Medical Insurance Being Used Instead of Workers Comp Insurance
My question involves labor and employment law for the state of: Illinois
Background. -State Illinois, non-union employer, mechanical environment, approx 100 workers.
Medical insurance being used for work related injuries. Is this “legal”?
Insurance company will not / cannot address this apparently due to privacy laws. Each year medical premiums increase by at least 50% due to higher risk. How can this matter be addressed? Employees are not united.
Re: Medical Insurance Being Used Instead of Workers Comp Insurance
Why is this happening? Does the employer not have workers comp insurance? Is the employer not submitting claims to the carrier? Are the employees not reporting claims? Are claims being denied by workers comp and then submitted to the medical insurance? More information is needed.
Re: Medical Insurance Being Used Instead of Workers Comp Insurance
They do have work comp insurance. The incidents are being reported as work related, yet the they choose to deal with it under medical insurance because it keeps their work comp premiums down....They made comment that the last "claim" filed in 2001 , that person did not last "very long"...
Re: Medical Insurance Being Used Instead of Workers Comp Insurance
So, they are making the employees use their OWN insurance for job-related injuries?
Re: Medical Insurance Being Used Instead of Workers Comp Insurance
Just for clarification of what Patty is asking; is the medical insurance that the claims are being put through, sponsored by the employer? Or are the employees required to buy their own insurance completely separate from the employment?
Re: Medical Insurance Being Used Instead of Workers Comp Insurance
There contribution is approx 50 % of the premiums
Re: Medical Insurance Being Used Instead of Workers Comp Insurance
Not what was asked, but I am assuming your answer means that the medical insurance that is being used is group medical insurance that is offered by the employer?
What happens if there is an injury to an employee who was waived the insurance?
Re: Medical Insurance Being Used Instead of Workers Comp Insurance
The company has a group policy. They would pay for the treatment and then claim pay under a short term disability policy that they pay for.
Re: Medical Insurance Being Used Instead of Workers Comp Insurance
This does not make sense. A group medical policy covers employees (and their dependents, if available and elected) and the employee must submit the claim to the insurance company for reimbursement (unless it's an HMO).
"They" who pays for the treatment? The employer or the insurance company upon request for reimbursement from the employee?
A short-term disability policy pays lost WAGES; it does NOT pay for medical treatment.
(pulling teeth here :wallbang: )
Re: Medical Insurance Being Used Instead of Workers Comp Insurance
The company picks up all of the out of pocket expenses after the group insunce has paid there portion. "They", is the company. If someone is injured that is not in the group the company pays for the treatment and claims loss of wages under their short term disability policy. The point being, this causes prmiums to go up each year at least 50 % for our portion, and if this policy is not followed then there is victimisation etc and of course the most obvious, lack of "work comp" benifits and protection , litigation etc and has led to additional medical problems for the same work related issue down the road that they then "fight". I thought that a person was supposed to be protected by the work comp laws ?