VOLUNTEER EXPOSURE AND WORKERS’ COMPENSATION
an employee for the purpose of workers’ compensation benefits.
DOES THE VOLUNTARY COMPENSATION AND EMPLOYERS LIABILITY COVERAGE ENDORSEMENT COVER VOLUNTEERS? To qualify for coverage under the Voluntary Compensation endorsement, a worker must be an excluded employee as defined by each state’ s WC law. As the name suggests, it is a coverage employers provide voluntarily and they choose to do it as a hedge against lawsuits by uninsured workers. For instance, most states exempt domestic workers, agricultural and farm workers, casual labor, and seasonal workers from benefits under the WC law, but they still define them as employees. This endorsement is intended to provide WC benefits for these exempt employees.
From a claims handling perspective, the amount of work that is needed to determine the compensability of a claim for a volunteer under an insured’ s WC policy is significant. The adjuster will need to determine whether or not a volunteer in a given state can be considered an employee under that state’ s WC statute and is, therefore, eligible for coverage under WC, or if he or she is excluded from coverage. In addition, for volunteers who also have a job where they are eligible for WC benefits, the carrier could also be liable for those wages( up to the maximum weekly WC rate) and be required to return the volunteer to work at his or her primary job. In addition, any claim paid for an injured volunteer will affect the insured’ s experience modification.
An Accident and Health policy is a simple way to provide volunteers with added protection to meet their individual needs without increasing benefit costs. It can complement existing medical coverage and help narrow financial gaps in coverage caused by out-of-pocket expenses, such as deductibles, co-payments, and non-covered medical services. These policies usually pay the costs of emergency room services and follow-up treatment to predetermined limits based upon the type of injury. Accident and health policies will also cover volunteers as they commute between their homes and places of service, a benefit not typically found in general liability or WC policies.
Additional accident and health benefits include partial or total disability benefits and critical care benefits. These policies are often excess insurance, meaning that they pay only after other available insurance( generally the volunteer’ s personal health insurance) is exhausted. If the volunteer is uninsured, the accident and injury policy would“ drop down” and become primary coverage for the injury. Please keep in mind that accident and health insurance coverage varies by carrier and must be reviewed carefully. +
Volunteer Exposure & Workers’ Compensation
BY: LARRY WICKS, CPCU, WORKERS’ COMPENSATION CLAIMS ADVOCATE, SPECTRUM INSURANCE GROUP
FALL 2016 | 31