North Carolina Worker's Compensation - Help For Injured North Carolina Workers

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  1. #1
    Join Date
    May 2011
    Posts
    25

    Default Accident Policy and Workers Comp

    I have a supplemental accident policy I bought at work and it covers "at work and home". I am involved in a WC claim at work and my HR guy called me and said they had forgotten about this policy. He mailed me a claim form and said "they will owe you some money" for your accident. Is this normal to have a policy that pays even if WC is paying the medical bills? It clearly states at work and home on the paper work. Just curious if anyone has ever ran into this?

    Thanks!

  2. #2
    Join Date
    Aug 2011
    Location
    Georgia
    Posts
    800

    Default Re: Accident Policy and Workers Comp

    I'm hoping that "complwyr", a member here will reply to you. He's actually a WC atty in your State.

    I'm not versed in NC law, and won't profess to be. I am, however, fairly certain that you could not collect insurance benefits from two sources for the same injury (double-dipping) without some form of subrogation for the WC carrier to recover monies paid from your private carrier. This may be an attempt by the ER to lessen the impact of your claim on their carrier so as to prevent their rates from being increased. I'd be very careful about submitting a claim form for private insurance to cover a work-related injury without consulting an attorney.

  3. #3
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,017

    Default Re: Accident Policy and Workers Comp

    Does the 'at work or home" policy you purchased include wage loss, as well as medical?
    You should make the application...there may be max/min amounts of coverage... specifically to wage loss I'm thinking...if thats the case, you would be eligible for some cash benefits... that policy will still be second to the WC coverage.

    WC is about your ER's liability for work injury, medical, wage loss etc... any other policy, or SSA benefits you may be eligible for would always be second to the WC coverage. You still are subject to the max rate, but IE comp pays 2/3's of your average weekly wage, the policy you bought may pay 80%, you be paid the difference..sometimes that can be significant depending on your numbers.

  4. #4
    Join Date
    Aug 2011
    Location
    Georgia
    Posts
    800

    Default Re: Accident Policy and Workers Comp

    Quote Quoting BvIA View Post
    Does the 'at work or home" policy you purchased include wage loss, as well as medical?
    You should make the application...there may be max/min amounts of coverage... specifically to wage loss I'm thinking...if thats the case, you would be eligible for some cash benefits... that policy will still be second to the WC coverage.

    WC is about your ER's liability for work injury, medical, wage loss etc... any other policy, or SSA benefits you may be eligible for would always be second to the WC coverage. You still are subject to the max rate, but IE comp pays 2/3's of your average weekly wage, the policy you bought may pay 80%, you be paid the difference..sometimes that can be significant depending on your numbers.
    While I somewhat agree with this, I'd still suggest that the IW consult legal counsel to make sure the ER isn't trying to pull a fast one.

  5. #5
    Join Date
    Jun 2011
    Posts
    208

    Default Re: Accident Policy and Workers Comp

    sounds something like AFLAC which some guys at work used to help with bills. I dropped mine stupid me. It helps with loss of income even when work related.

  6. #6
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,017

    Default Re: Accident Policy and Workers Comp

    Consultation is always good... but unless this ER is self insured... then don't make any decisions in the claim...once the ER files a claim wth their WC carrier... the IC assignes a CA, and the ER is out. (for all intent and purpose)
    This poster has purchased sepreate disability coverage... and is entitled to any benefits due. The IC will however always be second to the ER/IC subject to the statutory min'/max and the policy EOC'/Evidence Of Coverage.

    The underlying process here is... IW's cannot make more money being disabled then as if they were working. Double dipping comes to mind...

  7. #7
    Join Date
    Aug 2011
    Location
    Georgia
    Posts
    800

    Default Re: Accident Policy and Workers Comp

    I'm guessing what the poster may have then is some type of "gap" insurance (as puppy said AFLAC). I would still err on the side of caution.

  8. #8
    Join Date
    Feb 2007
    Location
    Charlotte, NC
    Posts
    3,008

    Default Re: Accident Policy and Workers Comp

    IF you paid the premium on the policy and can get additional disability benefits, then the comp carrier and employer will not be able to assert a credit or subrogation against it in NC. But without actually seeing the policy, it is not possible to tell you much more. I don't think there is any harm in investigating it as it may pay you some additional benefits.
    The North Carolina Court of Appeals has held that "In contested Workers' Compensation cases today, access to competent legal counsel is a virtual necessity." Church v. Baxter Travenol Labs, Inc., and American Motorists Insurance Company, 104 N.C. App. 411, 416 (1991).

    Bob Bollinger, Attorney at Law

  9. #9
    Join Date
    Aug 2011
    Location
    Georgia
    Posts
    800

    Default Re: Accident Policy and Workers Comp

    Therein lies the necessity of using legal counsel to fully examine the situation to make sure you're making the right move.

  10. #10
    Join Date
    Jan 2010
    Location
    Pennsylvania
    Posts
    609

    Default Re: Accident Policy and Workers Comp

    Unless AFLAC has another kind of disability coverage that you can buy, it doesn't cover work related injuries. I know, I had the AFLAC disability coverage and was sent a letter by AFLAC stating that basically, in no way shape or form can they pay me benefits, they do not nor do they ever intend to cover work related injuries. I still have the letter within my WC file that I keep.

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