Knowing the process

Knowing the process

In the event of an employee injury, it's important to know the details of your workers' compensation coverage.

November 17, 2016

Many owners and managers of horticultural businesses treat their workers' compensation policies like other types of insurance: it’s often out of sight and out of mind.

However, also like most coverage plans, workers' compensation is an important consideration for any company and demands more attention than it may receive. Specific laws and regulations vary by state, but many state governments require coverage for wage replacement or other accommodations in the event of an employee injury that leaves them unable to work at their full ability.

Bill Brandl, director of workers’ compensation claims with Sentry Insurance, says the basic goal of workers’ compensation is to provide medical benefits and/or wage replacement as needed by state requirements.

“What that means, ultimately, is that when someone’s injured and they go to the doctor, those medical charges would be tied to a workers' compensation claim, it would come to us and we would assess them,” Brandl says. “If someone is taken off of work by their medical provider or cannot work because of their injury, we would be responsible, in accordance with state statutes, for wage replacement.”

Workers’ compensation claims take many forms, but Brandl says back injuries caused by lifting and carrying are among the most common cases, especially in the horticulture industry.

“Ultimately, about one third of all workers' comp injuries are lumbar and lower-back injuries, so it is very common,” Brandl says. “We have workers' comp injuries that come in because of lifting something or twisting or slipping when lifting something.”

When it comes to buying a workers’ compensation policy from an insurance company, Brandl says the most effective type of policy depends in part on the size of the client company. Smaller businesses tend to use policies with a set coverage limit, which is based on exposures and quoted risk factors – similar to an auto or homeowner’s insurance policy.

“Larger customers in this space may take some of the risk on themselves and have a deductible,” Brandl adds. “The first X amount of dollars on the claim are truly their dollars, we’re managing it for them.”

Most people, CEO or not, see insurance as something they hope they’ll never need. Workplace injuries are thankfully rare for many businesses, but for others, they’re an unfortunate inevitability. Brandl says the likelihood of injury depends heavily on the type of tasks required of staff. Other factors like training and safety protocol can influence frequency of injuries. 

Horticulture careers often involve physical labor, so it’s especially important for those businesses to think carefully about their workers’ compensation coverage.

“It really does depend upon what their job requirements are and how big of an operation they are,” Brandl says. “There are absolutely horticultural customers that we are insuring today that have no losses for five years, and others that might have 50 or 100 employees, where it’s probably pretty common practice for them to have a couple of losses every year.

“In total, there are about 3 million workers' comp injuries per year and the horticultural group is more physical in nature, so there’s more lifting and people doing more physical jobs. So, I would suspect that the scale of injuries and the probability of injuries are higher in that niche than in others,” he adds.

Most of all, Brandl says it’s important for business owners to know the process of reporting an injury and filing a compensation claim correctly and efficiently. Too often, upper management is unfamiliar with the workings of their coverage and take longer than they should to address a claim.

“The biggest issue that we always have is that because customers don’t have a lot of losses, they’re not very familiar with the process,” Brandl says. “And when they have an employee that gets injured, they don’t know what to do. So, it’s always about early reporting and making sure that notice of that injury gets to us as soon as possible so we can help them through that process and explain the expectations, what available benefits there are. That’s the biggest thing – just knowledge of the process and early reporting is always a key component.”

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Disclaimer: This document is of a general nature and is not intended to address the circumstances of any particular individual or entity. No one should act on the information contained in this document without advice from a local professional with relevant expertise.

Disclosure: Hortica® property and casualty coverages are underwritten, and loss control services are provided, by Florists' Mutual Insurance Company and Florists' Insurance Company, members of the Sentry Insurance Group. For more information, visit Policies, coverages, benefits and discounts are not available in all states. See policy for complete coverage details.