Many times an Injured Worker reports a work injury claim and their Employer is not responsive in providing them their Workers’ Comp Insurance information. Workers’ Compensation Insurance information is important because it is the Insurance Company that is responsible for authorizing and paying for medical care as well as paying workers’ compensation benefits such as total temporary disability benefits, permanent disability benefits, and medical mileage. Also, the Insurance Information will allow for the Claim to be opened in situations where the claim is initially not accepted. Once a claim is opened, the Insurance Company has a duty to investigate the claim. Also, they have the obligation to provide up to $10,000.00 of medical care during the investigation period. Failure to obtain and notify the Insurance Company will most likely cause a delay in the acceptance of the claim and the provision of benefits.
The Different California Workers’ Compensation Insurance Categories
In Workers’ Compensation, Employers’ Insurance exists in three ways. Further, the State of California has a Fund to deal with employers who do not have insurance. The three categories of coverage are:
- Self-Insured and
- Legally Uninsured
When your Employer or Company has no insurance coverage, an Employer is considered to be “Illegally Uninsured”.
First, there is regular insurance. If you need to find out to see if your employer has regular insurance, you can find it using a search engine online. In the State of California, there is the Workers’ Compensation Insurance Rating Bureau (WCIRB) which collects workers’ compensation insurance coverage information to assist injured workers, insurers and others identify which insurer wrote a workers’ compensation policy for a specific company. The WCIRB makes this information available to injured workers via it’s website. If you would like to find out your employer’s carrier information, here is the link https://www.caworkcompcoverage.com/Disclaimer.aspx. When you are doing the search, it is very important to know your Employer’s correct name. I would recommend starting with your paycheck to see who is listed on it. For example, you might work for a McDonalds. Your store, however, might be a franchise and not.
Second, there is self-insurance. The State of California allows for self-insurance through an Office of Self Insurance program. This program is operated through the Department of Industrial Relations. The Office of Self Insured Program keeps a list of employers who are self-insured. Here is a link to the rosters of the self-insured employers. http://www.dir.ca.gov/osip/pubandforms.htm. Further, Small and Medium-sized Businesses have the option of joining with others in the same industry to self-insure their workers’ compensation liability as a group. Self-Insured Employers can administrate their claims “in house” or refer them out to a Third Party Administrator. They are also known as a TPAs. TPAs are companies that self-insured employers contract with to administer the claims administration process.
Third, there are entities which are Legally Uninsured. Such entities are very few. One of them is the State of California.
Fourth, there are employers who are “illegally uninsured.” In those circumstances, the illegally uninsured employer may handle and pay for the workers’ compensation claim. If they do not cooperate, the Injured Worker can submit their claim to the State of California which has it has the Uninsured Employers Benefits Trust Fund (UEBTF) which is a special fund used to pay the claims of employees who get injured or become ill while working for an illegally uninsured employer. In order for an Injured Worker to get the UEBTF involved, the UEBTF must be “joined” as a party. There are special forms, notice, and service requirements necessary to have the UEBTF joined as part of the case. It is strongly recommended that you seek the services of an attorney to do so.
What do I do after I reported the injury and my Employer did not give me the Insurance Information?
I recommend that you go do the WCIRB website to see if there is Insurance. The following is the link. https://www.caworkcompcoverage.com/Disclaimer.aspx. If there is no coverage, then you should investigate to see if your Employer is Self-Insured. You can use the following link to check to see if your Employer is Self-Insured. http://www.dir.ca.gov/osip/pubandforms.htm. If you are unsuccessful in finding the information, it is likely that your employer was not insured. In that circumstance, you need to consult an attorney who handles Uninsured Employers cases.
With more than 23 years of expertise in defending workers’ rights, the Law Offices of Edward J. Singer, A Professional Law Corporation, is here to assist. If you have any questions concerning your rights, please do not hesitate to contact our offices. Please contact us today concerning any workers’ compensation questions or issues.