Workers Compensation Insurance Basics

What is Workers Compensation Insurance? 

The Texas Workers´ Compensation system is the method by which covered workers are compensated for work-related injuries or illnesses. An employer´s insurance company, self-insurance group with a certificate of approval, or an individual employer with a certificate of authority to self-insure pays benefits for work-related injuries, even if the injured worker´s negligence contributed to the accident. However, neither the insurance company nor the employer is liable for injuries that

• are intentional or self-inflicted
• result from the employee´s horseplay or voluntary intoxication (either alcohol or drug-induced)
• arise from voluntary participation in off-duty recreational, social, or sports events
• result from "acts of God," unless a person´s job exposes him or her to a greater than ordinary risk of injury from such acts
• are inflicted by someone else for personal reasons unrelated to employment.

What Coverage Does Workers Compensation Insurance Provide? 

The Texas Workers´ Compensation Act limits a covered employer´s liability to a specific schedule of benefits based on the type and severity of the worker´s injury. Benefits include lifetime medical benefits for necessary treatment of compensable injuries and illnesses

• lifetime medical benefits for necessary treatment of compensable injuries and illnesses
• disability income benefits for a specified period of time and up to dollar limits set by law
• limited funeral expenses for workers killed on the job
• death benefits for surviving dependents of workers killed on the job.