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The Cost of Failing to Provide Adequate Workers’ Comp

Posted by David Ross on Sat, Jan 30, 2021

Avoid the cost of failing to provide Adequate WC Insurance. Get the right workers comp insurance from American Insuring Group. Serving Philadelphia, Reading, Pittsburgh, Erie, Harrisburg, Allentown, and all of Pennsylvania.Most employers in Pennsylvania are required to have Workers’ Compensation (WC) Insurance. Failure to carry adequate WC can result in civil and criminal penalties. Therefore, employers must understand their WC obligations. Here's what you need to know... 

What is Workers’ Compensation?

The Pennsylvania Department of Labor & Industry defines Workers’ Compensation as “mandatory, employer-financed, no-fault insurance which ensures that employees disabled due to a work-related injury or disease will be compensated for lost wages and provides necessary medical treatment to return them to the workforce.”

The goals of WC are simple:

  • safer workplaces
  • prompt treatment and compensation for work-related injuries and illnesses
  • reduced litigation costs

With only a few exceptions, Worker’s Compensation insurance is mandatory for any employer in Pennsylvania who employs at least one employee. If ALL workers employed by that employer fall into one or more of the following categories, they may be excluded from mandatory WC. This is a general list, minus the fine print.

  • Federal workers
  • Longshoremen
  • Railroad workers
  • Casual workers
  • Persons who work out of their own homes or other premises not under the control or management of the enterprise AND make up, clean, wash, alter, ornament, finish, repair, or adapt articles or materials for sale that are given to them.
  • Agricultural laborers making less than $1200 per year
  • Domestic workers who have not elected to come under the provisions of the WC Act (they must notify the Department of Labor & Industry)
  • Sole proprietor or general partners with no other employees
  • People granted exceptions due to religious beliefs
  • LLC’s in which only the employees are members of the LLC
  • Executive officers who have been given an exclusion
  • Licensed real estate salespersons or associate real estate brokers

Workmen’s Compensation rules for independent contractors can be complicated. Merely referring to someone as an independent contractor doesn’t mean the Department of Labor & Industry will agree. Here are a few factors that may indicate an individual is not an independent contractor but an employee.

The individual…

  • Performs duties assigned by the employer
  • Works hours set by the employer
  • Uses tools, equipment, or materials that the employer provides

The bottom-line is… before you assume your employees are exempt from Workers’ Compensation Insurance, check with your insurance agent or the Department of Labor & Industry or risk facing civil or criminal penalties.

According to the National Academy of Social Insurance, the estimated cost of WC Insurance in Pennsylvania is $1.34 per $100 covered in payroll.

Filing a Workers’ Compensation Claim

Employers are required to report all injuries to their insurer or program - in the case of a self-insured employer - the person responsible for managing their WC. 

Employers are also required to submit a First Report of Injury to the Bureau of Workers’ Compensation within seven days if the injury results in the loss of one or more day, shift, or turn of work. If the injury results in death, the employer must file a First Report with the Bureau within 48 hours. The injured workers and the employer’s insurer should also receive copies of the First Report. 

Penalties for Non-Compliance

Refusing to file a Workers’ Compensation claim on behalf of an employee is against the law.

 If an employee is injured, and the employer does not have WC insurance, the Uninsured Employers Guaranty Fund will pay the employee’s benefits. The employer will be required to reimburse the fund, including costs, interest, penalties, and other fees. 

Injured employees covered under WC insurance have very limited ability to sue their employers. However, that is not the case when the employer fails to carry WC insurance. Employers without WC are open to litigation for workplace injuries and illnesses. And often, the damages awarded are higher than what the employer would have paid for WC insurance. 

Employers who fail to maintain WC coverage could be found guilty of a misdemeanor, which carries a fine of up to $2,500 and up to one year in jail. If the courts decide the failure to comply was intentional, the employer could be facing a felony charge that carries a fine of up to $15,000 and up to seven years in jail. 

Getting the Right Workers’ Compensation Insurance

American Insuring Group specializes in Workers’ Compensation Insurance. We can help you determine 1) whether or not your business is required to carry WC and 2) how you can get the best price on quality insurance protection if it is needed. Call us today at (800) 947-1270 or (610) 775-3848 or connect with us online.

Tags: Workers Compensation Insurance, workers comp, workers comp insurance, workers comp costs

How Pre-Employment Tests Can Lower WC Insurance Costs

Posted by David Ross on Sat, Jan 16, 2021

How to Use Pre-Employment Tests to Lower WC Costs in Reading, Philadelphia, Lancaster, Allentown, Pittsburgh and throughout Pennsylvania and elsewhere.Workers’ Compensation Insurance (WC) is designed to protect employers and employees from financial loss when an employee is injured on the job or becomes ill from a work-related cause.

