BGES Group Video

What Is a Workers Compensation Rating and Why Does It Matter?

BGES Group Video

Most business owners and executives understand the value of workers compensation insurance not just to protect the worker, but to protect the company as well. Fewer, however, are aware of the mechanics of how premiums are arrived at, and how their own company’s safety track record figures into their rating.  Understanding the process, however, may well enable you to qualify for lower premiums down the road, saving your business money and making you more competitive.

Industry underwriters set workers compensation premiums using a process similar to how most companies price group health insurance: They look at the actual claims experience for similar workers in your area, and if there is a history of claims, at your company specifically. Where there is insufficient local claims experience to look at, underwriters turn to the National Council on Compensation Insurance, a clearing house of workers injury and compensation data.

Generally, underwriters will take your payroll and multiply it by an average claim factor for that type of worker. This produces a baseline average of the total number of expected claims, which they subdivide as claims per $100,000 of payroll, claims per year, or claims per time unit. The frequency of claims is considered to be a close proxy for the safety culture of the individual business. They then account for the average severity of claims for that type of worker in your industry and combine the two to arrive at a baseline prediction for expected losses.

Underwriters must then try to assess your business and answer the following question: Given the policies and procedures in place at your business and your claims history, is your company likely to produce losses that are higher than the industry baseline or lower?

Over time, underwriters have discovered that the most likely future claims predictor is a past history of claims at your company. Therefore, to save money on workers compensation premiums, it behooves the company to invest aggressively in preserving the safety of the work environment, both in terms of resources and management focus.

Your workers compensation agent and underwriting team will assign your company an insurance rating, with 1 deemed equal to the average claims experience in your industry for the area.

Any rating higher than 1 indicates a worse-than-average risk for workers compensation claims. If your rating comes out higher than 1, you may be able to qualify for lower rates in future years by reviewing your safety program and the types of losses your company has incurred. Identify any patterns and refcurring themes. You may benefit from bringing in a risk management consultant for an outside set of eyeballs. Some investment in equipment or improved training may be needed, or you may need to be more vigilant for workers compensation fraud in a few cases.

Best Practices

In the long run, your safety record is a reflection of your overall safety culture. That’s not something limited to the rank and file worker and shop foremen, though. The most important link in the safety culture chain is at the top.

  • Invest in training your workers in all aspects of safety relevant for their jobs.

  • Appoint a senior manager with clout to monitor your safety and OSHA compliance, and empower him or her to enforce it throughout the company.

  • Empower any worker to halt work activities if he or she becomes aware of an unsafe work condition, until that condition can be corrected.

Everyone is part of your workplace safety culture – but senior management is the most important link in the chain, because management sets the tone throughout the organization.

[embedyt] https://www.youtube.com/watch?v=eWFmjYirlkw[/embedyt]

About BGES:
[embedyt] https://www.youtube.com/watch?v=eWFmjYirlkw[/embedyt]
BGES Group’s officeis a full service agency offering funding, property, liability, umbrella liability, auto, bid & performance bonds, inland marine, worker’s compensation, New York State Disability and health insurance coverages too.
BGES Group are worker’s compensation specialists (NY, NJ, CT) insuring contractors, limousine services, auto services, local truckers, manufacturers and staffing agencies (Note: we can insure any business).  Workers Compensation issues we address:  1) Lowering rates – our specialty programs have been able to save businesses up to 40%; 2) Being non renewed?  3) Audit disputes; 4) Lowering high experience modifications factors; 5) Misclassification of payrolls; 6) Lowering or eliminating renewal deposits; 7) Getting coverage when you’ve been without for a few months; 8) Covering multiple states under one policy; 9) Eliminating 10% service or policy fees; 10) Timely issuance of certificates; 11) Always being able to get someone on the phone or by email when you need to.
Special Contractor Insurance Programs (NY, NJ, CT) – We we have 50 insurance companies to market your general liability, umbrella liability, business auto, workers compensation, bid & performance bonds and group health coverages to.

