Workers’ Compensation vs Health Insurance
Are Employers Required to Carry Workers’ Compensation for Workplace Injuries?
If you are injured on the job, and have workers’ compensation coverage, you should immediately report your injury to your supervisor. Your supervisor can direct you in seeking care.
If you are not covered by workers’ compensation insurance, your personal medical insurance carrier will pay for workplace injuries. In the latter case, your personal medical insurance carrier may be entitled to recover any amounts paid from entities liable by state or federal workers’ compensation law, employer liability, or occupational disease laws.
What happens if you are injured, and do not have time to coordinate your care through workers’ compensation? Will private health insurance pay for a workplace injury? The short answer is yes. If you are injured while working, and seek care, the healthcare provider is going to ask for your insurance information. If you have not coordinated your care through your employer’s workers’ compensation insurer, and you provide your personal health insurance information, the claim will be processed through your health insurance, and not your workers’ compensation benefit. Once your medical insurance company receives the claim, and it’s identified as care resulting from a workplace injury, you may be contacted and required to provide more information before the claim payment is approved. This is called Coordination Of Benefits. Coordination Of Benefits is a time-consuming process and delays provider payments.
Best practice is to understand your coverage and procedures for reporting and seeking care before an injury occurs, so that you have properly disclosed to your providers the responsible payer.
Notes:
Please see Employer Coverage Requirements as published on tn.gov (1/12/23).
- All employers in the construction business or trades (construction service providers) that have one or more employees (unless they are specifically exempted).
- Effective March 1, 2011, owners of construction businesses are also required to carry workers’ compensation coverage on themselves or be listed on the Exemption Registry.
- Employers in the coal mining industry must secure coverage if they have one employee.
- Every other employer in the state of Tennessee that has five or more employees must secure workers’ compensation insurance coverage for their employee.