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3 reasons not to use your health insurance for a work injury

On Behalf of | Apr 21, 2021 | Workers' Compensation

A workplace injury severe enough to require time off of work typically qualifies an employee for workers’ compensation benefits. These include health coverage and disability benefits that replace missed wages.

Some people try to use their own health insurance policy instead of reporting the issue as a work injury. There are several reasons why doing so is a mistake.

Your health insurance plan passes expenses on to you

No matter how good your health insurance plan is, it will inevitably have cost-sharing rules. You may have to pay a co-pay and co-insurance even after you meet your deductible. Workers’ compensation has no cost-sharing, meaning you don’t have to pay for your treatment out-of-pocket.

You might also qualify for disability benefits

If you are going to miss a significant number of days from work, filing a workers’ compensation claim protects you because it can replace some of your missing wages. Rather than struggling to make ends meet or forcing yourself to work when you should rest, getting disability benefits can be the best decision for someone with a noteworthy workplace injury.

You could wind up responsible for your own medical expenses

Trying to use your own health insurance policy means you can skip filling out paperwork with your employer, but you are the one taking the biggest risk. You only have 30 days to report a workplace injury and usually only a year to initiate a claim for workers’ compensation. Injuries reported and claims filed after that window likely won’t succeed.

Unfortunately, if your insurance provider finds out that the care you received relates to something that happened at work, they will likely reject your claim or try to subrogate it to the workers’ compensation insurance company. If they start that process after your ability to seek benefits ends, you could wind up in a difficult position where no insurance company feels it has the responsibility to pay for your care.

Filing for workers’ compensation benefits can also help you because it requires that you report the issue to your employer. That in turn will motivate your employer to accommodate you if you try to return to the job or at least create penalties if they retaliate against you for reporting your injury or after you apply for benefits.

For assistance with your workers’ compensation claim, contact local attorney Steven Morgan. Schedule a free consultation by calling 912-289-0640 or sending an email.