It bears repeating that WC is meant for WORK-RELATED illnesses and injuries.

But consider this, according to AARP, more than 19 million working Americans between the ages of 21 and 64 have some physical limitation that could affect their ability to perform certain tasks. According to the CDC, the most common type of disability (one in seven adults) affects mobility, and with age, disabilities become more common.

That means there’s about a 10% chance that a potential new-hire could have a pre-existing impairment – knowingly or unknowingly - that could put them at risk for an injury.

While that person should still be able to get whatever benefits they are entitled to, his or her employer should not be responsible for paying for an injury caused by a condition the employee had before they were hired. But how would you know if a potential hire has a pre-existing impairment? A pre-employment human performance evaluation (HPE)!

The Americans with Disabilities Act allows employers to physically and medically evaluate their workers at all stages of their employment. After an individual is offered a job, the employer can make the job contingent on several things, such as a background check, drug test, and pre-employment testing.

Keep in mind that The Society for Human Resource Management (SHRM) cautions, “Pre-employment tests need to be selected and monitored with care; employers run the risk of litigation if a selection decision is challenged and determined to be discriminatory or in violation of state or federal regulations. Tests used in the selection process must be legal, reliable, valid, and equitable, and HR professionals need to stay aware of any developing trends.”

What is a Pre-Employment Human Performance Evaluation?

The pre-employment HPE (also called a pre-placement test) is a standardized test often conducted in a physical therapy or occupational medical clinic. It helps companies get an overview of the prospective employee’s overall health status and make better choices when hiring new candidates.

An HPE can do the following:

  1. Assure employers that the prospective employee is physically able to perform a job safely
  2. Protect employers from WC injury claims that are not work-related, but the result of a pre-existing impairment
  3. Protect employees from injuries while performing jobs they should not be doing due to a pre-existing impairment
  4. Protect the employees’ co-workers

According to Concentra, a national health care company, information commonly collected during this test includes:

  • A review of the workers’ medical and occupational history
  • A medical exam
  • An evaluation of functional tasks such as lifting, carrying, pushing, and pulling

The test can also be used to establish a baseline so an employer can monitor any changes in the employee’s health over time and use it for future reference in the event of an injury. This information often shows that only part of an employee’s injury is caused by his or her current work.

For example, an HPE may reveal that a worker has a 5% impairment in his or her shoulder. If that employee is injured and is determined to have a 7% impairment, the employer would only be responsible for the additional 2% impairment under Workers’ Compensation insurance.

Employers don’t want to pay for injuries or illnesses that were not caused on the job, and a pre-employment HPE – that follows all legal requirements – can help minimize that risk.

Lower Your Workers’ Compensation Insurance Costs!

Another way to save on WC costs is to work with one of the experienced agents at American Insuring Group. We specialize in WC insurance, and we're independent agents, which frees us to quote lots of competing insurance providers so that you get the right coverage at the best price.

Call us today at (800) 947-1270 or (610) 775-3848 or connect with us online.

Tags: Workers Compensation Insurance, PA Workers Compensation Insurance, workers comp costs, Return-To-Work Programs

Lower Contractors Insurance Costs by Lowering Your Experience Rating

Posted by David Ross on Sat, Dec 19, 2020

Here's How to Lower Your Contractors Insurance Costs in Philadelphia, Reading, Erie, Pittsburgh, Lancaster and Throughout Pennsylvania.Want to lower your Contractors Insurance Costs? Lower Your Experience Rating.

Your construction company’s experience rating helps determine your Workers’ Compensation Insurance costs and is based on your company’s WC claim history compared to other companies similar to yours.

You can think of a lower experience rating as a reward for having a safer work environment or perhaps as an incentive to create a safer work environment. The bottom line is that a lower experience rating results in a lower insurance premium.

The Experience Rating

The Pennsylvania Compensation Rating Bureau (PCRB) describes your experience rating as “a systematic, mathematical method of modifying future premiums.” It is based on past claims and helps determine your experience modifier, which is an adjustment of your annual premiums based on the likelihood that you will file a claim.

You qualify for an experience rating if your audited payroll or other exposures over a three-year period, multiplied by the current PCRB lost costs by classification, add up to $10,000 or more.

The experience rating is continually being updated based on a sliding three-year experience period, which according to PCRB, “assures a stable historical record for the individual employer, while also using the most recent available loss experience of the employer.” This means improving workplace safety and minimizing claims can change your experience rating and the premiums you pay.

