Workers’ Compensation And Health Insurance Issues
Insurance issues can be complicated, especially if you are not used to dealing with insurance companies on a regular basis. With more than 30 years of experience handling workers’ compensation insurance issues in Colorado, attorney Cliff Eley can provide you with the guidance, support and representation you need at every stage of the process.
Get answers to your insurance questions from an experienced lawyer. Call us at 720-759-3064 for a free case evaluation.
Does Workers’ Comp Or Health Insurance Pay My Medical Bills?
If you are injured at work, both the workers’ comp insurer and your health insurer may be obligated to provide coverage. If the workers’ compensation claim has been admitted, that carrier should pay the medical bills. But if the claim is denied, your medical insurance will probably pay the bills while compensability is being decided. You do not need to worry about which insurer should be providing you with coverage. Simply submit your medical claim to both insurers. Then, if both insurers end up paying your bills, they can work it out between themselves through a process known as subrogation. Through subrogation, an insurer can pursue compensation from another insurer, a settlement or a judgment, in order to recoup the payments the insurer has made.
Can I Keep My Health Insurance While On Leave?
It will depend on your situation. Generally, employers and their insurers can choose whether or not to continue coverage for employees who are out on leave. Even if your coverage continues, however, you may be placed on Consolidated Omnibus Budget Reconciliation Act (COBRA) and have reduced coverage. Likewise, you may be required to pay your insurance premiums if you are out on unpaid leave. However, if your insurance is terminated because you are not working, the cost of the insurance should be added to your average weekly wage, and will increase the amount you can receive for temporary total disability benefits (lost wages) and permanent disability.
There is an exception for cases that fall under the Family and Medical Leave Act (FMLA). The FMLA provides protections for those who are unable to return to work after an injury or illness. FMLA protects an employee from losing his or her job and health coverage for up to 12 weeks.
We can help you determine if you qualify for FMLA leave and the impact that leave may have on your insurance coverage.