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By John Pinoth [January 30th, 2011]

If you are injured at work, immediately report the accident to your employer and seek medical treatment from an employer authorized doctor. Read on for further information.

Why can’t I see my own doctor?

The law often says that employers must pay for all medical care related to the accident, so they control which doctors you may see. If you decide to go to your own doctor you’ll be responsible for the bills. In limited circumstances, an employer’s workers’ compensation insurance company will authorize a doctor of your choice. The earlier you make the request the more likely the Workers’ Compensation insurance carrier will authorize a doctor of your choice.

How will I be paid while I am out of work?

If you miss work, you are entitled to Temporary Disability Benefits. These are paid weekly until you return to work.

How much will I be paid?

You’ll receive around 70% of your gross weekly pay at the time of the injury, up to the state maximum, which is currently around $550.00 on average.

If the Workers Compensation Insurance Company denies my claim, can I apply for unemployment?

No, but you are entitled to weekly disability payments. If the Workers’ Compensation Insurance Company denies your claim for Temporary Disability Benefits, you cannot apply for unemployment because you are not actively seeking work and are unable to work. You should apply for State Temporary Disability Benefits. The State may request that you file a Workers’ Compensation Claim Petition to protect a lien for Temporary Disability Benefits paid to you.

How soon after the accident do I have to file a workers’ compensation claim?

You could have up to two years from the last date that workers’ compensation benefits (medical bills or temporary disability) were paid. If no medical bills or temporary disability benefits were paid, then you would have two years from the date of the accident.

Can I receive a monetary settlement if I am at work?

Yes, after you receive medical treatment and return to work, you are eligible to receive a settlement for your injury.

Can I collect workers compensation benefits if the accident was my fault?

Yes. As long as you were involved in performing your work while you were injured, it doesn’t matter if the accident was caused by you, a co-worker, or your employer.

Can I collect monies for my pain and suffering?

In some cases a claim, in addition to a workers compensation claim, can be filed against another party (known as a Third Party) seeking damages in addition to an award in the workers’ compensation court. You should consult with an attorney as soon as possible after the accident to determine whether your case would entitle you to bring a Third Party action. If you are successful in your Third Party action, you will be compensated for your pain and suffering.

Source

By DEBRA ALFARONE PIX11.com

10:26 a.m. EST, February 16, 2011

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NEW YORK (WPIX) —
It’s not only illegal and unsafe, but now, it might jack up your car insurance and bring you that much closer to losing your license.

Starting Wednesday, if you’re found guilty of driving and talking on your cellphone without a hands-free device, it’ll cost you the usual fine +2 points on your license, and that can pump up your insurance rates.

New York was the first state to adopt the ban on handheld phone use while driving back in November 2001.

For years, it was punishable of a fine of up to $100; now, the Department of Motor Vehicles (DMV) will tack on 2 points to your driving record as well. It seems the offense is now catching up to the violation of texting while driving.

In November 2009, the state declared it illegal. It’s punishable by a $150 fine, and 2 points on your license.

The state says distracted driving has a role in at least 20 percent of all car crashes in New York.

If you rack up 11 or more points on your driving record, the DMV can suspend your license.

NEW YORK – You drive across what seems to be the Grand Canyon of pot holes seriously damaging your car’s front end. Does your insurance policy cover the cost of the repairs?

That’s just one question being asked as consumers from Buffalo to New York City see their cars take a beating this winter. Pot hole-scarred streets, fallen tree limbs and other snow-related situations have taken a toll on many consumers’ vehicles.

“Consumers can help themselves by understanding what their policy covers and what is excluded from coverage. They should also know that they can turn to the Insurance Department if they need help with an automobile insurance issue they cannot resolve themselves,” Insurance Superintendent James Wrynn said.

Mandatory no-fault, liability and uninsured motorist coverages do not apply to damages to your own vehicle. Claims related to losses to your vehicle can generally be covered by optional collision and comprehensive coverages.