What if your insurance premiums are less than $10,000? The merit rating plan enables businesses to receive a 5% discount or surcharge depending on their loss history, which provides financial incentives for small businesses to operate safer workplaces.

The following factors affect your experience rating, which determines your experience modifier:

  • Number of Claims
  • Cost of Claims
  • Frequency of Claims
  • Severity of Claims
  • Closed vs. Open Claims
  • Claims History of other businesses in your industry
  • Years in business
  • Number of employees
  • State minimums

The following formula then determines your WC premiums:

WC Premium = Class Code Rate X Experience Modifier X payroll/$100

So, you can see how a lower experience modifier can lower your WC costs.

NOTE: The experience rating formula places more emphasis on loss frequency than it does on loss severity. Therefore, a business with many small losses can end up with a higher experience modifier than a company with fewer, but more severe, losses.

Tips to Lower Your Experience Rating

It comes as no surprise that the number one tip to lower your experience rating is to reduce the number of accidents in your workplace. How do you do that?

  1. Institute a Workplace Safety Program
  2. Engage management and employees in safety protocols
  3. Properly train employees and management on safety
  4. Identify and mitigate hazards
  5. Provide employees with proper PPE
  6. Have adequate staff levels
  7. Inspect and maintain all equipment

The Insurance Information Institute offers this advice, “Review, respond, and improve. Promoting workplace safety is an ongoing process. You should review and improve your program—especially in response to accidents or ‘near misses.’ Employees should always be encouraged to report newly identified hazards or workplace incidents so that you can respond appropriately.”

The other thing you can do is get injured workers back to work as quickly and safely as possible with a Return-to-Work program.

Here's How to Save on All Your Commercial Insurance Needs

American Insuring Group specializes in Contractors Insurance and in all types of commercial insurance. Our independent agents will compare the cost of your coverage among many insurance companies to help you get the best rate on all your Contractor Insurance needs.

Call today at (800) 947-1270 or (610) 775-3848 or connect with us online.

Tags: Workers Compensation Insurance, Construction Insurance, Contractor Insurance, workers comp costs, Commercial Insurance, Contractor Safety Management

Safety Hazards Can Be Found in Any Workplace

Posted by David Ross on Sat, Dec 12, 2020

Improving workplace safety can help lower Workers’ Compensation Insurance costs in Pittsburgh, Philadelphia, Lehigh Valley, Erie, Lancaster, and in counties throughout Pennsylvania.We often discuss how improving workplace safety can help lower Workers’ Compensation Insurance costs, and we typically focus on very hazardous industries, such as construction. But every workplace has its share of hazards that can cause employee injuries.

The National Safety Council reports that a worker is injured on the job every seven seconds. What may surprise you is the three most common types of injuries that keep workers away from work are sprains, strains, or tears; soreness or pain; and cuts, lacerations, or punctures. The three most common workplace injuries resulting in lost workdays include overexertion, contact with objects or equipment, and slips, trips, and falls.

While these types of injuries may be more prevalent at construction sites and other obviously dangerous workplaces, they can happen at just about any worksite – even a seemingly safe office setting. For example, an employee can lift a heavy box of office supplies improperly and experience overexertion. Or someone can fail to clean up spilled coffee in the breakroom, causing someone else to slip and fall.

Minimizing accidents can help lower your WC Insurance costs because there is a specific formula for determining the cost of your WC insurance:

Premium = (Payroll/$100) x Class Code Rate x Experience Rate Modification

Your experience rate modifier, often called MOD, is a numeric representation of your claim experience. The number is based on how your claims compare with other companies with a similar classification of employees. Employers with fewer than average and less severe accidents than average will have a lower MOD, which will help lower the cost of WC Insurance.

Whether you are looking at employees in a highly hazardous occupation like construction or a less hazardous occupation like an office setting, minimizing workplace injuries can help lower WC and other costs. The first step to lowering injuries is to identify and assess potential hazards.

Here are the types of hazards you should look for:

Safety Hazards are unsafe working conditions that can potentially cause illness, injury, or death, such as spills that aren’t cleaned up, frayed cords, and confined spaces.

Physical Hazards include exposure to extreme temperatures, the sun, radiation, or loud noise.

Chemical Hazards include dangerous chemicals in any form (solid, liquid, or gas) and can occur during the use, transfer, or storage of those chemicals. Potentially dangerous chemicals include cleaning products, pesticides, gasoline, paints, etc.

