My Employer is Self-Insured. How Will This Affect My Workers’ Compensation Claim?

Workers’ compensation benefits are often paid by insurance companies. Employers are required to carry some form or workers’ compensation policy to ensure the expenses of injured employees are covered in the event of an accident. Although workers’ compensation plans are available from established insurance companies, it is possible for an employer to insure themselves. When an employer is self-insured, work injury expenses are covered by the business rather than an insurance company.

Why Would an Employer Choose to Self-Insure?

In California, employers must apply to qualify for self-insurance by demonstrating to the state that they are financially able to cover the associated costs. If a business meets the requirements and qualifies, they can choose to supply their own workers’ compensation insurance program.

One of the draws to self-insurance for employers is that, when self-insured, they are able to manage all workers’ compensation decisions. When self-insured, employers can approve or deny workers’ compensation claims, choose medical providers, and administer the workers’ compensation claim process without relying on an insurance provider.

In some cases, self-insurance is just less expensive for employers. Some businesses find that rather than paying premiums, deductibles, and the other costs associated with insurance policies, it is more cost-effective to cover the costs of employee injuries on their own. Although self-insuring may be less expensive for some businesses, self-insured employers are required by law to provide the same amount in workers’ compensation that an insurance company would.

Navigating a Workers’ Compensation Claim with a Self-Insured Employer

If your employer is self-insured, they will decide whether or not your workers’ compensation claim is approved. This is the main difference between filing a claim with a self-insured employer and an employer who works with an insurance company — all negotiations related to your claim will be done through your employer. If your claim is approved, your employer will pay for your medical bills, income, and other expenses. As the employee of a self-insured business, you will also not need to rely on an insurance company to receive your workers’ compensation benefits.

If your claim is denied by a self-insured employer, you can appeal the denial with California’s Division of Workers’ Compensation. Our attorneys can assist you with objecting a claim denial or through any part of your claim.

At Smolich and Smolich, our legal team is dedicated to helping injured employees recover the resources they deserve. We are available to answer your questions about your workers’ compensation case.