ALERT NEW JERSEY  & CONNECTICUT CONTRACTORS:  We have an extremely competitively priced General /Excess Liability program.  You want to lower these costs, get a quote today!  Call Gary Wallach at 914-806-5853 or click here.
To Speak With Us Call 914-806-5853, click here to email or click here to visit our website .
http://www.bgesgroup.com or http://www.workerscomp.store
Company: BGES Group, 216A Larchmont Acres West, Larchmont, NY  10538
e-mail: bgesgroup@gmail.com

(C) – Copyright – BGES Group

Gray Wallach

Performing a Thorough Background Check

Gray Wallach

Employment background checks are not just for executive-level management. A thorough background check should be performed to avoid making any assumptions about an employee’s history.

To help you get started, here are some essentials of a complete background check:

Current address – Confirm a current address through a telephone directory, confirmation with landlord, rental or mortgage company, or county tax office.

Former addresses – Confirm prior addresses through former employers, credit agencies, or by contacting landlords of former residences.

Other detailed information you might choose to verify is the amount of rent or mortgage paid, whether it was paid on time, details of complaints made against the applicant, whether their former residence was left in good order when vacated, whether they left on their own accord, and any eviction details, if applicable.

Current and former employers – Employers are reticent about providing too much information on current or former employees, since negative references occasionally result in lawsuits.

Most employers will verify an employee’s job title, length of employment, starting and final salary, and reason for leaving. You might obtain resume’ data on old application forms to compare with the resume’ of the person you are considering for the position.

A more detailed background check might include trying to establish contact with the applicant’s immediate supervisor or manager. Again, there are legal limits on taking this route and there is a fine line between gathering information and invasion of privacy.

Obtain the applicant’s permission in writing if necessary. Protect your liability exposure by discussing the legality of the background check with your company’s lawyer beforehand.

Education – Transcripts from most secondary institutions can usually only be obtained either by the applicant themselves or through a signed release that includes enrollment dates, department and subject of study or major, student identification number or Social Security number, and date of birth.

A photocopy of the degree or certificate should be obtained for verification, if possible. Contact the applicable registrar’s office and they will be able to specify what is required to release information.

Additionally, verify that the college is legitimate. Fake diploma mills offer degrees from fictitious institutions possessing names very similar to known established educational institutes, so do not  automatically assume you recognize the name.

Credit check – This is not legal in all states, so check your local laws or with an attorney before acting. Usually there are exceptions to the rule for certain fiduciary positions, even in those states.

A credit check is usually required in those situations where the position involves security, fiduciary responsibility, or bonding. Verify that all information provided in the credit check conforms to the information provided on the application.

Poor credit references should be cross-referenced and authenticated.

References – All personal references listed by the applicant should be contacted. If it is a basic employment check, the integrity of the applicant’s personal character can be established by phone.

Detailed checks may necessitate personal contact to meet with the references face to face, as the references given might provide information prejudicial in favor of the applicant.

Miscellaneous – Additional items which may be of relevance include drug tests, criminal records check in all states listed on the application form, driver’s abstracts and records check on civil suits.

The takeaway

Be methodical and take the time to perform a thorough background check that satisfies the need of your business.

BGES Group’s office, located in Larchmont, NY is a full service insurance agency offering, Property, Liability, Umbrella Liability, Business Auto, Bid & Performance Bonds, Inland Marine, Funding for the Construction Industry, Worker’s Compensation, New York State Disability, Group Health, Life insurance and Personal lines.

BGES Group are Worker’s Compensation Specialists for the States of New York, New Jersey and Connecticut – Issues we address: 1) Lowering pricing – we have specialty programs that can save you up to 40%; 2) Finding a new company; 3) Being cancelled or non renewed; 4) Audit disputes; 5) Company creating fictitious payroll at audit time; 6) Lowering high experience modifications factors; 7) Misclassification of payrolls; 8) Lowering or eliminating renewal deposits;   9) Getting coverage when you’ve been without for a few months; 10) Covering multiple states under one policy; 11) Eliminating 10% service or policy fees; 12) Timely issuance of certificates; 13) Always being able to get someone on the phone or by email when you need to.

