Oh My Back! | Limits & Benefits | Mods, Rates & Dates Oh My! | EL Adventures | What should I call this category? |
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What is Compensable Injury
A contractor drops a 2x4 on their leg injuring their knee
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What is Disfigurement Benefit
All states have some form of this benefit
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What is an Experience Modification (Ex Mod)
A provision of adjustment recognizing the pros and cons of an insured's loss history and risk
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What is Exclusive Remedy
WC is considered a no-fault coverage and is based on this doctrine
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What are Covered locations/states
Item 1 and 3A
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What is Non-Occupational Disease
An employee claims his/her role causes him/her much anxiety and limits their ability to work. A stress claim has been submitted.
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What are Disability, Medical, Rehabilitation and Survival
Name the key benefits under WC policy
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What is remuneration
Salary, wages, commissions, bonuses, non-cash compensation, vacation pay, and sick leave pay
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What are exceptions to Exclusive Remedy doctrine
Injuries not covered by WC, Third Party Over, Dual Capacity, Loss of Consortium or Consequential BI Claims
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What is All states except those listed in 3A and OH, ND, WA, WY
3.C. CYA
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What is Accidental Injury
The injured person point of view is what matters here
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What are Medical Benefits
A benefit not subject to a limit or time period
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What is 3 Years
Number of years of payroll & loss information included in an ex-mod calculation
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What is Negligence
Employers Liability is based on the legal premise
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What is Incurred but not yet reported
IBNR
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What is USLH
An insured's employees who work on a boat or within 50 feet of the water are excluded because of this
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What are disability benefits
Subject to schedule, weekly vs lump sum, temporary vs permanent, and partial vs total
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What is the NCCI Unit Statistical Plan
This does not apply when a state has it's own Unit Statistical Plan
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What are Assumption of Risk, Contributory Negligence and Negligence of a Fellow Employee
Three key employer defenses for EL claims
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What are expenses that are included/reported as loss
Physical rehabilitation costs, testing fees for vocational rehabilitation purposes, legal court expenses
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What are employees subject to Federal Workers Compensation Laws, Federal Occupational Disease Laws, and Non-Occupational Disability Laws.
Not included under an unendorsed policy
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What are BI by Disease Each Employee, BI by Disease Policy Limit (aka Aggregate), BI by Accident - Each Accident
EL Limits of Liability
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What is 18 months after the inception off the policy
First valuation of claims for inclusion in the ex-mod calculation
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What is Third Party Over Claim.
Your employee is injured and sues the property management firm for your building. The Property Management company sues you in term alleging you failed to up keep the premise per your lease agreement.
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What are individual case, tabular and average value.
Key ways to reserve a claim
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