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MO Property & Casualty--Chap 17 Workers' Compensation Ins
MO Property & Casualty Insurance Workers' Compensation Insurance
31
Insurance
Not Applicable
12/04/2011

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Cards

Term
Compulsory
Definition
Employers are required by law to provide Worker's Compensation benefits to their employees with insurance, or demonstrate the ability to provide required benefits.
Term
Elective
Definition
Employers have the choice to accept or reject state Workers' Compensation laws. If an employer chooses to reject the Workers' Compensation laws and an employee is injured, the employee may then bring a suit against the employer and the employer is denied the use of common-law defenses, such as assumption of risk, contributory negligence, and negligence of a fellow employee.
Term
Monopolistic
Definition
Workers' Compensation insurance is only available through a state fund.
Term
Competitive
Definition
Workers' Compensation insurance is available through private insurers (most states).
Term
Exclusive Remedy
Definition
The process by which the employer assumes absolute liability for injuries to the employee. Under Workers' Compensation, if the employee is injured, the employee may not:
a) collect benefits from the employer or the employer's insurance company and then sue the employer for negligence or liability, or b) refuse to accept compensation benefits in order to sue the employer for a larger award.
Term
Disability Income Benefits:
Temporary Total
Definition
An injury, from which an employee is expected to recover and return to work, but is unable to do any work while recovering.
Term
Disability Income Benefits:
Permanent Total
Definition
An injury that prevents an employee from being able to do any work for the rest of his/her life.
Term
Disability Income Benefits:
Temporary Partial
Definition
An injury with which an employee is able to do some work, but is unable to earn his/her usual wage until full recovery.
Term
Disability Income Benefits:
Permanent Partial
Definition
An injury with which an employee is able to do some work, but will never fully recover.
Term
Disability Income Benefits:
Scheduled Injuries
Definition
A schedule of benefits that applies for specific permanent partial injuries, such as a specific amount for the loss of an eye, or a specific amount for the loss of a hand.
Term
Rehabilitation Benefits
Definition
Physical therapy and vocational training are utilized with the objective of returning the injured employee back to work as soon as possible.
Term
Death and Survivor Benefits
(Funeral Expense Benefit)
Definition
A statutory maximum amount, varying from state to state, is provided as a burial allowance. Income benefits are a percentage of the deceased worker's wages and are also provided to the surviving spouse (and usually end at remarriage); and/or children (until age 18, or longer if a full-time student).
Term
Second Injury Fund
Definition
Pays compensation on behalf of an employer to an employee who has already suffered a prior disabling injury, and now sustains a subsequent injury, and the combination of the 2 injuries creates a greater disability than the second injury would have created by itself.
Term
The Federal Employers Liability Act
Definition
Applies to interstate railroad workers.
Term
The US Longshoremen and Harbor Workers' Compensation Act
Definition
Applies to workers who load, unload, build, or repair ships (but not the crew of the ship).
Term
The Jones Act
Definition
Applies to the crews of ocean vessels.
Term
The Federal Employees Compensation Act
Definition
Applies to all US civilian employees.
Term
Part One
Definition
Workers' Compensation Insurance
Term
Part Two
Definition
Employers Liability Insurance (Stop-Gap Coverage)
Term
Part Three
Definition
Other States Insurance
Term
Part Four
Definition
The Insured's Duties if Injury Occurs
Term
Part Five
Definition
Premium
Term
Part Six
Definition
Conditions
Term
Voluntary Compensation Endorsement
Definition
Used when an employer wishes to provide Workers' Compensation benefits to employees even though the law does not require the employer to provide coverage.
Term
Foreign Coverage Endorsement
Definition
Makes the coverage under a Workers' Compensation Policy around-the-clock, continuous coverage for those employed in foreign operations or endeavors.
Term
Premium Computation:
Manual Rating (Job Classification)
Definition
The rates for Workers' Compensation are based upon job (work) classifications. Each job classification has a corresponding manual rate. Rates are higher for higher-risk occupations.
Term
Premium Computation:
Experience Rating
Definition
Used to encourage employers to decrease the frequency and severity of accidents, by basing premium on the prior loss experience of the employer.
Term
Premium Computation:
Premium Discount
Definition
Takes into account the fact that certain expenses included in the premium rate are fixed and do not increase as the size of the risk increases. Therefore, larger risks receive a "discount" as credit for those expenses that do not increase proportionately with the risk.
Term
Premium Computation:
Participating Plans
Definition
The insured is eligible for a premium refund (dividend) if the experience over the policy period falls within the guideline established by the insurer. This provides effective insurance based upon the current policy.
Term
Other Sources of Coverage:
Assigned Risk Plan (Residual Market Plan)
Definition
If an employer is unable to purchase coverage in the voluntary market, many states offer an employer this kind of coverage.
Term
Other Sources of Coverage:
Self-Insurance Plans and Employer Groups
Definition
All states, except North Dakota & Wyoming, allow employers to self-insure upon satisfying certain statutory requirements that are a guarantee of their ability to meet their obligations.
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