Special Contractor Insurance Programs (NY, NJ, CT) – We we have 50+ insurance companies to market your general liability, umbrella liability, business auto, workers compensation, bid & performance bonds and group health coverages.  We help contractors set up proper risk transfer mechanisms.  If you’re a contractor we offer extensive information about insurance markets, coverages, risk transfer mechanisms, subcontractor screening, ways to lower your insurance costs that lower them.

New Jersey and Connecticut Contractors:  We have a fiercely competitively priced (savings up to 50%)  General Liability, Umbrella Liability, Business Auto, Workers Compensation program.  Want to lower these costs?  Get a quote today!

If you would like to speak with us call Gary Wallach at 914-806-5853 or click here to email or click here to visit our website.

http://www.bgesgroup.com or http://www.workerscomp.store

Company: BGES Group, 216A Larchmont Acres West, Larchmont, NY 10538

e-mail: bgesgroup@gmail.com

© – Copyright – BGES Group

BGES Group Video

If You are a NY, NJ, CT Contractor Who Is Unhappy with Their Worker’s Comp Company, Pricing, Service, We Have a Construction Worker’s Compensation Program Just for You!

BGES Group Video

(Please Note this program is designed for contractors and is not a State or Assigned Risk plan.)

 

Rate Comparison – We Chose One Company Whose Rates are Up To 40% Higher Than Ours.  There’s a Good Chance You’re With That Company or a Company Who Also Has High rates Compared To Our Companies.

 

Workers Compensation Program:

 

  • Savings up to 40%.                                                                                                                                                    

  • Our program was created to provide worker’s compensation coverage to contractors country wide.                                                                                                                                                                          

  • Our program offers long-term coverage stability.                                                                                            

  • We have one of the best claims services in the industry.  If a claim is questionable we know how to fight it and we will.  We want to keep your experience mod low and rates too.                                                                                                                                                                         

  • We cover you with THE RIGHT coverage while operating outside of your home state.  For example, if you are a NY contractor and take a job in NJ that will last 1 ½ months, the NY state plan will not cover a claim arising from that job.  Did you know New Jersey’s medical benefits are substantially higher than New York’s?  Not having the right coverage can knock you out of business.                                                                                                                                                                   

  • To bind we require a low up front deposit.  On renewals, NO deposit is required.                                                                                                                                    

  • Proper payroll assignments.  Payrolls will be assigned to the right class codes.  You are given control over this.                                                                                                                                                                                   

  • Proper payroll caps – Our program caps payrolls as required by your state’s worker’s compensation rules.                                                                                                                                             

  • Simplified audits – Our auditors just want to make sure you classified workers correctly.  They also want to make sure your subs have coverage.  They can be in and out in 15 minutes.                   

  • You can issue your own certificates on-line.  C105.2’s for DOB and DOT done by our organization in less than 10 minutes.                                                                                                                                   

  • FIRST CLASS service.  You will work with one person who has 37 years experience and when you call or email responds immediately.  This person is very responsible, picks up the phone when you call even on weekends and is a pleasure to deal with.  He is knowledgeable, street smart and gets the job done.                                                                                                                               

  • We DO NOT charge $500 to $5,000 policy or 10% service fees.  We provide V.I.P. service to every client we work that’s in program.                    

 

BGES Group’s office, located in Larchmont, NY is a full service insurance agency offering, Property, Liability, Umbrella Liability, Business Auto, Bid & Performance Bonds, Inland Marine, Funding for the Construction Industry, Worker’s Compensation, New York State Disability, Group Health, Life insurance and Personal lines.                                                                                                     

BGES Group are Worker’s Compensation Specialists for the States of New York, New Jersey and Connecticut – Issues we address: 1) Lowering pricing – we have specialty programs that can save you up to 40%; 2) Finding a new company; 3) Being cancelled or non renewed; 4) Audit disputes; 5) Company creating fictitious payroll at audit time; 6) Lowering high experience modifications factors; 7) Misclassification of payrolls; 8) Lowering or eliminating renewal deposits;   9) Getting coverage when you’ve been without for a few months; 10) Covering multiple states under one policy; 11) Eliminating 10% service or policy fees; 12) Timely issuance of certificates; 13) Always being able to get someone on the phone or by email when you need to.