Microbiological Hazards can include exposure to mold, sewage, airborne illnesses, insects that bite or sting, poisonous plants, animal feces, etc. This is one of the most commonly overlooked hazards.

Electrical Hazards include damaged equipment, overhead powerlines, improper grounding, overloaded circuits, etc. Even improperly used extension cords can become a safety hazard to employees.

Ergonomic Hazards can be found in uncomfortable workstations, repetitive movements, poor body positioning, or anything that puts a strain on an employee’s body. These can be the most difficult to spot because the strain isn’t always noticed immediately. Discover more about minimizing ergonomic hazards here.

Organizational Hazards is a broad category that includes workplace violence, high stress, excessive workplace demands, lack of respect, or sexual harassment. It can also include housekeeping hazards, such as blocked fire exits, cluttered desks, and over-stacking loads.

Here's How to Save a Bundle on Workers’ Compensation Insurance!

The independent agents at American Insuring Group specialize in Workers’ Compensation Insurance. We'll make sure that you get the right coverage at the best price. That's because we're free to shop the market for you, unlike those single-brand agencies.

So call us today to start saving at (800) 947-1270 or (610) 775-3848 or connect with us online.

Tags: Workers Compensation Insurance, PA Workers Compensation Insurance, workers comp costs, Safety Programs

5 Benefits of Prompt WC Insurance Claims Reporting

Posted by David Ross on Sun, Oct 25, 2020

Promptly filing your workers comp claims can help lower your WC insurance costs.You’ve purchased the appropriate Workers’ Compensation (WC) Insurance, as required by Pennsylvania law. That’s a significant first step to protecting your employees and your business, but there’s more to a healthy WC program, including the prompt reporting of injuries and claims.

We understand that you have a lot on your plate and may wear many hats, but not reporting a claim promptly can have a negative impact on your WC program, your business, your injured employee, and your worker's comp insurance costs.

5 Reasons Prompt Reporting of Workplace Injuries and WC Claims is Crucial to Your Business

Preserve Evidence

When an injury occurs, it’s essential that the injury is investigated as quickly as possible, or you could risk losing crucial evidence. Therefore, as soon as an injury occurs, someone should document details of the injury, investigate to try to determine how the injury occurred, interview the employee and any witnesses, and of course, ensure that the injured employee receives appropriate medical attention.

Lower Cost of Claims

The National Council on Compensation Insurance (NCCI) found that the median cost of WC insurance claims that were reported between one day and two weeks were “significantly lower,” and the cost rose as the time it took to report a claim rose. The bottom line is that delayed reporting can increase WC claim costs up to 51%.

Better Medical treatment

When an injured employee receives prompt medical treatment from competent, in-network healthcare providers, they are more likely to receive a proper diagnosis and effective treatment to heal faster.

Plus, even seemingly minor injuries can escalate into more significant issues if they are not immediately looked at by a medical professional.

Quicker Return to Work

The sooner you can get an injured employee back to work safely, the better it is for everyone – the injured employee, co-workers, and your business. Having a return to work program can shorten the length of time an injured worker is out of work by an average of 3.6 weeks, according to the RAND Institute for Civil Justice.

Health providers who are familiar with treating workers’ compensation injuries will focus on facilitating an early return to work for the injured employee. The sooner the injury is reported, the sooner that process can begin.

Decrease in Litigation

Promptly reporting an injury and keeping in touch with the injured employee throughout the claim process helps reduce employee’s fears and makes them feel as if their employer cares about them and is treating them fairly. According to NCCI research, this all translates to a lower chance of litigation.

Fraud Prevention

According to the National Insurance Crime Bureau (NICB), “Workers’ compensation claimant fraud and medical fraud are significant contributors to our nation’s annual $30 billion insurance fraud problem.”

Prompt reporting of an injury helps ensure 1) the injured worker receives proper medical treatment, 2) the injured worker feels they’ve been treated fairly, and 3) allows a better investigation of the incident. All this helps minimize fraud.

Quicker Closure

The longer a claim remains open, the more resources you have to use. Promptly reporting an employee injury can get an employee back to work and the claim closed more quickly.

Safer Workplace

When an injury is reported and investigated quickly, you are more likely to recognize safety issues, correct them, and ensure the safety of your employees.

One More Step: Lower Workers Compensation Insurance Costs

If you want to learn more about how to get the lowest cost on WC Insurance and other commercial insurance, give the independent agents at American Insuring Group a call at (800) 947-1270 or (610) 775-3848 or connect with us online. We shop and compare competing insurance carriers to get you the best rates on quality insurance protection. Call today.

