearing loss resulting in a compensable work injury resulting in a workers compensation insurance claim.

Hearing loss may be a compensable work injury

The Workers’ Compensation Act provides for benefits for loss of hearing related to exposure to noise while at work, and it’s estimated that $242 million is spent annually on workers’ compensation for hearing loss disabilities.

While most states recognize hearing loss as compensable, the specifics of the law may vary (for instance, in some states the employee must have hearing loss of at least ten percent in both ears in order to be entitled to benefits). The employee must be evaluated by a physician who specializes in hearing problems to determine the percentage of hearing loss, and the worker must show that there was exposure to hazardous noise in the workplace.

The difficulty for any workers’ compensation adjuster will be determining what portion of hearing loss is work-related and what part of the loss is age-related or is due to non-work related activities (shooting a gun for sport or using a chainsaw on weekends). Another issue that the adjuster may face is finding a previous audiogram from which to compare the present test to get a true measure of hearing loss.

Protect your business against hearing loss claims

There are steps that employers can take to eliminate or reduce the size of a hearing loss workers comp claim, and in the process lower your long-term workers compensation insurance costs:

• New employees who will be exposed to excessive noise should have an audiogram completed as part their hiring requirements. This will provide the baseline for any future hearing loss claim.
• Do a risk assessment by having the decibel level of your plant checked. Any noise level above 85 decibels can then be addressed.
• If a worker is constantly exposed to tools and machinery that reach more than 85 decibels, an audiogram should be completed annually.
• The mandatory use of hearing protection (earplugs or earmuffs) should apply to all employees who work in areas of excessive noise.
• All employees should be provided with safety materials that address the importance of hearing protection at work and in non-work related activities that create high noise levels.

Occupational hearing loss is one of the most common work-related illnesses. Safeguard your workers and minimize the costs to your business by effecting and maintaining these essential controls and programs.

Workers Comp Questions? Contact Us!

To learn more about Workers Compensation Insurance, contact us online or call (800) 947-1270 or (610) 775-3848.

Over 4,000 employees are injured, and another 325 die each year in workplace electrical accidents. Do not let this be one of your employees! Protect your employees and minimize your workers compensation insurance costs through proper safety procedures.

Downed electrical wires are one of the leading causes of electrical accidents, and most can be prevented. Being aware and well educated on how to handle these situations can be the difference between life and death!

Extreme Danger: Downed Power Lines

Workers involved in clean-up and recovery efforts are three times more likely, when compared to other occupations with electrical hazards, to be injured or killed by downed and low hanging electrical wires. These disaster scenes are usually very chaotic and uncontrolled, which can easily lead to mistakes and injuries. When first arriving at a scene, it is important to stop and look around, evaluate the situation and assess for any loose or low hanging electrical wires, quickly make a plan, and then proceed.

Safety Tips for Handling Downed Power Lines

Checking on equipment and electrical lines is the first step to ensuring safe working conditions for everyone involved in the effort. It should ALWAYS be assumed that all electrical wires are live and active!

• Downed and low hanging wires must always be considered active, regardless of whether or not they are touching the ground, because voltage may still be running through them and one touch could be deadly! Also keep in mind that all wires are designed differently and just because the wire is well insulated, coated, and weatherproofed does not automatically make it a television or cable wire. It could still be a high-voltage electrical wire.
  
  
• Always assume that all equipment, such as generators and conductors, are live even if they are not sparking or humming. Some of this equipment does not automatically turnoff when damaged, and a simple touch to the equipment or the ground around it could kill you instantly!

Energy that is provided through electrical wires is amazingly powerful! Therefore, its strength should never be tested.

• Never drive over power lines. You run the risk of becoming trapped in your vehicle or at the very least your vehicle could become entangled within the wire. This goes for any equipment vehicles you may be driving.
  
  
• If you are in a regular or equipment vehicle, and you were to come into contact with an electrical wire, ALWAYS assume it is live. Your best choice to resolve this situation is to remain inside your vehicle and place a call for help. If this is not possible, such as if your vehicle is on fire, you need to jump as far away as possible from the vehicle making sure NOT to touch the vehicle and the ground at the same time. Proper landing technique is with both feet together, maintaining good balance, and then continuing to shuffle away in small steps to eliminate the path of electric current, and ultimately electrical shock.

