December 8, 2017
Can employers pay small medical bills without submitting them to their workers’ compensation insurer?
By Kathy Bray, Esq.
When dealing with small medical bills, you may think that covering it yourself rather than submitting it to your workers’ compensation insurer will be easier and less costly.
While this seems logical, choosing to pay a medical bill yourself can create a ripple effect of future problems.
The Minnesota Department of Labor and Industry explains why employers should not pay medical bills in its training guide for employers .
"If an employer does not report an injury to its insurance company, it could become a more expensive workers’ compensation claim. The workers’ compensation law is complicated. It has many requirements, such as deadlines for payment, forms that must be filed, determining what medical treatment is reasonable and paying bills according to medical fee schedules. Workers’ compensation insurers are required to know how to comply with these requirements. Penalties may be imposed if the claim is handled inappropriately. If the error leading to a penalty was the fault of the employer, the insurer may pass that cost on to the employer. The employer may jeopardize the ability to adequately defend the claim or opportunities to minimize losses if the insurer does not have immediate knowledge of the injury."
In most states, including Minnesota, unless your business is self-insured, paying a claim rather than reporting it to your workers’ compensation insurer is also illegal. It’s also likely a violation of your contract with your insurer because it can artificially lower your experience modification factor (e-mod) and premium.
“Is paying small work comp claims out of pocket ever a good idea?” on Zywave
This is not intended to serve as legal advice for individual fact-specific legal cases or as a legal basis for your employment practices.