Workers' Compensation Insurance Ch 14

Which statement is false regarding Workers' Compensation?

A It pays medical expenses, loss of time benefits and death benefits B It covers investigation and defense costs C The premium is paid by the employee D Payment is made without regard to negligence C - The cost of the Workers' Compensation program is paid by the employer.

Under the Workers' Compensation Policy, all of the following are true, except:

A A covered injury must be caused by the conditions of employment B The policy covers litigation costs taxed against the insured C Coverage applies to bodily injury due to disease, as well as to injury due to accident D Injury caused by an accident occurring after the policy period expiration date will be covered D - The accident causing the bodily injury must occur during the policy period.

Which of the following work-related injuries might not be covered by Workers' Compensation insurance?

A An employee suffers his/her second injury in the same year B An employee is injured despite the extensive safety measures taken by the employer C An employee from accounting is injured while assisting an assembly line worker D An employee is injured when a fellow employee pushes him/her into heavy machinery C - A covered injury does not include an injury to an employee performing duties he/she was not hired or trained to do

If an employer cannot obtain Workers' Compensation coverage for his employees, which of the following is an alternative?

A Assigned Risk Plan B Surety Fund C Workers' Compensation Fund D State Claim Fund A - This state Plan offers Workers' Compensation coverage for employers who are unable to purchase coverage in the voluntary market, and all authorized Workers' Compensation insurers in the state must participate in the Plan.

Which of the following is the sole representative under the policy?

A Company legal representative B First Named Insured C Employer and his partners D Named Insured B - The First Named Insured will receive any cancellation notice and receive any unearned premium.

Which type of regulatory environment permits Workers' Compensation benefits only through a state fund?

A Competitive B Compulsory C Monopolistic D Elective C - Monopolistic Workers' Compensation insurance is only available through a state fund.

Which of the following Workers' Compensation programs applies to sailors injured due to the negligence of others?

A Defense Base Act B Federal Employer's Liability Act C Harbor Workers' Compensation Act D Jones Act D - FELA applies to interstate railroad workers, the Harbor Workers' Act applies to workers who load, unload, build or repair ships, and the Defense Base Act applies to workers on military bases outside the United States.

Which of the following expenses would not be reimbursed under the Workers' Compensation policy?

A Defense costs B Claim expenses C Premiums for appeal bonds D Loss of insured's earnings because the insurer requested the insured come to court D - The Insurer will pay expenses incurred by the insured, at the request of the insurer, but not loss of earnings.

When an employee is injured by a product manufactured by the employer, the Employers Liability will provide coverage under which of the following?

A Doctrine of Dual Capacity B Third-party Action Claim C Consequential Injury Fund D Loss of Services A - Doctrine of Dual Capacity applies when an employee is injured by a product the employer manufactures.

Which of the following types of Workers' Compensation laws is available through a state fund?

A Elective B Competitive C Monopolistic D Compulsory C - The Monopolistic law is only available through a state fund, and the Elective version allows employers to accept or reject the state Workers' Compensation law.

Each of the following is an exempt worker under Workers' Compensation statutes, except:

A Employee in a company of 100 employees B Independent contractor C Sole proprietor D Farm laborer A - Some states exempt workers of employers with fewer than three employees.

Which of the following statements is false regarding Workers' Compensation law?

A Employers are liable for injuries occurring outside the course of employment B Benefits are paid for on-the-job injuries, regardless of negligence C An employee may not refuse Workers' Compensation benefits in order to sue the employer for a larger award D The employer assumes absolute liability for injuries that arise out of and in the course of employment A - Workers' Compensation Insurance covers employee's injuries arising out of and in the course of employment, and these benefits are the exclusive remedy for the employee injured under these circumstances.

Employers Liability Insurance is designed to do all of the following, except:

A Fill in gaps of compensation coverage B Cover claims that are not subject to compensation laws C Extend policy benefits to states not listed on the Declarations page D Protect the employer against common law claims C - Part II does not extend the coverage to other states. Other States Insurance is provided by Part III of the policy.

An employee injured in an auto accident while on company business would be covered under the:

A Group health insurance policy B Garage Liability Form C Workers' Compensation Policy D Garagekeepers Form C - Workers' Compensation is the exclusive remedy for on-the-job injuries.