Tags: Workers Compensation Insurance, PA Workers Compensation Insurance, workers comp costs, Workers Compensation Insurance Fraud

Telecommuting and Workers’ Compensation Insurance

Posted by David Ross on Sat, Oct 10, 2020

Telecomuting can impact your workers compensation insurance costs in Philadelphia, Berks County, Lancaster County, Alleghany County, PA and beyond. Here's what you should know.If the COVID-19 pandemic has forced many of your employees to work from home, have you considered the ramifications it may have on your Workers’ Compensation Insurance? It may not be high on your radar as you continue to struggle through all the logistics of staff working from home, but it should be.

Workers’ Compensation claims can be complicated enough. If that injury occurs while the employee is at home, it can complicate it even further. The Society for Human Resource Management states, “In general, an employee injury or illness is compensable under workers’ compensation if it arises out of and in the course of employment, regardless of the location the injury occurs.”

Due to 1) a lack of defined case law in this area and 2) the limited ability to investigate incidents that occur at home, telecommuting is creating WC issues for many employers.

Injuries can and do occur while employees are working from home. Therefore, you must do your best to ensure that…

  • Employees have a safe work environment even if they are working from home

  • Both you and your employees understand what is expected of them

  • You respect their rights

  • Employees receive appropriate medical attention if an injury “arises out of and in the course of employment”

  • You have a process in place to properly investigate work injuries that occur at home.

The best way to ensure this and avoid potential WC issues is to create a Telecommuting Policy before something does happen.

A Telecommuting Policy

A Telecommuting Policy forces you to address the potential risks of working from home and lets employees know what is expected of them. Create and implement a written work-at-home contract that is signed by both employee and employer and is strictly enforced.

This contract should do the following:

  • Outline the hours that an employee will be working, including meals and rest periods. Also, include provisions regarding overtime. If the schedule changes, it should be documented via email.

  • Define where the employee will be working, whether that’s his or her home address or another physical location they chose to work from. Define the specific work area(s) within the home or other location and provide training to help them set up a safe workstation. If it is possible, check an employee’s home office to identify potential safety hazards and how to eliminate them.

  • Discourage employees from performing personal activities in their at-home workspace.

  • List what employer-owned equipment – such as laptop computers – the employee can use outside of the workplace.

  • Describe how employees should store and dispose of sensitive information.

  • Include details about how any work-related injury investigations will occur. You need to respect your employee’s privacy, but you also have the right to do an investigation of any work-related injury. Specific language is key. Require the employee to state in writing that they understand that their home-work environment must be safe and that they need to cooperate if a work-related injury occurs. That includes seeking medical treatment if needed, documenting the injury, and allowing the employer access to the workspace during regular business hours.

  • Include a Workers’ Compensation Statement that informs the employee of their protection under WC laws and that they are responsible for reporting all work-related injuries promptly.

Our Experts Will Help You Save on Workers’ Compensation Costs

Ensuring the safety of your employees and having a process to investigate injuries that occur at home can help you save on Workers’ Compensation costs.

Another great way to save is to work with one of the independent insurance agents at the American Insuring Group. We specialize in WC insurance and will compare pricing and coverage among many competing insurance carriers. We research so you can save! Give us a call at (800) 947-1270 or (610) 775-3848 or connect with us online.

Tags: Workers Compensation Insurance, workers comp, workers comp costs

Workers Compensation Basics: What Employers Need to Know

Posted by David Ross on Sat, Sep 26, 2020

The basics on reducing the cost of workers comp insurance in Philadelphia, Lancaster, Pittsburgh, Erie, Allentown, and throughout Pennsylvania.One of the most important types of insurance that almost every business needs is Workers' Compensation Insurance (WC). It helps protect both employees and employers when there is a work-related injury or illness. In Pennsylvania, most employers are required by law to carry WC for their employees.

For many employers, WC is one of the most expensive types of insurance they need to carry, which is why working with an insurance agent who has experience with WC – like those at American Insuring Group - is essential to keeping those costs as low as possible.

They say knowledge is power, so here are the basics every employer should understand about Workers' Compensation Insurance.

What is Workers' Compensation?

If a worker is injured in the workplace or becomes ill because of his or her work environment, Workers' Compensation helps cover medical costs and lost wages if the employee is not able to work. It doesn't matter who or what caused the injury – a faulty machine, the employee, a co-worker, etc. - WC will pay those expenses.

In Pennsylvania, WC covers health care expenses (doctor's visits, surgery, etc.), ongoing care (such as physical therapy), illnesses, repetitive injuries (such as carpal tunnel syndrome), partial or total disability payments, permanent injury payments, and death benefits.

