Can Disability and Accident Coverage Serve as a Workers’ Comp Substitute?

Sometimes I just don’t get it.

An article published today in Insurance Journal, which looks more like a copied Aflac news release than a news article, says that employers who offer accident and disability coverage see reductions in workers’ compensation claims.

What?

Maybe I am naïve, but I thought work-related incidents were why workers’ comp existed in the first place. The article, based on a study of 600 employers, is clearly a marketing tactic to get employers to buy what Aflac offers. But does this approach, even if legal, mean employers and employees are giving up their rights under workers’ comp laws?

I have so many questions. Is it even legal to apply for non-occupational disability coverage for work-related incidents? What is the medical care like? Do the employees get the immediate sports medicine approach to health care with the best doctors? How soon do these workers return to the job?

You don’t see those questions  — or the answers  — in the article. Nor do we know how much the Aflac coverage goes up from higher claim filings. Does anyone have any idea how this works? Please let me know!

6 thoughts on “Can Disability and Accident Coverage Serve as a Workers’ Comp Substitute?

  1. johnkenny690 says:

    An example – Employee is shoveling snow on an off day (say Saturday) and injures his knee. On Monday he simulates a knee injury by tripping over a hose, generating a WC claim. If this fellow had Voluntary accident coverage, that policy would pay $$ to the injured party, thus avoiding the fake claim.

  2. Christina Bergman, CWCP, CHRS says:

    When I read the Aflac article, I took the message to be – if you don’t have some form of non-occupational benefits available as an option, an employee may report an event as work-related when they have a non-occupational incident – they have no alternative options available to them for insurance coverage. When there is no option except Workers’ Compensation, it creates a moral hazard because they can’t afford to absorb the associated cost and out-of-pocket medical bills so they use Workers’ Compensation benefits as the only option to have the bills paid.

    • annmariecommunicatesinsurance says:

      Personally, I think responsible employers should offer non-occupational short-term and long-term disability coverage. But if claims are being filed with Aflac (or any other non-occ-related disability coverage) that should be filed under workers’ compensation, I am concerned that workers and employers are missing opportunities that would benefit both. And I am not sure if this practice is legal either.

      The work-relatedness of an occupational injury or disease is a common gray area, especially as states have been narrowing the definition of what is compensable under workers’ comp. And sometimes, it is just hard to tell how much a cumulative trauma injury, for example, was caused by work compared to activities outside of work.

      On LinkedIn’s WorkComp Analysis Group, there were several other interesting observations about the Aflac results. An actuary wondered if the numbers are based on an analysis workers’ compensation experience before Aflac and after. Another person observed that offering Aflac allows employees the chance to double-dip. There was no enthusiasm about Aflac’s results.

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