What Kind of Coverage Does Your Employer Have For Work Injuries?

Suffering an injury at work has numerous consequences! And, without sound legal advice, you’re putting your future at risk! Who pays your wages and the doctors’ bills? What if you have to live with this injury for the rest of your life?

In Texas, coverage for work injuries depends on Employer status: Are they a Texas Non-Subscriber? Are they Texas Self-Insured?Do they have Texas Worker’s Compensation?Or, are they UNINSURED?

Texas Work Injury Attorney Hector Sandoval represents injured workers employed by Texas Non-Subscriber Companies. A Texas Non-Subscriber Employer is a company that does not subscribe or carry TEXAS WORKERS’ COMPENSATION INSURANCE. An injured worker needs to be diligent in determining the status of his employer as a Worker’s carrier or a Non-Subscriber. You can count on the employer, the insurance companies and even the treating physicians to refer to it as “Worker’s Comp” and even fill out the Department of Worker’s Compensation forms from the Department of Insurance. That’s because the difference only really matters to the injured employee but, be certain that Texas Non-Subscriber insurance is not the same of Worker’s comp nor is it a replacement for it. In fact, the rights you have under each type of coverage are very different.

In Texas, employers ARE NOT REQUIRED to carry insurance that covers injuries to their employees. This means that not all companies have Texas Worker’s Compensation Insurance. Some companies do carry commercial liability insurance that covers any personal injury or property damage that that company’s employees may cause to third parties while they are operating their business but, this type of insurance does not cover INJURIES TO THAT COMPANY’S OWN EMPLOYEES. For this reason, there is often confusion about whether injured workers are receiving the benefits they deserve.

If you are injured on the job, you may be facing one of the following scenarios:

  • Your Employer has NO INSURANCE at all! Generally, this means if you get injured because of your employer’s negligence, you could only sue him or the company directly and recover from what assets your employer or the company may have, depending on how the business is set up with the State;
  • Your Employer only has a General Commercial Liability Policy! This type of policy does not provide coverage for injuries to employees or contractors of that company;
  • Your Employer is a Texas Workers’ Compensation Subscriber and has insurance to cover injuries to employees. This means you will be covered but, the Workers’ Compensation rules are very specific, and you may need help making sure you get the right treatment and benefits before you are send back to work;
  • Your Employer is Self-Insured, meaning the company is large enough that they qualify for self-insured status under Texas law and they would be directly responsible for any injuries an employee suffers as a result of that Employer’s negligence.
  • Your Employer is a TEXAS NON-SUBSCRIBER. The Company has chosen not to “subscribe” to the Texas Worker’s Compensation Program and has instead, elected an insurance plan that provides benefits and covers injuries to employee while on the job. These are Non-Subscriber Employers. In 2016, it was estimated that there wereapproximately 80,000 Non-Subscriber employers in Texas. Some of these Texas Non-Subscribers are “well-known” retail stores, restaurants, and other industrial companies. Generally, when an employee suffers an on-the-job injury while working for a Texas Non-Subscriber, the medical and wage benefits under the insurance PLANS are administered or managed by another company. Some Examples of these third-party administrators include: SEDGWICK, PROVIDENCE RISK MANAGEMENT, GREAT AMERICAN, CAPROCK CLAIMS, ANCHOR RISK, CLAIMS MANGEMENT INC and HELMSMAN MANAGEMENT SERVICES. Essentially, these are the insurance companies providing the policy to the employer that covers worker’s injuries. Texas Employers love these policies because they are managed primarily with the company’s interests in mind; protecting the business, controlling costs, controlling claims and, “getting the employee back to work”! Maybe not so surprising, “getting the employee healthy” is not one of the insurance company’s primary concerns. That’s where we can help!

 

As an injured employee, figuring out what benefits you are entitled to is a difficult process and most of the time, if not always, employers are not going to help you figure it out. Therefore, if you been seriously injured while working for a Texas Non-Subscriber, and the company and/or the insurance administrator is doing any or all of the following:

  • giving you the runaround about your treatment,
  • failing to approve significant procedures (MRIs, Injections, surgeries);
  • declining benefits because they say you have old or un-related injuries;
  • sending you to a doctor who is supposedly giving you an independent medical examination (IME) but he never actually examines you;
  • telling you that you have to work even though the company doctors have you on restrictions; or
  • denying benefits because, even though there were witnesses to the incident, you didn’t report the incident within the time they require you to report it;

You should get help and call Sandoval Law Firm at (346) 347-7777. Unlike the insurance companies, our focus as your lawyer would be to make sure you are getting the treatment you need to get healthy again and, to make sure that you are fairly compensated for their injuries you’ve suffered.

When you call Texas Work Injury Attorney Hector Sandoval, he immediately gets busy finding out what coverage might be out there for your injury? Attorney Sandoval handles all types of work injuries against non-subscribers, self-insured and even uninsured

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