Backfeeding occurs when electrical conductors are unexpectedly energized by outside sources such as lightning, downstream events, generators, and circuit ties/switch points, which can result in additional injuries or death. Therefore, it is important to understand how voltages are spread and how to disable all electrical equipment properly and efficiently from the start.

• Proper lockout/tagout procedures ensure that all necessary energy sources have been properly disabled and do not pose a threat of being reignited due to unexpected circumstances such as lightning or generator reboots.
  
  
• Since electricity spreads outward, in a circular motion throughout the ground, when you move outside of the main point of contact, you can be creating larger, more dangerous voltages. This creates a hazardous situation for yourself and anyone else standing close to you.

Keeping Business Insurance Costs in Check

Safety should be your number one priority for the safety of your employees and as a means to keeping insurance costs – health insurance, workers compensation insurance, liability, and disability insurance – in check. Sharing this information with employees who respond to a clean-up or recovery effort could save a life and help your company’s bottom line.

Contact Us

For more information about saving on all your commercial insurance costs, please contact us online or give one of our experienced agents a call at (800) 947-1270 or (610) 775-3848.

Need something to jolt you awake faster than your morning espresso? Try these government statistics: About 70 percent of people over age 65 will need some type of long-term care during their lifetime, and more than 40 percent will need care in a nursing home at some point.

If you’re one of the many Americans who are not overly concerned about long term care insurance because you believe your kindly Uncle Sam will foot the bill, you should continue reading. 

What is Long-Term Health Care?

When someone requires help with physical or emotional needs over an extended period, this is long-term care. It involves a variety of services—from bathing and dressing to managing money--designed to meet these needs for a short time (several weeks or months) or a much longer period. These services help people live as independently and safely as possible when they can no longer perform everyday activities on their own.

Who Will Likely Need It?

While no one can predict how much or what type of long-term care insurance a person might require, there are several factors that can increase the chance of needing it:

• Age: The risk increases as people get older.
• Gender: Because women live longer, they are at a higher risk than men.
• Marital status: Single people are more likely than married people to need care.
• Lifestyle: Poor diet and lack of exercise can increase a person's risk.
• Health and family history: These factors also affect risk.

How to Pay for Long Term Care — the Myths

• Family members: Depending on a person's needs, long-term care can be provided at home by unpaid family members and friends. This option is becoming less reliable, however, as the ratio of available help for each aging family member continues to fall. Today there are about seven potential caregivers for one eighty-year-old requiring long-term care. By 2030 that ratio is expected to fall to 4-to-1 and by 2050 it could be as low as 3-to-1.
  
  
• Medicare: Many people mistakenly assume that Medicare will cover most long-term care costs. And while it does pay for some part-time services for people who are homebound and for short-term skilled nursing care, it does not cover ongoing personal care at home, like help with bathing, dressing, and eating. It may cover the first 100 days in a nursing home, but there will be some hefty co-payments, and nothing will be covered after that.
  
  
• Medicaid: This Federal and State health insurance program for people with limited income and resources can provide help only if you have less than $2000 in assets.
  
  
• Medicare supplement policies: These are not designed to meet long-term care needs, but some policies do cover co-payments for nursing home stays that qualify for Medicare coverage.
  
  
• Reverse mortgages: People who are considering tapping their home’s equity through a reverse mortgage in order to pay long-term care should be aware of the high closing costs, fees, and interest rates. This is not a viable solution for most people.

Long-Term Care Insurance—the Real Solution

Depending on the coverage options you select—from in-home help to nursing home care--long-term health care insurance can help you pay for the care you need. The insurance might also provide payment for adult day care, care coordination (helping you to find appropriate care services) and, in some policies, help pay costs associated with modifying your home so you can continue living in it safely.

Contact Us for Assistance with Long Term Care Insurance

Because the insurance can be set up many ways to pay for a wide range of services and support, it can be complicated. We recommend you spend time with one of our specialists to establish a policy based on your preferences, needs, and budget. Give us a call at (800) 947-1270 or (610) 775-3848.

Sobering Statistics on Business Interruption Insurance

A recent national survey of small businesses yielded some sobering statistics. It found that 66 percent of these businesses do not have business interruption insurance—even though an estimated 25 percent of them will not be able to reopen following a major loss, such as a fire, a break-in, or a storm.

That same survey also revealed that three out of four small business owners do not have a disaster recovery plan, yet more than half of them admit that it would take at least three months for them to recover from a disaster.

 

Most small business owners are at risk of disaster, but they are least likely to have disaster recovery insurance or a plan in place to help them recover. About a third of the owners say it is not important for their business to have a disaster recovery plan, and they give interruption insurance a low priority.