 

Special Contractor Insurance Programs (NY, NJ, CT) – We we have 50+ insurance companies to market your general liability, umbrella liability, business auto, workers compensation, bid & performance bonds and group health coverages.  We help contractors set up proper risk transfer mechanisms.  If you’re a contractor we offer extensive information about insurance markets, coverages, risk transfer mechanisms, subcontractor screening, ways to lower your insurance costs that lower them.                                                                                                                               

New Jersey and Connecticut Contractors:  We have a fiercely competitively priced (savings up to 50%)  General Liability, Umbrella Liability, Business Auto, Workers Compensation program.  Want to lower these costs?  Get a quote today!                                                                                                    

If you would like to speak with us call Gary Wallach at 914-806-5853 or click here to email or click here to visit our website.                                                                                                                                           

http://www.bgesgroup.com or http://www.workerscomp.store

Company: BGES Group, 216A Larchmont Acres West, Larchmont, NY 10538

e-mail: bgesgroup@gmail.com

© – Copyright – BGES Group

 

Gray Wallach

NY, NJ, CT Contractors – Unhappy With Your General & Umbrella Liability, Auto, Workers Comp, Bond Rates or Coverage? We are one of Tri-States Top Construction Specialists and Have 50 Companies to Market Your Account To. More Options Equal Lower Rates, Better Coverage!

Gray Wallach

Have The Following Problems With Your Insurance:

  1. Unhappy with your General Liability pricing?

  2. Does your General Liability Policy prevent you from getting work?

  3. Do you understand the exclusions in your General Liability Policy?  Some are:

    1.   A. Labor Law

    2. Contractual liability

    3. Employee injury

    4. Height limitation

    5. Exterior work limitation or exclusion

    6. Residential exclusion for condo’s, co-ops

    7. Restriction as to type of work you can do

    8. Subcontractor coverage and limit requirements.

    9. Exclusion – Designated Ongoing Operations

    10. Exclusion – Newly Constructed Residential Housing

   4.  Do you use subcontractors?  If so, are there subcontractor coverage requirements in your general and umbrella liability policies?  WARNING!  Failure to comply with requirements can leave you without coverage.

   5.  Has your Umbrella Liability pricing gone thru the roof?  Does your policy have exclusions that make it very difficult to live with?

   6. Worker’s Compensation

        a. Rates high?  There are a few companies whose rates are 20-40% higher than our companies.  Call Gary at 914-806-5853 to find out if you are with one of them (we are not comfortable listing there names but are glad to tell you over the phone).

        b. Work out of state 3 days to weeks at a time? Warning!  You may not have coverage for workers injured out of state (especially if you are thru a state or assigned risk policy). ​

        c. In the middle of an audit dispute?  Carrier charging you for uninsured subcontractors that have coverage?  Carrier creating fictitious payroll because of sales?  Being told pay bill or be cancelled?   Have a high experience modification factor?

       d. Being punitively surcharged due to past loss experience?     

       e. Without coverage? 

      7.  Unhappy with your Business Auto premium?   Certain carrier rates are thru the roof.  Other companies are more reasonable.  We can help you find better rates.

      8.  Unhappy with your Bid & Performance rates?   Need higher bonding limits?  We have a bonding department that can help you get better pricing and limits.

      9. Can you get your broker on the phone when needed?  Does he/she specialize in construction insurance?  Does it feel like you are dealing with inexperienced people?  Do you get a different person on the phone when you call?  Do you get placed on hold for minutes?   Do you get charged all sorts of ridiculous fees?   Do you get certificates timely?  Your broker may be the nicest person in the world but if they lack the proper knowledge you can get stuck with an uncovered claim that can knock you out of business.   After talking to your broker you ever have these type of concerns?

                       

About our Agency:

                                                           

1. Construction is our #1 specialty.  With the exclusions companies place in policies it is critical you work with a specialist.  Most agencies are NOT, we are.

2. We have 50+ insurance companies.  These companies are the TOP and BEST general liability, umbrella liability, auto, bid & performance bond, worker’s compensation and group health companies for the construction industry. Some programs are exclusive to our agency.

