Oh My Back! Limits & Benefits Mods, Rates & Dates Oh My! EL Adventures What should I call this category?
100
What is Compensable Injury
A contractor drops a 2x4 on their leg injuring their knee
100
What is Disfigurement Benefit
All states have some form of this benefit
100
What is an Experience Modification (Ex Mod)
A provision of adjustment recognizing the pros and cons of an insured's loss history and risk
100
What is Exclusive Remedy
WC is considered a no-fault coverage and is based on this doctrine
100
What are Covered locations/states
Item 1 and 3A
200
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.
200
What are Disability, Medical, Rehabilitation and Survival
Name the key benefits under WC policy
200
What is remuneration
Salary, wages, commissions, bonuses, non-cash compensation, vacation pay, and sick leave pay
200
What are exceptions to Exclusive Remedy doctrine
Injuries not covered by WC, Third Party Over, Dual Capacity, Loss of Consortium or Consequential BI Claims
200
What is All states except those listed in 3A and OH, ND, WA, WY
3.C. CYA
300
What is Accidental Injury
The injured person point of view is what matters here
300
What are Medical Benefits
A benefit not subject to a limit or time period
300
What is 3 Years
Number of years of payroll & loss information included in an ex-mod calculation
300
What is Negligence
Employers Liability is based on the legal premise
300
What is Incurred but not yet reported
IBNR
400
What is USLH
An insured's employees who work on a boat or within 50 feet of the water are excluded because of this
400
What are disability benefits
Subject to schedule, weekly vs lump sum, temporary vs permanent, and partial vs total
400
What is the NCCI Unit Statistical Plan
This does not apply when a state has it's own Unit Statistical Plan
400
What are Assumption of Risk, Contributory Negligence and Negligence of a Fellow Employee
Three key employer defenses for EL claims
400
What are expenses that are included/reported as loss
Physical rehabilitation costs, testing fees for vocational rehabilitation purposes, legal court expenses
500
What are employees subject to Federal Workers Compensation Laws, Federal Occupational Disease Laws, and Non-Occupational Disability Laws.
Not included under an unendorsed policy
500
What are BI by Disease Each Employee, BI by Disease Policy Limit (aka Aggregate), BI by Accident - Each Accident
EL Limits of Liability
500
What is 18 months after the inception off the policy
First valuation of claims for inclusion in the ex-mod calculation
500
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.
500
What are individual case, tabular and average value.
Key ways to reserve a claim






Workers Compensation - Employers Liability

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