Frequently Asked Questions about Occupational Accident
When working with a TPA or broker for the first time, questions are bound to arise. At GWI, we have the knowledge backed by experience to answer all of your questions. Below are a listing of commonly asked questions, but if you find your question is not answered below, do not hesitate to speak with a member of our team. We are always just a phone call or e-mail away.
What is Occupational Accident?
Occupational Accident is an employee benefit program provided by an employer. This product is available in the State of Texas where employers are permitted by law to opt out of the Worker's Compensation System. Occupational Accident covers employee on-the-job injuries only, and will pay for medical benefits, AD&D benefits, and disability arising out of said employee injury.
What is PEI?
PEI, or Primary Employer’s Indemnity insurance, reimburses for amounts the employer becomes legally obligated to pay subject to the terms and conditions of the policy and its limits of liability related to workplace negligence claims.
Does Occupational Accident coverage replace Worker's Compensation?
No, this is not a policy of Worker's Compensation insurance. The employer does not become a subscriber to the Worker's Compensation system by purchasing this policy, and if the employer is a non-subscriber, the employer loses certain common-law defenses to a law suit as well as certain limitations on liability that would otherwise be available under the Worker's Compensation laws. The employer must comply with the Worker's Compensation law as it pertains to non-subscribers and the required notifications that must be filed and posted.
Does Occupational Accident protect against lawsuits?
Not directly. Our Occupational Accident policy contains a Mandatory Binding Arbitration clause, which in combination with an Employee Retirement Income Security Act (ERISA) benefits plan is a powerful tool that helps to protect the employer against trial by jury.
With a proper benefits plan in place, claims, including claims for wrongful denial of insurance benefits, may be tried in federal court, rather than state court. A jury trial is usually not available and many plantiffs’ attorneys have less experience and less comfort in the federal court system. A written plan can also clarify that providing benefits to an employee is not an admission of liability for the injury. A written plan can also move the case to an Arbitrator, which will review the case more quickly and keep it out of the court system.
Occupational Accident Insurance products that GWI offers are through what carrier?
GreenWood International Insurance Services, Inc underwrites Occupational Accident Insurance products on behalf of Starr Indemnity & Liability Company.
This is only a brief description of the coverage(s) available. The policy will contain reductions, limitations, exclusions, and termination provisions. For costs and complete details of the coverage(s) contact GreenWood International Insurance Services, Inc at 512-477-2116.
This is not a policy of workers’ compensation insurance. The employer does not become a subscriber to the workers’ compensation system by purchasing this policy, and if the employer is a non-subscriber, the employer loses these benefits which would otherwise accrue under the workers’ compensation laws. The employer must comply with the worker’s compensation law as it pertains to non-subscribers and the required notifications that must be filed and posted.
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