3. We insure over 750 tri-state contractors.  We have extensive expertise in designing policies.

4. We do over $160 million in premium – this translates into buying power for YOU.

5. Subcontractor Screening – Most general and umbrella liability policies have subcontractor conditions which if not met exclude coverage.  Do you know what is in your policies?  We have a dedicated department that offers subcontractor screening and you can get us on the phone when needed.

Services We Offer:

  1. Annual Risk Survey

  2. Claims Management Services

  3. Contract Reviews

  4. Coordinated Loss Control Survey and Inspection

  5. Disaster Recovery

  6. Employee Background Screening

  7. OSHA Compliance

  8. Risk Transfer Services

  9. Safety Manuals

  10. Stewardship Reports

  11. Subshield – online proprietary Certificate of Insurance management

  12. Workers’ Comp Experience Modification Review

  13. Workers’ Compensation Premium Recovery

OFFER:  Let us review your policies. All you will have to do is email us copies.  Within a few days you’ll have our recommendations.  Then you’ll know where you stand.   It’s like getting a FREE second opinion.  You can also just call and talk with us.  Call Gary Wallach at 914-806-5853.  You will immediately get him on the phone without waiting.  WE PROMISE NOT TO SELL OR PRESSURE YOU IN ANYWAY. 

BGES Group’s office, located in Larchmont, NY is a full service insurance agency offering, Property, Liability, Umbrella Liability, Business Auto, Bid & Performance Bonds, Inland Marine, Funding for the Construction Industry, Worker’s Compensation, New York State Disability, Group Health, Life insurance and Personal lines.

BGES Group are Worker’s Compensation Specialists for the States of New York, New Jersey and Connecticut – Issues we address: 1) Lowering pricing – we have specialty programs that can save you up to 40%; 2) Finding a new company; 3) Being cancelled or non renewed; 4) Audit disputes; 5) Company creating fictitious payroll at audit time; 6) Lowering high experience modifications factors; 7) Misclassification of payrolls; 8) Lowering or eliminating renewal deposits;   9) Getting coverage when you’ve been without for a few months; 10) Covering multiple states under one policy; 11) Eliminating 10% service or policy fees; 12) Timely issuance of certificates; 13) Always being able to get someone on the phone or by email when you need to.

Special Contractor Insurance Programs (NY, NJ, CT) – We we have 50+ insurance companies to market your general liability, umbrella liability, business auto, workers compensation, bid & performance bonds and group health coverages.  We help contractors set up proper risk transfer mechanisms.  If you’re a contractor we offer extensive information about insurance markets, coverages, risk transfer mechanisms, subcontractor screening, ways to lower your insurance costs that lower them.

New Jersey and Connecticut Contractors:  We have a fiercely competitively priced (savings up to 50%)  General Liability, Umbrella Liability, Business Auto, Workers Compensation program.  Want to lower these costs?  Get a quote today!

If you would like to speak with us call Gary Wallach at 914-806-5853 or click here to email or click here to visit our website.   
     
http://www.bgesgroup.com or http://www.workerscomp.store

Company: BGES Group, 216A Larchmont Acres West, Larchmont, NY 10538

e-mail: bgesgroup@gmail.com

© – Copyright – BGES Group

BGES Group Insurance

Why Every Contractor Should Require Workers Comp Insurance

BGES Group Insurance

Two construction workers died on the job every day in 2013, according to the U.S. Occupational Safety and Health Administration. One out of every 25 construction workers got hurt on the job that year. Workers in this industry need the protection of Workers’ Compensation benefits more than most.

Most states require employers to carry Workers’ Compensation insurance, but not in all cases. Many states exempt one-person operations from the requirement, for example. Regardless, it is a good practice for project owners and general contractors who hire subcontractors to require the subs to carry this insurance, whether the law requires it or not.

A typical construction project involves three types of entities: The owner who is paying to have the project done; a general contractor or independent contractor whom the owner hires to do the work; and subcontractors whom the GC hires to do portions of the work. The relationships between these entities and their employees differ.

