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Flashcards in Comm Chp 9 Deck (28)
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Workers Compensation Statute

a statute that obligates employers, regardless of fault, to pay specified medial, disability, rehabilitation, and death benefits for their employees job related injuries and diseases


Occupational Disease

disease thought to be caused by work or the work environment


Temporary Partial Disability

a disability caused by a work related injury or disease that temporarily limits the extent to which an employee can preform job duties for a period of time


Temporary Total Disability

a disability caused by a work related injury or disease that temporarily renders an injured worker unable to preform any job duties for a period of time, the worker eventually makes a full recovery and can resume all job duties



a person hired to preform services for another under the direction and control of the other party call the employer


Independent Contractor

a person or organization hired to preform services without being subject to the hirers direction and control regarding work details


United States Longshore and Harbor Workers Comp Act (LHWCA)

a federal statue that eliminates the right of most maritime workers ( other than crew members of vessels) to sue their employer and in return requires such employers to provide injured or ill workers with benefits like those provided by state workers compensation statues


Competitive State Fund

a state fund that sells workers compensation insurance in competition with private insurers


Monopolistic State Fund ( Exclusive state fund)

a facility, owned and operated by a state government that provides workers comp insurance and that does not permit ay other insurers to sell workers comp insurance in that state ( nd, oh, wa, wy)


Employers Mutual Insurance Company

a mutual insurer established by a states legislature to write workers comp insurance for any qualified employer in that state


Specific Excess Insurance

insurance that covers loss due to a single occurrence only for the amount that exceeds the policy retention


Workers Compensation and Employee Liability Policy (WC&EL)

the policy used in most states to provide workers comp and employee liability insurance


Stop Gap Coverage

coverage for employers liability that private insurers provide to employers operating in a monopolistic fund state that does not include such insurance in its workers comp policies


Voluntary Compensation and Employee Liability Coverage Endorsement

endorsement that amends WC&EL policy to cover employees who are not subject to a workers comp statue


United States Longshore and Harbor Workers’ Compensation Act Endorsement

an endorsement that amends WC&EL policies to cover insureds obligations under the US LHWCA


Experience Mod

a rate multiplier derived from the experience rating computation


Retrospective Rating Plan

a rating plan that adjust the insured premium for the current policy period based on the insurers loss experience during the current period; paid losses or incurred losses may be used to determine loss experience


Large Deductible Plan

an insurance policy with a per occurrence or per accident deductible of $100,00 or more


Omicron Corporation currently does business in Colorado, Nebraska, and Kansas. These states are listed in Item 3.A on the Information Page of Omicron's Workers Compensation and Employers Liability Insurance Policy. The company is hoping to expand its operations into Utah, Arizona, and New Mexico during the next year. Which one of the following statements is correct with respect to workers compensation insurance in the states where Omicron hopes to expand?

C. Omicron should include Utah, Arizona, and New Mexico in Item 3.C on the Information Page and advise the insurer immediately if the company begins operations in any of those states.


Which one of the following items found in the information page specifies which states the workers compensation policy applies?

Item 3


Which one of the following statements is true with regard to workers compensation statutes?

Federal government workers are excluded from workers compensation because they are covered under alternate plans.


A state should be listed in Item 3.C of the Workers Compensation and Employers Liability Insurance Policy Information Page under which one of the following circumstances?

D. The insured expects operations might be extended to that state.


The Voluntary Compensation and Employers Liability Coverage Endorsement to a workers compensation policy is needed for which one of the following reasons?

he workers compensation laws of most states exempt some types of employment from statutory workers compensation benefits.


Which one of the following would be covered under Part Two of the Workers Compensation and Employers Liability Insurance Policy?

An employee is exposed to disease during the policy period but symptoms don't appear until after the employee is fired.


Which one of the following statements is correct with respect to large deductible plans for workers compensation insurance?

They allow the insured, in effect, to self-insure most of its workers compensation exposures.


When an employee at Lambda's plant accidentally backs a forklift into a tank containing a caustic chemical, the tank ruptures and six employees are badly burned. Although all of the workers recover fully, each of the six requires $25,000 in medical treatment. Which one of the following best describes how Lambda's insurer would respond?

The insurer would pay the benefits required by the workers compensation law up to the limits found within the law itself.


ill's Premium Packing (BPP) operates a fruit and vegetable canning operation. It purchases its produce from growers in three states in the Northeast.

The insurer would defend the insured against the employee's suit and pay any settlement awarded, subject to the stipulated limits of liability.


factory fire caused by an employer's negligence results in the death of one employee. The employee was the sole parent and caregiver of a disabled young adult. The young adult sues the employer for loss of services. Which one of the manufacturer's policies would respond to this suit?

e workers compensation and employers liability policy would respond as loss of services is considered under employers liability insurance.