WC also benefits the employer by limiting an injured employee's right to sue an employer directly for damages that injury or illness causes.

Who is Required to Carry Workers' Compensation?

The Department of Labor & Industry states, "If you employ workers in Pennsylvania, you must have workers' compensation insurance -- it's the law." This includes both full and part-time employees, even if they are family members.

The only exceptions are If ALL employees fall into one or more of the following categories:

  • Federal workers
  • Longshoremen
  • Railroad workers
  • Casual workers
  • Persons working out of their own homes or other premises not under the control of management
  • Agricultural laborers making less than $1200 per calendar year
  • Domestic workers who have not elected to come under the provisions of the Workers' Compensation Act
  • Sole proprietors or general partners
  • Those who have been given an exemption by the Department of Labor and Industry due to religious beliefs
  • Executive officers who have been granted exclusion by the Department of Labor and Industry
  • Licensed real estate salespersons or associate real estate brokers affiliated with a licensed real estate broker or a licensed insurance agent affiliated with a licensed insurance agency, under a written agreement, remunerated on a commission-only basis and qualifying as independent contractors for State tax purposes or for Federal tax purposes under the Internal Revenue Code of 1986.

If a business does not qualify for one of these exceptions, it must carry Workers' Compensation Insurance for its employees. Failure to do so can result in the employer being required to pay back any costs paid by the Uninsured Employers Guaranty Fund or a work-related injury or illness, including interest, penalties, and fees. An uninsured employer may also face civil and criminal risks that can result in fines and imprisonment.

How Much Does Workers' Compensation Insurance Cost?

How much you pay for WC is based on a formula:

RATE x (PAYROLL/100) x EXPERIENCE MODIFIER = PREMIUM

An employee's classification code determines the RATE. Those codes are based on the likelihood of that employee being injured on the job. Employees doing more dangerous jobs, such as construction workers, will have a higher rating than someone in a less dangerous job, such as office workers.

A projection of your payroll determines PAYROLL.

Your business's loss history determines the EXPERIENCE MODIFIER compared with the average loss history in your industry. An experience modifier of one is average. A lower number will reflect a better than average loss history, and a higher number will reflect a loss history that is worse than the average. The lower your experience modifier number, the lower your WC rates. 

 

How Can You Lower Workers' Compensation Insurance Costs?

An independent insurance agent who specializes in WC - like those at American Insuring Group – can help ensure you pay the lowest premium possible. By searching among many competing insurance carriers, we obtain the right insurance at the lowest price possible. So give us a call at (800) 947-1270 or (610) 775-3848 or connect with us online.

 

Tags: Workers Compensation Insurance, workers comp insurance, PA Workers Compensation Insurance, workers comp costs

How to Handle a Questionable WC Insurance Claim

Posted by David Ross on Sat, Aug 01, 2020

Handle questionable workers compensation insurance claims properly, and reduce your WC costs in Philadelphia , Pittsburgh, Erie, Harrisburg, Berks County, PA and beyond.Most employers in Pennsylvania are required to carry Workers' Compensation (WC) Insurance to pay medical expenses and lost wages if an employee is injured or develops an illness on the job.

The majority of WC claims are legitimate; however, Workers' Comp fraud is costing businesses billions of dollars every year. WC fraud occurs when employees fake an injury, exaggerate an injury, claim an injury occurred at work when it did not, etc.

If an employer doesn't want to pay more than they have to for WC Insurance, they need to be on the lookout for questionable claims. Here are 4 valuable tips:

Report All Injury Claims

Even if you suspect a claim is not legit, you must report all injury claims to your Workers' Compensation Insurance carrier. Failing to do so could result in hefty penalties.

To do this, complete an injury/illness report. Some employers have their own reporting forms, and others use forms from their WC carrier or state WC agency. You should have every type of workplace accident report form available to avoid legal issues. Fill out the form with the injured employee if possible or deliver the form to the doctor who attended the employee first.

Typical information requested on these forms include (but is not limited to) the following:

  • Date of injury
  • Where the injury occurred
  • A description of the injury or illness
  • When the employee became aware of the injury or illness
  • The date the injured employee received AND returned the form

Inspect and Document

You can help any WC investigation by gathering information as soon as an injury occurs while the information is fresh in everyone's minds.  That includes surveying the scene of the accident, collecting information (such as talking to witnesses and writing down the details of the accident), and completing an incident report.