While most states require employers to provide Workers’ Compensation benefits to employees, their laws also define who exactly is an employee. If someone is working on my property, but the law does not consider that person to be my employee, then I do not owe that person Workers’ Compensation benefits. States use several criteria to determine whether two parties are in an employer-employee relationship. These are similar to the criteria the Internal Revenue Service uses, such as control over when and how work is performed.

Typically, state regulators do not find a construction worker to be an employee of a project owner. The same cannot be said about independent contractors and employees of subs, however. Some sole proprietor subcontractors who suffer worksite injuries claim Workers’ Compensation benefits under the policies of the contractors who hired them. Often, state Workers’ Compensation law judges rule that these individuals were acting as employees of the hiring contractors, not independent contractors.

In addition, many state laws require an independent contractor who hires a sub to provide Workers’ Compensation benefits to the sub’s employees if the sub fails to obtain insurance. The injured subs or their employees end up collecting benefits even though that was never the intention of the hiring contractors. Consequently, insurance companies can and do charge independent contractors additional premiums when they find that uninsured subs have worked for them.

In a worse case scenario, both the independent contractor and the sub may fail to buy Workers’ Compensation insurance. Leaving aside the legal problems that will result for the employers, this leaves injured workers without sources of the benefits to which they are entitled. Their logical recourse is to sue the project owner. They may seek damages for an alleged failure to maintain a safe worksite or for negligence in the hiring and supervision of contractors. Since the project owners are not the employers of these injured workers, their own Workers’ Compensation policies will not help. Rather, they will have to seek legal defense and the payment of any awards from their liability insurance companies.

For these reasons, project owners should insist and verify that all contractors working on the job, including subs, carry their own Workers’ Compensation insurance. Independent contractors should do likewise with the subs they hire. Project owners may want to supplement their protection by making the independent contractors responsible for verifying that the subs have insurance, and by requiring the independents to hold the owners harmless from any lawsuits resulting from workplace injuries.

Construction is dangerous work. Every contractor setting foot on a job site should carry its own Workers’ Compensation coverage, whether the law requires it to or not.

[embedyt] https://www.youtube.com/watch?v=eWFmjYirlkw[/embedyt]

BGES Group’s office, located in Larchmont, NY is a full service insurance agency offering, Property, Liability, Umbrella Liability, Business Auto, Bid & Performance Bonds, Inland Marine, Funding for the Construction Industry, Worker’s Compensation, New York State Disability, Group Health, Life insurance and Personal lines.

BGES Group are Worker’s Compensation Specialists for the States of New York, New Jersey and Connecticut – Issues we address: 1) Lowering pricing – we have specialty programs that can save you up to 40%; 2) Finding a new company; 3) Being cancelled or non renewed; 4) Audit disputes; 5) Company creating fictitious payroll at audit time; 6) Lowering high experience modifications factors; 7) Misclassification of payrolls; 8) Lowering or eliminating renewal deposits;   9) Getting coverage when you’ve been without for a few months; 10) Covering multiple states under one policy; 11) Eliminating 10% service or policy fees; 12) Timely issuance of certificates; 13) Always being able to get someone on the phone or by email when you need to.

Special Contractor Insurance Programs (NY, NJ, CT) – We we have 50+ insurance companies to market your general liability, umbrella liability, business auto, workers compensation, bid & performance bonds and group health coverages.  We help contractors set up proper risk transfer mechanisms.  If you’re a contractor we offer extensive information about insurance markets, coverages, risk transfer mechanisms, subcontractor screening, ways to lower your insurance costs that lower them.

New Jersey and Connecticut Contractors:  We have a fiercely competitively priced (savings up to 50%)  General Liability, Umbrella Liability, Business Auto, Workers Compensation program.  Want to lower these costs?  Get a quote today!

If you would like to speak with us call Gary Wallach at 914-806-5853 or click here to email or click here to visit our website.   
     
http://www.bgesgroup.com or http://www.workerscomp.store

Company: BGES Group, 216A Larchmont Acres West, Larchmont, NY 10538

e-mail: bgesgroup@gmail.com

© – Copyright – BGES Group

BGES Group Video

As Health Deductibles Rise, Employees More Likely to File Workers’ Comp Claims: Study

BGES Group Video

Sometimes, injured employees are afraid to file a workers’ comp claim after being injured at work because they fear the specter of retaliation by their employer.

