Unit 20 (Workers Compensation)

How many coverage parts are there to a workers compensation policy

6

Which part of the workers compensation and employers liability policy coverage explains how the cost of the policy is determined?

Part Five

Which part of the workers compensation and employers liability policy coverage provides automatic coverage for states not specifically listed on the information page for part one coverage?

Part Three

Coverage for workers' compensation may be obtained from all of the following EXCEPT: A) self-insurance. B) a commercial general liability policy. C) assigned risk plans. D) the Federal Employers Liability Act.

a commercial general liability policy

which of the following individuals is likely to have a valid workers compensation claim?

employee injured while performing a task for which he had not yet been trained

the actual loss history of a business is taken into consideration when calculating a business workers compensation premium. this is called

experience rating

Which one of the following is NOT a benefit of workers compensation insurance? -medical expenses -rehabilitation costs -pain and suffering -lost wages

pain and suffering

when calculating premiums for a workers compensation policy, the insurer will multiple the job classification rate by

the number of $100 payroll units paid to employees in each job classification

workers compensation laws cover employees in the course of employment. Some classes of workers such as domestic servants are exempt but may be covered by a voluntary compensation endorsement. This endorsement agrees to pay benefits

to employees not covered or exempt

In most states workers compensation laws apply

to most workers except those specifically excluded by law

workers compensation pays

without regard to fault

premiums for workers compensation polices are based upon the

work classification number of employees and the total payroll

Which one of the following statements about workers compensation insurance is CORRECT?

workers compensation benefits apply without regard to the employer negligence

Bill's construction company had an experience modification factor added to his workers' compensation policy. What did this do to his premium? A) An experience modification factor is applied as a method of rewarding those employers with better-than-average loss experience. B) An experience modification factor is applied as a method of penalizing those employers with poor experience. C) Nothing. D) An experience modification factor is applied as a method of rewarding those employers with better-than-average loss experience and penalizing those with poorer experience.

An experience modification factor is applied as a method of rewarding those employers with better-than-average loss experience and penalizing those with poorer experience.

If an insured has a loss history that is better than average, what will be applied to reduce the workers compensation premium?

Experience modification factor

Joe is the general contractor building a new shopping center. He has hired subcontractors to do some of the work for him. What will cover the employees of the subcontractor if the subcontractor does not take out workers' compensation coverage? A) The Federal Employer's Liability Act. B) They must sue their employer for coverage. C) Joe's workers' compensation policy. D) Assigned risk plan.

Joes workers compensation policy

Which of the following is a federal workers compensation act that provides compensation for lost wages, medical benefits, and to rehabilitation maritime workers who are injured during their employment?

Longshore and harbor workers compensation act

Sue, an employee of Paul's Bicycle Shop, was on a service call repairing some bicycles at Bill's home. On her way back to the shop she was involved in an automobile accident and injured. Where would Sue find coverage? A) Paul's auto policy. B) Both Paul's auto policy and workers' compensation policy. C) Paul's workers' compensation policy. D) Her own auto policy.

Pauls workers compensation policy

Bob is employed as ship's navigator on an American flagged ship in Duluth, MN, and is injured as a result of the owner's negligence. Under which law would Bob find coverage? A) Federal Employee Compensation Act. B) U.S. Longshoremen's and Harbor Workers' Compensation. C) Jones Act. D) Workers' Compensation.

The Jones Act

Which of the following is a federal law that allows members of a ships crew to sue the ship owner for injuries caused by the ship owners negligence?

The Jones Act

a particular state gives employers the option of purchasing workers compensation insurance from a state fund or a private company. This is an example of

a competitive state fund

When a policy is written on a reporting basis, a premium is paid at the beginning of the policy period that is based on an estimate of what the final premium will be. This is called

a deposit premium

Which one of the following injuries would qualify as a compensable injury under workers compensation laws?

a factor worker fractures her arm while working overtime on the assembly line

A certain state requires employers to purchase workers compensation insurance from a state fund. This is an example of

a monopolistic state fund

Which one of the following methods is used if an employer sets up a fund to pay workers compensation claims?

a self insurance method

Barneys breads and bakery store needs workers compensation coverage for his 7 employees. He could purchase coverage from all of the following sources EXCEPT -an assigned risk plan -self insurance or group insurance if available -the state fund -a private insurance carrier

an assigned risk plan

which of the following statements about workers compensation is NOT correct? -an employee who is eligible for workers compensation coverage may sue a negligent employer -most occupations are subject to state workers compensation laws -an employee must accept the benefits mandated by law -workers compensation covers work related injuries

an employee who is eligible for workers compensation coverage may sue a negligent employer

Which common law defense allowed the employer to deny liability on the basis that the employee knew what the situation was like before employment and assumed all of the risk of injury?

assumption of risk

which one of the following statements regarding workers compensation laws is CORRECT?

benefits are paid to workers injured on the job regardless of who is at fault

which of the following funding methods gives employers a choice between purchasing workers compensation insurance from a state fund or a private insurance company?

competitive state funds

Doug fell from a 12 foot ladder while stocking inventory at work one day and was unable to work for 3 weeks while he recovered from his back injury. Which of the following workers compensation benefit categories would compensate Doug for the loss of income while he was recovering?

disability benefits

which of these statements regarding workers compensation benefits is NOT correct? -payment of medical benefits is generally unlimited and does not contain deductibles -rehabilitation benefits pay reasonably justifiable expenses medical rehabilitation and physical therapy -survivor/death benefits include a weekly benefit and a stipulated amount for funeral and burial expenses -disability benefits pay the full amount of the employees lost income if a spouse partner or relative does not exist

disability benefits pay the full amount of the employees lost income if a spouse partner or relative does not exist