Try to determine the leading cause or causes of the accident and answer (in writing) the following questions:

  • Were company rules and regulations followed?
  • Were there any witnesses?
  • Did something unique happen that caused the accident?
  • Could the accident have been prevented?
  • If it could have been prevented, why wasn't it?
  • Is the risk still there?

As soon as possible, take photographs where the accident happened and any potential causes of the accident. Ask the doctor to document the state of the employee's injuries.

If there are witnesses, get the following information from them:

  • Their name
  • Their address
  • Contact information
  • A summary of what they saw

Let Your Claim Handler Know if You Believe a Claim is Questionable

The claim handler has experience and training in investigating WC claims – both legitimate and false claims, and they have the authority to deny a claim. However, you know more about your employees, your work environment, and the circumstances of an employee's claim than the claim handler.

If you feel a claim is questionable, you must let your claim handler know so that they can conduct a proper investigation.

Continue Communication

Once a claim is filed, the employer must continue to communicate with the carrier. Immediately forward any relevant information, such as medical documentation. Your claim handler may ask for additional information, such as the number of lost workdays, the RTW status, etc. If you want the claim resolved quickly, respond to claim handlers promptly.

 

How to Immediately Lower Workers' Compensation Insurance Costs:

If you want to lower your WC costs, work with an independent insurance agent like the pros at American Insuring Group. We can offer you lots of choices in WC insurance carriers. We'll make sure you get the right coverage at the right price. Give us a call today at (800) 947-1270 or (610) 775-3848 or connect with us online.

Tags: Workers Compensation Insurance, workers comp costs, WC Insurance, Workers Compensation Insurance Fraud

Workplace Ergonomics Minimizes Injury and Lowers WC Costs

Posted by David Ross on Sat, Jun 27, 2020

Workplace ergonomics can impact Workers Compensation Insurance costs in Philadelphia, Pittsburgh, Reading, Lancaster, Erie, PA and throughout the US. We often focus on minimizing Workers’ Compensation Insurance costs in potentially dangerous workplaces such as restaurants and construction sites: however, office spaces are not immune to workplace injuries.

One of the most significant work-related injuries in an office are musculoskeletal disorders (MSDs). According to OSHA, “Work-related musculoskeletal disorders are the most widespread occupational health hazard facing our Nation today.” Every year, almost two million workers suffer from work-related MSDs, and approximately 600,000 of those workers lose time from work due to the MSD.

OSHA estimates the direct cost of MSDs to be between $15 and $20 billion every year, with total yearly costs in the $45 to $54 billion range. Plus, $1 out of every $3 spent on WC is a result of insufficient ergonomic protection, which can help avoid MSDs.

What Are Musculoskeletal Disorders?

The Bureau of Labor Statistics (BLS) of the Department of Labor describes MSDs as “musculoskeletal system and connective tissue diseases and disorders when the event or exposure leading to the case is bodily reaction (e.g., bending, climbing, crawling, reaching, twisting), overexertion, or repetitive motion.” MSDs affect joints, bones, muscles, the spine, etc. Examples of MSDs include carpal tunnel syndrome, tendonitis, degenerative disc disease, and tension neck syndrome.

The Centers for Disease Control and Prevention describes work-related MSDs as conditions in which “the work environment and performance of work contribute significantly to the condition; and/or the condition is made worse or persists longer due to work conditions.”

What is Workplace Ergonomics?

Workplace ergonomics - the science of fitting a job to a person so that they can work safely, without injury or pain - can help prevent MSDs, thereby reducing workplace injury and reducing Workers’ Comp and other expenses. A bonus is that it can actually improve a worker’s productivity.

Often, a few simple adjustments can make a huge difference, and it doesn’t have to cost a lot.

Ergonomics in the Office

Occupational Health & Safety reports that workers spend an average of 1,700 hours per year in front of a computer screen. That’s more than 70 days every year sitting at a desk. Sitting in the same position for long periods of time can cause pain and injury and lead to MSDs. Many office workers don’t even realize that they are sitting in awkward postures that can affect their health and safety.

Here are some of the most common ergonomic problems in an office:

  • Monitors are too low, which forces flexion of the cervical spine.
  • Armrests are not used properly or not at all, which can cause tensions in the neck, shoulders, and trapezius muscles.
  • The mouse is not aligned with the shoulder, which can cause pain in the neck, wrist, and upper limbs.
  • Workers use phones without a headset, which can cause pain in the shoulder and spine.