All of the following are covered injuries occurring during the course of employment, except:

A Illness is contracted on the job B The employee is performing regular job duties C Injury must occur while the employee is at work D Injury occurs while the employee is playing in a company softball game D - While it is a company game, it does not occur while working, performing the assigned jobs, during the designated work hours, and it is not reasonably related to employment.

The Employers Liability pays for all the following for which the insured is legally obligated to pay, except:

A Intentional injury by the employee B Injuries claimed by a third party as a result of worker's injuries C Consequential injury to dependents D Care and loss of services A - Employers must be legally obligated to pay and the employer is also responsible for injuries to employees that arise out of the employment, but claimed against the insured while the insured is in a capacity other than as employer. Intentional injury by the employee is not covered.

Which of the following is true of Employers Liability insurance?

A It is excess coverage over Workers' Compensation benefits B It covers employees only if working in a state not listed on the information page C It covers actions brought against the insured in a capacity other than as an employer D It covers only executive officers C - Employers Liability covers actions brought against the insured in a capacity other than as an employer, such as consequential injury.

Which coverage is not included in a Workers' Compensation policy?

A Medical benefits B Second injury fund C Employer's liability D Disability income benefits B - The Second Injury Fund pays that portion of the loss attributed to the prior disabling injury. The purpose of the fund is to relieve an employer of the portion of claims related to prior injuries that are simply made worse by the employee's current work. This is part of the policy but something provided on a state-by-state basis.

Workers' Compensation provides coverage for all of the following, except:

A Pain and suffering B Death C Medical expenses D Disability income A - Pain and suffering are not covered under Workers' Compensation.

Employers Liability applies under which of the following circumstances:

A Punitive damages awarded because an employee was employed in violation of law B The employee is allowed to sue the employer for negligence C An obligation imposed by a Disability Benefits law D Liability is assumed under a contract B - Employer's Liability provides insurance for bodily injury and other damages for which the insured is liable outside of Workers' Compensation and the employee is permitted by law to sue the insured for negligence.

Which disability income benefit covers an injury that allows an employee to do some work, but is unable to earn his or her usual wage until full recovery?

A Scheduled Injury B Temporary Total C Temporary Partial D Permanent Partial C - Temporary Partial benefits are generally calculated as a percentage of the difference in wages.

Which of the following is used by an employer who wants to provide Workers' Compensation benefits even when it is not required?

A Stop-Gap Endorsement B Secondary Injury Fund C Voluntary Compensation Endorsement D Other Insurance Endorsement C - The voluntary compensation endorsement is used when an employer wishes to provide Workers' Compensation benefits to employees, although the law does not require the employer to provide coverage.

To which disability would a scheduled benefit apply?

A Temporary Total B Permanent Partial C Permanent Total D Temporary Partial B - A scheduled benefit applies to specific permanent partial injuries, such as a specific dollar amount for the loss of a hand.

An injury would not be covered by Workers' Compensation under which of the following circumstances?

A The injury occurs on the way to work B The injury occurs while a worker is performing his work duties C A worker is injured during assigned hours D The risk causing the injury is employment-related A - The injury must occur while the employee is at work or working.

Which of the following is not required by the Workers' Compensation policy's guidelines for providing "Other State" coverage?

A The insured must notify the insurer within 30 days when an employee begins work in a state not listed on the policy B If the insured begins work in a covered state after the effective date of the policy, the insurance, will apply if no other coverage exists C The state work is performed in may not be a compulsory state D The insurer must reimburse the insured for any payments the insurer is not allowed to pay directly C - Employers with operations in monopolistic states must purchase coverage directly from the state entity that sells this coverage. There is no prohibition regarding employers with operations in compulsory states.

Which of the following is not an element of a temporary total disability?

A The length of the disability must exceed the waiting period B The employee can work while recovering C The employee is expected to return to work D Retroactive benefits will be paid if disability exceeds the waiting period B - An employee with a temporary total disability would be unable to do any work.

Under Workers' Compensation insurance, the insured is responsible for paying benefits for:

A When the insured incurs expenses requested by the insurer B Taxes on litigation C Appeal bond premiums D Knowingly hiring an employee in violation of the employment law D - The insured must also pay because of his serious or willful misconduct, failure to comply with safety regulations, or discrimination.