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The Role of Insurance Companies in Workers’ Compensation

New Jersey law specifically requires that businesses carry workers compensation insurance. In addition to being required by law, a number of contractors, clients, customers, and partners will require a business to show proof of workers’ compensation before entering a contract or building a relationship. However, from an employee’s perspective the role of an insurance provider in workers’ compensation can be slightly mysterious.

Typical Workers’ Compensation Process from Employee Perspective

In most instances, when an employee is injured or falls ill at work he or she informs a manger or designated HR employee at the workplace. After this initial discussion and medical assessment of an injury, the process in New Jersey can progress without much interface with an injured employee. Unless there is dispute around the injury, employees likely have conversations with an HR manager and insurance representative, attend doctors’ visits, and within a short period of time begin receiving benefits.

Good employers will ensure that the steps to receive workers’ compensation benefits are seamless and smooth, which can leave an employee wondering why it is essential for their employer to carry this mandated insurance policy and what role the insurance company played in the process.

Why Workers’ Compensation Insurance Is Mandatory

Requiring that employers carry specific insurance for workers’ compensation ensures that employees are protected from legal or financial difficulties after an injury at work. It is the safeguard that an injured employee will receive adequate benefits. This is important because employees need a replacement income or partial replacement of income for the time period he or she cannot work after injury. As well, these benefits allow employees to seek all necessary medical care and prevent complications or worsening health repercussions.

For these reasons, employers that fail to procure workers’ compensation insurance, or do not qualify for the two exceptions in New Jersey, are subjected to harsh fines. If an injury occurs while an employer is uninsured, the employer is liable for the full amount of benefits entitled to such employee.

Actions of Insurance Companies After Employee Injury

After an injury, an employer will immediately notify their insurance provider. The insurance company will investigate the injury, including an initial conversation with the injured employee and receipt of any medical documentation or evidence. Then, the insurance company evaluates the workers’ compensation claim.
It is possible that insurance companies will partially or fully deny workers’ compensation benefits. In the past, insurance companies have been particular adverse to claims that involve an extensive or long-term injury, as these claims involve permanent disability or extensive medical care.

However, it is ultimately the role of the insurance company to ensure an employee receives benefits and compensation for medical costs. This includes the cost of hospital care, doctors’ visits, rehabilitation, and disability benefits.

Speak with a New Jersey Lawyer

Many of the processes and procedures for workers’ compensation are specific to the State of New Jersey. This includes insurance requirements and the exact role insurance providers play in providing workers’ compensation benefits to an injured employee.

Therefore, if you were injured at the workplace and have questions regarding insurance or conversations with your employer, you need a New Jersey lawyer to discuss your case. Albert J. Talone Esq.’s practice is dedicated to workers’ compensation claims and ensuring employees receive the benefits they deserve. Call our office at (856) 234-4023 to schedule a consultation.

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The Law Office Of Albert J. Talone
The Law Office Of Albert J. Talone is committed to providing for those with Workers Compensation cases throughout New Jersey.
302 N Washington Ave #101
New Jersey
United States

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