Business interruption insurance can be as vital as fire insurance

It’s unlikely that anyone would ever consider opening a business without buying insurance to cover damages from fire or windstorms. But many small business owners don’t give serious consideration to how they would survive if a fire or other disaster damaged their business premises and rendered them temporarily unusable. A business that has to close down completely while their buildings are being restored may lose out to competitors. A quick resumption of business after a disaster is essential.

A few key points about business interruption insurance

• Business interruption coverage is not sold separately but is added to a property insurance policy or included in a package policy. 
• It compensates you for lost income if your company has to vacate the premises due to disaster-related damage that is covered under your property insurance policy.
• Business interruption insurance covers the revenue you would have earned, based on your financial records, had the disaster not occurred.
• The policy also covers any operating expenses that continue even though your business activities have temporarily stopped.
• The price of the policy is related to the risk of a fire or other disaster damaging your premises.

 

A disaster could halt your business—even if your property remains undamaged

You have purchased a standard loss of business income policy, and you may think that you are totally protected from a disaster. Unfortunately, most policies do not cover utility interruptions—power, water, and communications--that originate away from your premises (for instance, the utility generating station may have been damaged or transmission lines could be down).

Losing these services for an extended period can be financially devastating. The first step is to evaluate the exposures facing your company. Will being out of power for hours or days adversely impact your operations and profits? If you come to the conclusion that it will, you should consider an endorsement that extends your coverage to include utility services interruptions.

Get back in business quickly with a Disaster Recovery Plan

In addition to the right insurance, a Disaster Recovery Plan (DRP) - a plan that describes how work can be resumed quickly and effectively after a disaster – is another element to ensure that a disaster doesn’t shut your business down. It consists of the precautions taken so that the effects of a disaster will be minimized and the organization will be able to either maintain or quickly resume critical functions. Typically, disaster recovery planning involves an analysis of business processes and continuity needs; it may also include a significant focus on disaster prevention.

Plans vary from one type of business to another, depending on the processes involved, and the level of security needed. Disaster recovery planning may be developed within an organization or purchased as a software application or a service. It is not unusual for an enterprise to spend 25% of its information technology budget on disaster recovery.

Contact Us for Help with Your Business Interruption Insurance Needs

A DRP, along with business interruption coverage, constitutes the business continuity planning that could rescue your business after a disaster. Depending on your particular business, properly planning for your business interruption insurance needs can be complex, but the well-trained staff at American Insuring Group can help. Click here to contact us or give us a call at (800) 947-1270 or (610) 775-3848.

Employees who are injured on the job may be entitled to compensation for medical care and wage replacement through their employer’s Workers Compensation insurance. The insurance provides medical care, lost wages, and any rehabilitation needed to return to work. Sometimes an employee is permanently and totally disabled or disabled to the point that the employee cannot return to meaningful employment. These cases are usually complex and can be difficult to settle. If a lump-sum cash settlement does not resolve a case, a structured settlement may offer a solution.

What is a Workers Compensation Structured Settlement?

A structured settlement is a financial or insurance arrangement whereby a claimant agrees to resolve a personal injury claim by receiving periodic payments on an agreed schedule rather than as a lump sum. Structured settlements are often used to resolve workers’ compensation insurance cases in which the negotiations between the plaintiff’s attorney and the insurance company have reached an impasse. The responsibility of future payments to the plaintiff falls on an independent third party—usually a life insurance company from which an annuity has been purchased by the workers’ compensation insurer.

Congress has encouraged the use of these settlements through the federal tax code since 1983. Internal Revenue Code section 104 specifies the amount of each payment, and the earnings on payments are excluded from the settlement recipient’s income.

Not all payout schedules from a structured settlement are alike. There are three main forms of periodic payments from a structured settlement:

• Deferred Lump-sum Payments: Payments are structured under a schedule of pre-determined dates. These payments are usually larger than regular periodic payments.
• Flexible Settlement Plan: Payments in this plan consider the needs of the injured worker—important future events at different stages of life—while maintaining control of the costs for the employer and insurer.
• Period Certain Annuity: The injured employee gets a larger settlement by agreeing to shorten the time period that the annuity will pay.

An initial lump-sum payment can be included in the settlement to cover such items as housing and transportation, and the settlement can also be structured to increase periodic payments at fixed dates in the future to account for inflation.