Here are some common ways that insurance can help motorists when winter gets the best of their cars:

* Pot holes – Damage caused by pot holes is covered under the collision portion of an automobile insurance policy. However, since collision coverage is optional, don’t look to your insurer to help you pay for damage caused by rough roads unless you’ve already purchased that option.
* Falling objects – Damage caused by falling objects, like ice, tree limbs or hail, is covered if your policy contains comprehensive physical damage coverage, which again is an optional form of coverage. Under comprehensive coverage, your insurer pays you, without regard to fault, for damage to your car from all causes, other than a collision. Besides protecting you from losses due to falling objects, comprehensive coverage protects against theft, fire, flood, windstorm, glass breakage or vandalism.
* Hitting a deer – Deer and other animals are often harder to see during winter’s shorter daytime hours. Damage caused by hitting or being hit by a deer or other kind of animal would be covered by your comprehensive physical damage coverage.
* Your parked car is hit by another vehicle – Your collision coverage would cover damages to your car. You may also be able to file a claim against the driver of the other vehicle.

Consumers will need to pay any deductibles that apply when filing claims for losses that are insured under the collision or comprehensive physical damage provisions of their policies.

Source

New York lawmakers are considering a bill designed to reduce fraud and other types of abuse in the state’s no-fault automobile insurance system.

The bill, introduced by State Sen. James Seward, would modify a rule that requires insurers to pay no-fault claims in 30 days, said Kristina Baldwin, assistant vice president for the Property Casualty Insurers Association of America.

Under current rules, insurers who miss the 30-day deadline are subject to a 2% interest per month penalty, plus they can’t raise any defense as to why they did not pay the claim.

“No matter what fraud is involved, they have to pay the claim in 30 days,” Baldwin said. Under the proposed bill, insurers would still face the 2% interest per month penalty, but could defend their action in not paying the claim in 30 days due to fraud.

Also, the bill would block medical providers who commit insurance fraud from continuing to receive payment under the no-fault system.

There’s a law on the books already that aims to do that, but it was dependent on the state insurance and health departments working together to create the regulations necessary to carry out the law. Under the proposed change, doctors who commit fraud would not lose their medical licenses, but would not longer be able to receive payment under the no-fault system.

“It’s a good step in getting these few bad apples, these crooked doctors that are plaguing the system, to stop committing fraud,” Baldwin said.

Fraud Costs New York, a statewide coalition that seeks to reduce auto fraud, praised Seward for introducing the legislation.

New Yorkers now pay the fourth-highest premiums in the nation for auto insurance due in large part to an outdated system that is rife with fraud and abuse, the group said. In 2010, no-fault fraud cost New Yorkers more than $241 million, a cost absorbed by all drivers in the form of higher premiums.

“New York’s no-fault auto insurance system is broken and needs to be fixed now,” Seward, chairman of the Senate’s insurance committee, said in a statement. Attempts to reach him for additional comment were not immediately successful.

The proposed bill also includes: tougher penalties on criminals who cheat the no-fault system; provisions to combat excessive and unnecessary medical charges; and would require medical providers to submit disputed claims to an arbitrator.

Last year, the New York State Insurance Department reported a 24% increase in fraud-related convictions, with rises in all types of fraud investigated by the department’s Frauds Bureau, but especially no-fault automobile insurance (BestWire, March 22, 2010).

The top five writers of private passenger auto insurance in New York, ranked by 2009 direct premiums written, were: Berkshire Hathaway Insurance Group, with 23.5% market share; Allstate Insurance Group, with 18.8%; State Farm Group, with 11.7%; Progressive Insurance Group, with 6.1%; and Liberty Mutual Insurance Cos., with 6%, according to BestLink, which provides online access to A.M. Best’s database of insurance information.

(By Meg Green, senior associate editor, BestWeek: Meg.Green@ambest.com)

The Workers’ Compensation Board issued a bulletin announcing the implementation of a new transaction code to allow carriers to close open expired policy terms for limited processing scenarios.

The new code may be used for renewals submitted with a prior policy that was not previously reported to the board. It may also be used in establishing transactions submitted out of policy year sequence or order. The board will monitor carriers’ use of the new code to ensure that it is being used only for those two scenarios. The board will reopen any policy that was closed due to the improper use of the transaction code and will subsequently cancel the policy via the open expired policy cancellation program.

Read more at the WorkersComp Forum homepage.