Reporting workers’ compensation claims

Workers’ comp insurance is a required coverage for businesses with at least one employee in most states. While it might be something your clients need, it’s probably not coverage they’re eager to use. In fact, filing a workers’ comp claim can sometimes be intimidating and even scary, especially for small businesses. 

Regardless, it’s important that your clients report any and all workplace injuries and file workers’ comp claims as soon as possible. As an insurance agent, you can make the experience easier for your clients by supporting them each step of the way. This support can begin long before any claim needs to be filed. Start by emphasizing to your business clients just how important it is for them to report workplace accidents and file workers’ comp claims immediately.

When should you file a workers’ comp claim?

Business owners should file a workers’ compensation insurance claim as soon as possible after an incident occurs. Each state has different deadlines for an employee to report a workplace accident to the employer, along with deadlines for the employer to file a claim. Even when these deadlines aren’t imminent, it’s always better to file your claim as soon as possible to get ahead of any negative consequences. 

Sometimes, an employer or employee delays filing a workers’ compensation claim for a variety of reasons. An employer may question whether the injury is truly work-related, or hope that if an injury is minor, it’ll just go away without needing treatment. An employee may fear embarrassment or blame for a workplace accident, feel their condition doesn’t warrant treatment, or worry about how filing a claim will impact their future at their job. 

None of these reasons should delay filing a workers’ comp claim in the event of a workplace-related accident, illness, or injury. It’s essential to make sure that your clients understand the importance of filing quickly.

Why file a workers’ compensation claim quickly?

Not only is it legally required in many states and in some cases by the Occupational Safety and Health Administration (OSHA), but filing your workers’ comp claim quickly can have other benefits for both employers and employees. 

The advantages of filing a workers’ comp claim quickly include: 

  • Filing a claim 29 days or more after the incident makes it 152% more likely to be litigated
  • The ability to impact the medical care of the injured worker, for example, sending them for treatment at a facility that will help control costs
  • A better chance at a quick recovery, resulting in less lost work and less medical expenses, with quick treatment and fewer complications 
  • Fostering employee trust and confidence in the employer to do the right thing

These are just a few of the many reasons it’s in your clients’ best interest to file workers’ comp claims quickly.

Who can file a workers’ compensation claim?

Either the employer or the injured employee can file a workers’ compensation claim. As an insurance agent, you can assist your client (and/or their employee) in navigating the claims process, but you can’t file a claim on their behalf.

What happens if an employer fails to quickly file a workers’ comp claim?

Delaying the filing of a workers’ comp claim has several negative consequences for both employers and employees. These can be financial, legal, or reputational costs for employers and worse health outcomes for employees.

Delayed workers’ comp claims filing can result in higher claims costs

When injured employees avoid filing a claim, they may not receive proper treatment as soon as they need it. This can worsen their condition, require more advanced (and expensive) treatment later, and lead to more time off work to recover. 

Without an immediate claim, employers may lose the ability to influence the employee’s care—for example, directing them to an in-network provider or assigning a nurse case manager to supervise treatment and costs. 

All of this means higher claims costs and likely an increase to your clients’ workers’ comp premiums in the future.

It’s harder for insurance carriers to investigate delayed workers’ comp claims

Sometimes, workers’ comp claims get denied by the insurance carrier because an investigation concludes the incident doesn’t qualify for coverage. This is a necessary part of the process to ensure only valid workers’ comp claims are paid out. 

Unfortunately, the more time that goes by without filing a claim, the greater the chances are that evidence will be lost and the insurance carrier won’t be able to deny a claim. For example, when too much time has passed, it may become impossible to prove an employee was under the influence of drugs or alcohol which would have invalidated their claim. 

Some states even have cutoffs after which a claim may not be denied. It’s in your clients’ best interest to file their claims immediately to allow for a proper investigation.

There may be financial penalties for failure to report a workers’ comp claim promptly

Many states, as well as OSHA, have financial penalties for failing to file a claim promptly. Waiting too long to file a claim can have steep financial implications beyond those associated with the increased cost of care.

Employee morale can be damaged when an employer delays filing a workers’ comp claim

Your clients know how quickly news travels at their companies. If an injured employee doesn’t get help from the workers’ compensation policy and begins to incur out-of-pocket expenses or medical complications, employee morale and trust in the business suffer. 

This can also impact other employees who have to pick up extra work to cover for the injured employee. If the case isn’t being dealt with properly and quickly, it can negatively impact the workplace culture.

Delaying a workers’ comp claim can lead to more accidents

A large part of the workers’ comp claims process is an investigation of the incident. Oftentimes, issues can be uncovered that once fixed, will prevent future accidents from happening. Delaying to file a claim, or simply not filing one at all, prevents this type of investigation from happening and can leave the door open for additional preventable accidents. If another employee is hurt, this can cost a company more in the long term.

How can you help your clients report workers’ comp claims quickly?

As an insurance agent, you can help make sure your clients don’t suffer the negative consequences that come along with delayed filing, or non-filing, of a workers’ comp claim. Here are a few concrete steps you can take: 

  • Educate your clients on the importance of reporting all workers’ comp claims promptly, as well as the negative consequences of not doing so. 
  • Provide resources for clients to give to their managers to help ensure employee accidents and injuries are reported quickly. 
  • Talk to your clients about the importance of communicating to their workforce that no punishment or retaliation will come from reporting accidents. 
  • Help your clients understand and communicate to employees that they should report all injuries regardless of severity. 

If your clients take these steps, they can avoid the more serious negative consequences of delaying or failing to file a workers’ compensation insurance claim.

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