What’s NOT Covered by Workers Comp Insurance?

Most people think that workers’ compensation insurance will cover all work-related injuries or illnesses. However, there are actually several things that workers’ compensation insurance does not cover.

If you’re not careful, you could end up being out of pocket for medical expenses and other costs. Please read our article to learn about the many things that workers’ compensation insurance doesn’t cover. This information could help you make more informed decisions about your coverage.

But before we proceed with the list, let’s first discuss what workers’ compensation insurance is.

The Coverage of Worker Compensation Insurance

Workers’ comp insurance is a vital part of any business. It could help cover the costs of medical expenses and lost wages if an employee gets an injury on the job.

This kind of insurance is mandatory in most states, meaning that employers must provide coverage for their employees. This ensures that employees have some financial protection if they cannot work because of the injury.

The coverage provided by workers’ compensation insurance are usually:

• Medical expenses: This includes the costs of hospitalization, surgery, and other medical treatment. It can also cover the costs of prescription drugs and rehabilitation.
• Income replacement: If you’re unable to work because of your injury or illness, workers’ compensation insurance can provide you with a portion of your lost wages.
• Death benefits: If an employee dies as a result of a work-related injury or illness, their family can receive death benefits from the workers compensation insurance policy.

Now that we have briefly discussed what workers’ compensation insurance is, let’s take a look at some of the things that it does not cover.

What Does Workers Compensation Insurance Not Cover?

Travel to/from work

If you get an injury while travelling to or from work, your workers’ compensation insurance will not cover you. This includes injuries that occur while you are on your way to a work-related event, such as a conference or training course.

This is because workers’ compensation insurance only covers injuries while you are at work. So, if you’re injured while commuting to or from work, the insurance will not cover it.

Intoxication

If you’re hurt while intoxicated, your claim is unlikely to be successful. This is because intoxication is considered voluntary and not covered by insurance. This includes injuries that occur while an employee is under the influence of drugs or alcohol or when they are hungover.

Horseplay

Employees injured while engaging in horseplay will not be covered under a workers’ compensation insurance policy. This includes injuries that occur while employees play pranks on each other or engage in other types of playful behaviour.

However, there is an exception to this rule if the employee is not directly participating in the horseplay. For example, if an employee gets an injury while watching someone else engage in horseplay, the insurance will cover it.

Intentional acts

If an employee injures themselves on purpose, their workers’ compensation insurance will not cover them. This includes injuries that occur as a result of suicide attempts or self-harm.

Illegal activities

Workers’ comp insurance will not cover someone harmed while engaging in illicit behaviour. This includes injuries that occur while an employee is committing a crime or participating in illegal activity, such as drug use.

Policy violations

If you get hurt on the job, and it’s your fault because you violated company policy, you generally can’t collect workers’ compensation. That’s because these injuries are considered self-inflicted, and most policies will not cover them.

For example, let’s say you’re a construction worker supposed to wear a hard hat while working on the job. If you don’t wear one and get hurt, your injury likely won’t be covered by workers’ compensation.

Terminated employees

If you’re an employee and got an injury after your employer terminated your contract, your workers’ comp insurance will not cover you. This is because most policies do not provide coverage for employees who no longer work for the company.

There are a few exceptions to this rule, such as being terminated due to an injury or illness that occurred on the job. In that case, you may still be eligible for workers’ compensation benefits.

Work from home

Workers’ compensation insurance may not cover you if you get hurt while working from home. This is because most policies only provide coverage for injuries that occur while you are at your place of work.

However, there are a few exceptions to this rule. For example, you may be covered by the insurance if you get an injury while working from home as part of your regular job duties at your work.

Conclusion

As you can see, there are several things workers’ comp insurance does not cover, but these are reasonable exceptions. The most important thing is that if you get an injury while at work, you should always report it to your employer to help you get the coverage and treatment you need.

In most cases, workers compensation insurance will cover you if you are hurt while working. Just read your policy carefully to understand what is and isn’t covered. And if you have any questions, don’t hesitate to speak with an insurance representative.