What Is Workers' Compensation Insurance?

Workers' compensation insurance covers employees who suffer work-related injuries or illnesses. This type of insurance ensures that employees receive medical care, compensation for lost wages and rehabilitation services. Additionally, it offers employers financial protection by covering legal expenses if an employee sues for a work-related injury or illness.

Workers’ compensation insurance comes in two parts: employee benefits and employer liability.

Employee Benefits

Employee benefits cover medical expenses, lost wages, rehabilitation and death benefits for work-related injuries or illnesses. These benefits ensure that injured employees receive the care they need to recover and return to work.

The amount the insurer pays to cover these benefits is typically unlimited as long as the expenses are deemed necessary and reasonable by a medical professional. Some benefits, such as disability payments or vocational rehabilitation, may be limited in duration to prevent abuse.

Employer Liability

Employer liability covers legal expenses in the event of a lawsuit, including attorney fees, settlements and judgments. This aspect of workers’ compensation insurance provides financial protection in case an employee sues over an injury or illness.

However, employer liability coverage comes with limits, which employers choose when purchasing their policy. These limits ensure that employers have a predictable financial protection level while maintaining the affordability of insurance premiums.

Workers' compensation insurance premiums are paid for by the business or the owner. Unlike other forms of insurance, such as health insurance, there are no employee payroll deductions associated with workers’ compensation insurance.

While the cost of workers’ compensation insurance premiums can vary, having coverage protects workers and businesses from financial hardships in the event of a work-related injury or illness.

Workers’ compensation insurance is a type of business insurance that covers the health and welfare of workers who incur injuries on the job. Below is a breakdown of what it covers:

• Medical expenses: If an employee suffers from a work-related injury or illness and must go to a hospital to get treated or is confined, workers’ compensation insurance can pay for their medical expenses.
• Ongoing care and rehabilitation: If an employee requires ongoing care or rehabilitation after an injury or illness, workers' compensation insurance can cover the costs of these services.
• Income replacement: If an employee cannot work due to a work-related injury or illness, workers' compensation insurance can provide income replacement benefits to help cover their lost wages.
• Disability benefits: Workers' compensation insurance can also provide disability benefits if an employee cannot return to work due to a permanent disability.
• Funeral costs: In case of a fatal work-related accident, workers' compensation insurance can cover funeral costs to help ease the burden on the deceased worker’s family.

Workers' compensation insurance helps ensure employees are financially cared for and protects against costly legal battles that could threaten a business’s cash flow.

As with any insurance policy, workers' compensation has limitations. It does not cover all types of work-related injuries and illnesses. Generally, workers’ compensation insurance does not cover:

• The salary of a replacement employee
• Injuries or illnesses as a result of violating company policies
• Injuries or illnesses as a result of intoxication or use of illegal drugs
• Injuries or illnesses that occur after termination
• Injuries or illnesses that were caused intentionally (e.g., a physical altercation with another employee)
• Injuries or illnesses that occur on the drive to and from work

For instance, if an employee gets injured while under the influence of drugs or alcohol, they may not be covered by workers' compensation insurance. Similarly, if employees violate company policies and get injured, they may not be eligible for benefits.

Workers’ compensation insurance requirements vary from state to state. In most states, coverage is legally required for all employees. For instance, in Georgia, businesses with three or more employees must have workers’ compensation insurance. In Florida, non-construction companies with four or more employees need coverage, while construction businesses with at least one employee must have coverage.

Industries that typically require workers' compensation insurance include:

• Construction companies
• Manufacturing businesses
• Health care providers
• Retail businesses
• Restaurants and hospitality services
• Transportation and logistics companies
• Agricultural businesses
• Small businesses with any number of employees

Some employers are eligible for a workers’ compensation insurance exemption — but these exemptions can also differ by state. Specific worker categories, however, are exempt from needing workers’ compensation across multiple states. These include:

• Farmers or agricultural workers
• Domestic workers
• Independent contractors
• Federal employees
• Sole proprietors
• Partners
• Employees of religious organizations

The specific circumstances under which these worker categories qualify for an exemption from coverage will depend on the regulations in your state.

Employers must purchase workers' compensation insurance according to state regulations. In some states, you can buy it from private insurers like Nationwide or The Hartford. In states like North Dakota, Ohio, Washington and Wyoming, you must purchase insurance through the state fund.

Generally, if your business is located in a state where you can purchase coverage through a private insurer, then the process of getting workers' compensation insurance involves:

1. Checking your state's requirements: Each state has its own workers' compensation insurance requirements, so it's wise to research these before purchasing a policy.
2. Exploring insurance providers: Research different business insurance providers that offer workers' compensation insurance in your state. A good place to start is by asking other business owners for recommendations.
3. Comparing coverage options: Get quotes from different providers to compare premiums and coverages. Some providers allow you to get quotes online, while others may want you to call or visit a physical location.
4. Applying for a policy: Once you've chosen an insurance provider and policy that meets your needs and budget, apply for the policy. Many insurers allow you to apply online after getting a quote.

The amount you pay for workers’ compensation insurance will depend on a number of factors, including:

• The industry your business is in
• The type of work your employees do
• The number of employees you have
• The safety measures your business has in place (e.g., protocols, training and equipment)
• Your claims history

Workers’ compensation insurance costs an average of $168 per month or $1,948 annually. This is based on quotes for a software development LLC that has been in business for five years, with 20 employees, $5 million in annual revenue and $1,250,000 in annual payroll costs. This sample policy has a $1 million total policy limit, $1 million per accident limit and $1 million per employee limit.

A workers’ compensation settlement is the financial compensation paid to an employee who has sustained work-related injuries or illnesses. It can be used to pay off medical bills, rehabilitation costs or even death benefits.

Generally, once a claim has been approved, the provider will offer the injured employee a settlement amount as a lump sum or through a structured payment plan. Employees can either accept or negotiate the amount — if accepted, the employee waives any right to pursue legal action against the employer related to the injury or illness.