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Who is Responsible for Managing Workers’ Compensation Insurance?

Even if an employer has an effective safety program in place, workers still get injured on the job, especially in the construction industry.  Workers’ compensation is designed to provide a no-fault protection for employee injuries and help employers avoid lawsuits.

When an employee is injured at work, he or she will either immediately return to work or go through the lengthy process to obtain workers’ compensation benefits.  Workers’ compensation benefits include payments for medical expenses and lost income.  Under New York state law, employers are required to purchase workers’ compensation insurance to protect employees.

Claims management is usually associated with insurance companies, the medical provider and so on.  However, employers are also involved in the management of workers’ compensation claims.  Employers are responsible for providing a safe working environment and taking certain measures to minimize the risk of injuries among workers.  The employer should have steps in place to help employees who have been injured, by providing assistance with the complex workers’ compensation medical system.  The attitude of the employer regarding the injuries can make a serious impact on claims management.

Insurance agents also play a role in the effectiveness of claims management.  For example, insurance agents who sell the workers’ compensation insurance to employers are often involved initially, but fail to follow through with future assistance.  Insurance agents sometimes fail to control the annual premium audit and do not monitor workers’ compensation claims, which include the status, reserves and subrogation.

Employees are usually the ones who suffer when it comes to workers’ compensation.  It is not uncommon for a workers’ comp claim to be denied, even if there is a legitimate injury or illness related to the work performed.  Workers’ compensation benefits are paid by the employer’s insurance company and the insurer will look for ways to deny the workers’ compensation claim.

If you have been injured while working on a construction site or other location, you have legal rights.  You can file a workers’ compensation claim to obtain the money necessary to cover your medical expenses and lost wages.  Do not be surprised though, if your workers’ compensation claim is denied.  In the situation of a workers’ compensation claim denial, contact Markhoff & Mittman, P.C. at 866-205-2415 for expert legal advice.   We have been helping injured workers obtain benefits for several decades, as we are one of the oldest New York disability firms in New York.