Here are some tips to improve office ergonomics:

  • An office chair should allow for height adjustment so that the worker can sit with his or her knees at a 90-degree angle. It should also have adequate lumbar support and armrests, so elbows are at a 90-degree angle.
  • The desk and chair should allow enough space for the user to cross their legs. Users should be able to rest their feet flat on the floor, so use a footrest if needed.
  • Pad the edges of the desk if there are hard edges.
  • A monitor should be placed, so the top is at or just below eye level and is an arm’s length away. The brightest light source should be to the side to avoid glare.
  • The mouse should be directly in line with the shoulder, so the wrist remains straight.
  • The height of the keyboard should allow the user to keep their wrists straight while typing.
  • A phone should be held in one hand, or the user should use a headset.

MyAbilities offers a tool called Rapid Office Strain Assessment (ROSA), which is a self-guided self-assessment that shows workers how to adjust their workstation to prevent discomfort and injury.

Want to Save Even More on Workers’ Compensation?

Creating safe workplaces to avoid injuries is the best way to reduce WC costs. Another way to save on all commercial insurance costs is to work with one of the independent agents at American Insuring Group who specialize in Workers’ Compensation Insurance. Give us a call today at (800) 947-1270 or (610) 775-3848 or connect with us online to see how we can help you save on your Workers’ Compensation and other insurance costs.

Tags: Workers Compensation Insurance, workers comp, PA Workers Compensation Insurance, workers comp costs, Safety Programs

Workers Compensation Insurance and Liability Insurance

Posted by David Ross on Sat, Jun 13, 2020

Understanding Workers Comp Insurance vs. Liability InsuranceEvery business in Pennsylvania with one or more employees is required to provide Workers’ Compensation Insurance to its employees – with very few exceptions. It’s the law. It doesn’t matter if those employees are full-time or part-time or even family members. Not having workers’ compensation insurance is a criminal offense. In Pennsylvania, you could face fines up to $2,500 and/or prison time.

Workers’ Compensation Insurance is designed to protect both the employee and the employer. There are two essential parts to WC insurance. The first part is coverage for medical expenses, rehabilitation costs, disability compensation, and lost wages when an employee is injured or becomes ill “in the course and scope” of their job, regardless of fault. It also pays death penalties to the family of an employee who is killed on the job.

According to the National Safety Council, the average cost of a WC claim in 2016-2017 was $40,051, with WC claims caused by injuries resulting from motor-vehicle crashes averaging $78,293. For many businesses, paying that amount of money out of pocket could put them out of business.

The second part of WC Insurance is coverage for employer liability. The first part of WC pays medical costs for work-related injuries and illnesses regardless of fault. However, if an employee feels the employer was negligent, they can file a lawsuit for additional damages in some instances. This is where the second part of WC – employer’s liability – kicks in. It helps employers pay for legal expenses, such as attorney’s fees, court fees, and settlements or judgments.

Types of Claims Employer’s Liability Insurance Covers

Third-Party Action

An employee who is injured on the job and receives workers’ comp benefits can’t sue their employer directly; however, they can sue a third party, such as the manufacturer of a piece of equipment that caused the injury. The manufacturer can then file a lawsuit against your company, creating a third-party action lawsuit.

Consequential Damage

An example of consequential damage would be a spouse who is injured as a result of caring for the injured employee.

Loss of Consortium

If an employee is severely injured or killed on the job, their spouse can file a lawsuit when the injury or death results in the loss of a family relationship.  

Dual-Capacity Suit

A dual-capacity lawsuit can occur if the employer and injured employee have more than one relationship. For example, if you manufactured a product that could have caused the injury, the employee can hold you liable.

What About Commercial General Liability (CGL) Insurance?

CGL covers bodily injury, personal injury, and property damage caused during business operations, as a result of one of your products, or on your business premises. Here are a few examples of when CGL will cover you.

  • A customer falls and hurts themselves while in your restaurant.
  • One of your employees accidentally causes a fire while working on the electrical panel in a customer’s home that causes damage.
  • Someone files a libel or slander claim as a result of an ad that you placed.

One of the most important things to remember about Commercial General Liability Insurance is that it does NOT cover bodily injury to an employee. That is what Workers’ Compensation is for.

 

Protect Your Business While Saving Money

American Insuring Group offers both Workers’ Comp Insurance and Commercial General Liability Insurance, along with any other type of insurance you may need to protect your business. Plus, as independent agents, we compare the cost of coverage among many insurance companies to ensure that you get the lowest price on quality insurance protection. Give our experts a call today at (800) 947-1270 or (610) 775-3848 or connect with us online.

Tags: Workers Compensation Insurance, Professional Liability Lawsuit, Commercial General Liability Insurance, WC Insurance