Which one of the following statements about workers compensation insurance is NOT correct? -every type of employment is subject to workers compensation laws -coverage for lost wages is a benefit of workers compensation insurance -self insurance of workers compensation is permitted -workers compensation policies provides benefits for rehabilitation

every type of employment is subject to workers compensation laws

part two, employers liability insurance, of a workers compensation insurance policy includes all of the following limits of liability EXCEPT -for each employee injured by disease during the policy term -for all bodily injury arising from a single accident -for all bodily injury by disease during the policy term -for all compensation paid under benefits required by workers compensation law

for all compensation paid under benefits required by workers compensation law

Janet, an employee of Carlas computer repair is injured while playing baseball for the company sponsored softball team. Under which policy would Janet find coverage for her injuries

health insurance

Which of the following occupations is least likely to be exempt for coverage of workers compensation laws? -certain farm and agricultural groups -charitable organization volunteers -casual laborers -high risk occupations

high risk occupations

in most cases, an injured employee receives payments under workers compensation insurance from whom?

insurance company

in workers compensation insurance, the experience modification factor

is applied as method of rewarding those employers with better than average loss experience

Bob's construction company, based in Wisconsin, is doing a job in Illinois. Bob's declaration page for his workers' compensation policy lists Minnesota, Iowa, Illinois, and Wisconsin as states where he will do work. Pete, an employee working in Illinois, is injured on the job. How would Bobs' policy respond? A) Pay benefits only if Bob is held liable. B) Pay benefits based on Illinois workers' compensation laws. C) Pay benefits as if Pete had been injured in Wisconsin. D) Pete may choose coverage under the benefits that are best for him.

it will pay benefits based on Illinois workers compensation laws

All of the following are factors used to determine if an individuals injury arose during the course of their employment EXCEPT -circumstance -place -time -job title

job title

If joes barber shop is located in an elective state, which of the following statements is incorrect in regard to workers compensation

joe must follow the state workers compensation laws

the purpose of employers liability insurance is to provide

liability protection where workers compensation does not apply

The standard workers compensation policy imposes all of the following duties on the employer EXCEPT: A) provide for immediate medical services as required by law. B) make voluntary payments to an injured employee. C) cooperate with the insurance company. D) immediately notify the insurance company of a work related injury.

make voluntary payments to an injured employee

workers compensation laws vary from state to state. The categories of coverage are electric or compulsory. In compulsory states, the basic methods of providing coverage are monopolistic or competitive. The monopolistic method is when the insurance

must be purchased from the state run insurer

Premiums for workers compensation are based on the amount of payroll and rates established for various occupational classifications set by the

national council on compensation insurance

Which of the following is NOT a benefit that is paid under workers compensation laws? -medical -rehabilitation -disability and income -pain and suffering

pain and suffering

Which section of the workers compensation policy contains the insurers promise to pay benefits to an injured or ill employee on behalf of the insured?

part one - workers compensation insurance

Which of the following sections provides coverage to the insured for sums the insured becomes legally obligated to pay under common law because of work related injury or occupation disease?

part two - employers liability

Which of these statements regarding workers compensation benefits is NOT correct? -payment of medical benefits is very limited in terms of the types of services covered and the length of time benefits are paid -survivor benefits pay a stipulated amount for funeral and burial expenses and a weekly benefit to surviving relatives -disability benefits are intended to replace a portion of lost income, but not all of it -rehabilitation benefits cover both medical and vocational rehabilitation

payment of medical benefits is very limited in terms of the types of services covered and the length of time benefits are paid

workers compensation coverage is rated on the basis of the employers

payroll

Which of the following limits does NOT apply to workers compensation part two - employers liability? -per employee -per property damage -policy limit -per accident

per property damage

All of the following are 3 separate limits that apply under part two of the workers compensation policy EXCEPT -policy limit per accident -policy limit for all bodily injury claims by disease -policy limit per employee for bodily injury by disease -policy limit per year for all accidents

policy limit per year for all accidents

What is the primary purpose of workers compensation?

provide compensation to employees for injuries arising out of their employment

What is the primary purpose of workers compensation laws

providing compensation to employees who have sustained injury, illness or death during the course of employment

In states that use the workers compensation competitive state fund, all of the following would typically be viable options available to an employer EXCEPT -purchasing coverage from the state fund -purchasing coverage from the state fund only -purchasing coverage from a private insurance company -if the employer meets certain criteria, providing coverage through self insurance

purchasing coverage from the state fund only

The federal employers liability act (FELA) covers which of the following types of workers

railroad employees

All of the following are benefits specified by workers compensation laws EXCEPT -medical expenses -rehabilitations benefits -lost wages -retirement plan contributions

retirement plan contributions

Which one of the following determines the amount of a workers compensation claim?

state law

What is the benefit for the employee covered by either the federal employers liability act or the U.S. longshoremen's and harbor workers compensation act?

the benefits are broader than workers compensation coverage

Which of the following sections of a policy form contains definitions and conditions that apply to the policy as a whole?

the general section

The insurer retains certain rights under the conditions section of a workers' compensation policy. Which of the following is one of those conditions? A) The insurer retains the right to inspect the insured's workplace for insurability when the insured can arrange it. B) The insurer does not have the right to inspect the insured's workplace for insurability at any time. C) The insurer retains the right to inspect the insured's workplace for insurability at any time. D) The insurer retains the right to adjust the premium if the loss experience becomes worse.

the insurer retains the right to inspect the insureds workplace for insurability at any time