Experts suspect that up to 10% of workplace injuries are never reported because the workers choose to have the injuries covered by their employer-sponsored health plans. Most employers may not be aware of the full extent of their workplace injuries because of this phenomenon.

But, that could change as workers are saddled with higher deductibles and out-of-pocket expenses, according to a new study.

A number of past studies have found that if the costs to workers for having their personal health insurance cover a workplace injury is less than the “cost” to them of filing a workers’ comp claim, they will opt to have their health insurance cover it instead.

Here’s what studies have found over the years:

  • A 1996 study found that workers without health insurance have an incentive to claim their medical issues are work-related even if they are not, so that workers’ compensation insurance will pay for care. The study also found that if the injury occurs at work, health insurance may deter workers from filing for workers’ comp if they feel there is a cost to filing a claim.

  • A 2007 study found that a genuine workers’ comp claim can be “costly” to file for a worker if:
    – The employer dissuades workers from filing workers’ comp claims because they fear the claims will increase their premiums.
    – The injured worker does not want to deal with the paperwork for a workers’ comp claim.
    – The individual feels there is a stigma associated with filing for workers’ comp.

  • A 2003 study of Michigan workers and their physicians found that 70% of injured workers did not file for workers’ comp, and that 36% of the non-reporting injured workers cited having health insurance as a reason they did not.

What could be ahead

The most recent study, by the Workers’ Compensation Research Institute (WCRI), found that injured employees are more likely to file workers’ compensation claims when they have high-deductible group health plans.

The study found that workers with a remaining group health insurance deductible that exceeds $550 are more likely to file workers’ comp claims than if the deductible were less. As more workers find themselves staring at higher health insurance deductibles, they will properly report their workers’ comp claims to their employers.

“In years past, workers may have chosen to have a work injury covered within their group health plan,” John Ruser, WCRI president and CEO, said in a statement. “But the increasing cost of deductibles may cause them to consider having the injury covered ─ where it potentially belongs ─ in the workers’ compensation system, where there are no deductibles or copayments for the medical care they receive.”

This is likely to add about 5% more claims into the system, the WCRI found.

What you can do

If you suspect that one of your employees has reported a workplace injury for something that happened during non-work hours you should look at the claim to see if it has the hallmarks of a potentially fraudulent claim.

Some warning signs the claim may not be legit include:

  • There are no witnesses to the incident.

  • The claim is reported late (usually many days since the alleged injury).

  • The injury is reported on a Monday morning (which could mean they injured themselves over the weekend).

  • The injured employee’s story is inconsistent or suspicious.

  • The incident is only vaguely described, incomplete as to details or out of the norm of the type of injury that might be expected.

  • The employee engages in sporting and outdoor activities regularly.

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BGES Group’s office, located in Larchmont, NY is a full service insurance agency offering, Property, Liability, Umbrella Liability, Business Auto, Bid & Performance Bonds, Inland Marine, Funding for the Construction Industry, Worker’s Compensation, New York State Disability, Group Health, Life insurance and Personal lines.

BGES Group are Worker’s Compensation Specialists for the States of New York, New Jersey and Connecticut – Issues we address: 1) Lowering pricing – we have specialty programs that can save you up to 40%; 2) Finding a new company; 3) Being cancelled or non renewed; 4) Audit disputes; 5) Company creating fictitious payroll at audit time; 6) Lowering high experience modifications factors; 7) Misclassification of payrolls; 8) Lowering or eliminating renewal deposits;   9) Getting coverage when you’ve been without for a few months; 10) Covering multiple states under one policy; 11) Eliminating 10% service or policy fees; 12) Timely issuance of certificates; 13) Always being able to get someone on the phone or by email when you need to.

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New Jersey and Connecticut Contractors:  We have a fiercely competitively priced (savings up to 50%)  General Liability, Umbrella Liability, Business Auto, Workers Compensation program.  Want to lower these costs?  Get a quote today!

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