Advantages of Structured Workers Comp Insurance Settlements

Structured settlements are helpful for the injured worker in compensation cases. They can be set up to provide tax-free money for long-term and immediate needs, while eliminating the worry of managing a large amount of money. In most cases, a structured settlement will provide more money over the long term than the employee would realize from a cash settlement. The plan can be structured around age and life expectancy, thereby providing funds for maintaining medical treatment, future surgeries, and replacement of durable medical equipment.

The closure of the claim, expedited through a structured settlement, is a major benefit to the employer. It also avoids the uncertainty of litigation and all of the expenses that go with it. In the case of a disability that lasts a lifetime, all of the mortality and investment risk is transferred to the third-party insurer.

Insurers benefit because they free up money that would have been used for a lump-sum settlement and can now concentrate on other cases.

The employee’s lawyer has a satisfied client for whom he has provided financial stability.

A word of caution

A structured workers comp settlement is a flexible tool for resolving troublesome claims. Keep in mind, however, that each state has different laws with regard to settling workers’ compensation claims. Be sure to partner with a professional who can confirm the laws of your state.

Learn More About Workers Compensation Insurance

For more information and advice on workers compensation insurance, contact us online or give us a call at (800) 947-1270 or (610) 775-3848.

Avoidinging Workers Compensation Insurance Claims via Risk Awareness

For construction workers and others whose jobs require them to be outside, winter means a few months of extreme cold and challenging days, during which they will be susceptible to cold-related injuries.

In addition to injuries resulting from slips and falls as temperatures dip below freezing, there is also the risk of cold stress. Cold Stress is the result of skin temperature being lowered, ultimately resulting in a reduced core body temperature.

The human body’s natural reaction when exposed to cold environments is to maintain its core temperature. To do so, blood shifts away from less critical body parts--hands, feet, arms, legs and skin--to concentrate in the vital chest and abdomen areas. As a result of the blood shift, the body parts containing less blood face an increased risk of cold-related injuries. Under severe conditions, tissue damage and death may occur.

Cold stress and the risk of cold-related injury can be reduced by increasing management and worker awareness of the hazards. In order to ensure a safe working environment, mitigate risk and prevent workers' compensation insurance claims, it is important to understand the elements of cold stress. 

Types of cold stress facts you need to know

• Hypothermia involves a severe loss of body heat, resulting in shivering, confusion, and loss of motor skills to an extent where workers cannot replenish their warmth.
  
  
• Frostbite is the freezing of an area of the body, typically the nose, ears, cheeks, fingers or toes. Severe cases of frostbite may lead to amputation. Symptoms include numbness, hard skin, tingling or blisters.
  
  
• Trench foot occurs when a worker's feet remain damp for a prolonged period of time. Although not directly tied to extreme cold (wet feet can contribute to the condition in warmer temperatures), it is a threat in winter with symptoms of red skin, numbness swelling, or bleeding.

Workers can help prevent cold stress

Workers will be able to monitor their own health and identify problems with colleagues if they understand the symptoms of cold stress. Following some simple guidelines will also help them to prevent cold stress injuries:

• Dress in several loose-fitting layers and don’t forget boots, gloves, and a warm cap
• Have at least one layer of waterproof clothing to protect at least some of their other clothing from getting wet
• Take breaks to get warm. If possible, go indoors for a few minutes or at least get out of the elements
• Stay hydrated. This is every bit as important in winter as it is in hot weather
• Keep spare clothing nearby in case the clothing they’re wearing gets wet

What can employers do about cold stress?

A cooperative approach with employees is important. A cold stress prevention program, outlining steps to limit cold stress and reduce risk of injuries and illnesses, is a good start.

Another step you can take is a review of your scheduling. If at all possible, plan outdoor work, equipment repairs and other tasks when the weather is more favorable. While it is not always possible to prevent workers from operating outside at all times, especially in the construction industry with its deadline pressures, you can limit the length they have to spend in the coldest temperatures. 

Next, you must train your team. Review the symptoms of cold stress in a group meeting. Emphasize the safety measures that workers must take, and discuss the best emergency response methods and who to notify should an employee begin to show signs of cold stress.

Finally, you need to provide resources for your workers. These can include insulated clothing, a heated shelter, warm beverages or educational materials. Above all else, call attention to cold-weather safety this winter. These measures will help to keep your workers on the job and your workers compensation insurance costs low.

Control Your Workers Compensation Insurance Cost

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