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INSOMIS
PO Box 542, Big Bear City, CA, 92314
Construction Insurance Bulletin
909-878-0260 Website

DEPARTMENTAL RESPONSIBILITY TO REDUCE WORKERS COMPENSATION CLAIMS

When it comes to Workers Compensation claims, companies are looking constantly for ways to reduce claims and reduce costs.

Ascribing the cost of Workers Compensation claims to applicable internal departments can encourage supervisors and managers to pay more attention to training and safety programs and more carefully monitor injured employees returning to work.

Some companies have even deducted the claim cost from the budget of the ascribed department instead of a general company fund as an additional incentive to curb Workers Compensation costs.

Through implementing a few procedures that place Workers Compensation expenses directly on internal departments, employers have more control over prevention and injury management measures that can decrease the severity and frequency of workplace injury.

Related services can be found at Claims Management Services & Workers' Compensation Insurance.

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Safety goals can be met by communicating directly with all potential Workers Compensation employees.

Use a claim and injury history to identify high-risk employee groups, then, on a departmental level, discuss the injury management process with employees.

Communication will improve as employees are given a chance to discuss how they feel the job could be performed with less risk of injury.

It also gives the employer an opportunity to modify safety procedures or dangers in the work environment, such as faulty equipment or inadequate work protocols that are identified by employees.

A common problem related to workplace injuries is a lack of prompt reporting.

Too often supervisors don't appropriately acknowledge workplace accidents in the hope that the incident will not result in time off of work or medical expenses.

However, putting an initial injury off and not reporting it immediately often actually results in increased costs.

Cost impact of delayed reporting

  • Injuries reported one to two weeks following the incident were 18% more expensive than those reported within a week of the incident.
  • Injuries reported three to four weeks after the incident were 30% more expensive than those reported within a week of the incident.
  • Injuries reported after four weeks of the incident were 45% more expensive than those reported within a week of the incident.

Showing supervisors and managers statistics such as these will help to ensure timely injury reporting, especially if Workers Compensation costs will be coming out of the departmental budget.

Although the goal is prevention of workplace injury, once an employee has been injured, the objective should turn to a timely and safe return to work.

This can best be achieved if both employer and employee share a desire to obtain the most effective care, which will help to expedite recovery and a safe return to the job.

Since each department is faced with the claim cost coming out of their own budget, managers and supervisors can take a more active role in assisting injured employees returning to work.

For example, instead of the usual claim adjuster or attorney contacting the injured employee, the company concern can be conveyed through the department head(s) or talk to an agent.

One last element is fraudulent claims. Although deliberate fraudulent claims are a rarity, they do exist.

These fraudulent claims will be much more difficult to file when Workers Compensation costs are analyzed departmentally.

Employers in specific industries may also review industry-focused programs such as Sporting Goods Manufacturing Insurance for guidance on reducing risk.

Accidents are going to happen. There simply isn't a way to prevent all accidents and eliminate all claims.

But, it is realistic to reduce the frequency and severity of workplace injuries by making the department responsible directly, whether by penalty or by reward, for a safe work environment.

Frequently Asked Questions

What does attributing workers' compensation costs to a department mean?

It means tracking and assigning the financial impact of a claim to the responsible department so managers see the direct budgetary effect of injuries.

How does timely reporting affect claim costs?

Reporting injuries promptly generally reduces costs because early intervention can limit medical expenses and lost time, and speeds recovery.

Will charging departments for claims reduce workplace injuries?

Tying costs to a department can increase attention to safety, training, and return-to-work practices, which may reduce frequency and severity of injuries.

What should supervisors do immediately after an injury?

Supervisors should report the incident promptly, document what happened, ensure the employee receives appropriate care, and coordinate return-to-work plans.

INSOMIS 909-878-0260 Website
 

UNDERSTANDING WORKERS COMP WAIVERS OF SUBROGATION

It is very common for the insurance requirements in a construction contract to include a provision requiring the subcontractor to waive all rights against the owner and general contractor for recovery of damages to the extent these damages are covered by the sub’s workers’ compensation and general liability or commercial umbrella liability insurance.

Owners and general contractors insist on this provision because they want to protect themselves from being held liable for injuries to a subcontractor’s employee. Typically, the contractor giving the waiver asks its insurance company to attach a “Waiver of Subrogation” endorsement to its Contractors Workers Compensation policy.

The endorsement states that the insurance company will not enforce its right to recover payments it makes to an injured worker from the person or organization listed on the endorsement. It applies only to the extent that the employer insured by the policy performs work under a written contract requiring the employer to obtain the insurance company’s waiver.

The endorsement does not directly or indirectly benefit anyone not listed on the endorsement. With this endorsement on the policy, the company cannot attempt to recover payments it made to an injured worker from the company listed on the endorsement, even if that company was responsible for the injury.

Consequently, the loss impacts the employer’s experience modification and may increase future premiums. In addition, the endorsement usually carries an additional premium for the employer, normally some percentage of the premium attributable to the job.

The endorsement and the waiver agreement in the contract do not bind the injured employee. The employee still has the ability to sue the owner and general contractor for his injuries, and construction contracts commonly require the subcontractor to defend and indemnify the owner and general contractor from such suits.

Therefore, it is probable that the employer will pay an additional premium for the endorsement, face higher future workers’ compensation premiums for the loss, and pay higher future liability insurance premiums because its policy will cover the other parties’ liability.

For example, assume the subcontractor’s employee suffers serious injuries when tools and materials fall off a scaffold and strike him. He collects workers’ compensation benefits for medical costs and lost wages.

The subcontractor’s workers’ compensation policy includes the Waiver of Subrogation endorsement, so the insurance company cannot recover any of its payments. The worker sues the owner and general contractor for pain and suffering, but the contract requires the subcontractor to cover the owner’s and general contractor’s liability, so the subcontractor’s liability insurance pays for the lawsuit.

In that situation the subcontractor’s insurance effectively pays twice for the same injury to the same worker.

Owners and general contractors require waivers for several reasons. Insurance consultants, brokers, and risk managers usually encourage them because waivers protect liability insurance and reserve it for other claims, which can make a contractor’s liability coverage more attractive to insurers and may lower premiums.

Subcontractors often do not resist these requirements because they feel they lack negotiating leverage and their insurance companies are usually willing to provide the endorsement.

A few states have limited the use of Waiver of Subrogation in their workers’ compensation systems; some jurisdictions make such contract provisions unenforceable or allow employers to recover some proceeds from third-party suits.

In most states that allow waivers, contractors should work with professional insurance agents experienced in construction insurance to find appropriate coverage and to handle contractual issues such as waivers. If you're unsure how a provision affects your risk, talk to an agent.

Above all, contractors must read and understand their contracts so that these agreements do not become an ugly surprise after a loss.

Frequently Asked Questions

What is a waiver of subrogation endorsement?

It is an endorsement that prevents an insurer from seeking reimbursement from a third party who may have caused an employee’s injury when the employer is contractually required to waive that right.

Who typically pays for the endorsement?

The employer usually pays the additional premium for the endorsement, and the cost may be passed through in the contract or affect the employer’s future premiums.

Can an injured employee still sue the owner or general contractor?

Yes; the endorsement binds the insurer but does not prevent the employee from bringing a lawsuit against other parties.

Do all states allow waivers of subrogation?

No; some states restrict or prohibit waivers of subrogation in workers’ compensation contexts or limit their enforceability.

INSOMIS 909-878-0260 Website
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