FAQ

FAQS About Workers Compensation – Good to Know!

Q: How are my premiums determined?
A: Premiums are derived by a few different factors that include annual payrolls, job classifications, and a numerical modifier called an “Experience Modification Factor” or an (ex-mod), it is much like a credit score it’s calculated by your “loss history”. A loss history includes the total incurred costs for the claims in a policy period.

Q: Are all work related injuries workers comp claims?
A: No. If a work related injury occurs resulting in only the need for first aid, such as a band aid, or a one trip visit to the Dr.’s office, there is no need to report this to the insurance company nor do you give the injured a DWC-1 claim form.

Q: Are Ex-Mod’s always correct?
A: No. It is estimated that approximately 20% of ex-mods contain an error.

Q: Do all of the claims filed against my policy affect my ex-mod?
A: No. “take-nothings” which are proven “claim denials” that have incurred costs but have been determined by a judge to be non-compensable are not included in unit stat reports. (Unit stat reports are reported to the state who then calculates your ex-mod).

Q: What are the exceptions to work injuries being workers comp claims?
A: These are the employer’s exceptions to compensation:
intentionally self inflicted, or if the injured is the initial aggressor in an altercation,
or if the injury results while committing a felony for which he is convicted, if injury results from a non-condoned recreational activity, alcohol intoxication or a controlled substance – although difficult to apply.

Q: How long can a claimant receive temporary disability benefits?
A: There is now 104 week cap or two years total, with very strict exceptions.