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Workers Compensation

What is Workers Compensation

Workers compensation insurance is a type of comprehensive insurance that offers employees benefits in the event of accidents at work, work-related injuries or occupational diseases. With a few exceptions, almost all workers are insured via their employer.

Employee compensation pays all of an injured employee’s reasonable medical expenses associated with an injury and a percentage of their lost wages. If an employee suffers a fatal injury, the compensation also provides benefits, including funeral and funeral expenses, paid to surviving family members.

An accident at work can be scary and hurt you so much that you can’t return to work immediately – or maybe never again – with rising medical bills. For workers who are injured in the course of their employment, there may be several ways to claim maximum compensation.

Workers compensation insurance benefits (known more commonly as ‘Workers Comp’) covers medical and rehabilitation costs, as well as a portion of lost wages. It is worth noting that there is currently no workers compensation that will replace 100% lost earnings nor will it compensate an employee for ‘pain and suffering’.

Recipients of workers compensation insurance payouts are restricted from litigating directly against their employers for the work related injury. However, there are some notable exceptions when looking to maximize compensation via a third party workers compensation claim.

What Is a Third Party Claim in Workers Compensation?

A third party lawsuit can be best described as a personal injury claim filed if you are hurt during the course of your employment, and if the accident can be proven to be due to the negligence of a person or business other than their employer or a co-worker. In some cases, injured workers can pursue both a third party claim and workers’ comp. There are several parties that third party claims can be filed against, including but not limited to the following:

  • Contractors
  • Subcontractors
  • Product manufacturers
  • Product distributors
  • Other drivers if the employee was in a car accident, bicycle accident or pedestrian accident while working

Who can be held liable in a third party workers compensation claim?

An injured worker can file a third-party application against a third party who has acted negligently, thereby contributing to or causing injury to the worker.

For example, a liability lawsuit can be filed against: The manufacturer or distributor of a dangerous or incorrectly designed or manufactured product, the owner of a property in a dangerous condition that has not been corrected, the owner of another company that works on the same construction site, a third-party driver or machine operator. The list of third party liability is endless and varies from case to case and its always advisable to seek solid legal advice when looking at all aspects of workers compensation claims.

Burden of proof in a third party workers compensation claim

Employees wishing to file a liability claim must provide evidence that the third party against whom they are suing should be held liable. This means that the evidence must prove that the plaintiff’s case is more than 50 percent likely to be true.

Establishing Grounds for a Third-Party Lawsuit

Standard workers’ compensation insurance is “no-fault insurance,” meaning workers can file a claim to receive medical and limited wage benefits for a work-related injury without having to prove the employer did anything wrong. It’s easier for the injured worker, but won’t fully compensate the worker for severe injuries.

However, to win a third-party claim, you’ll have to prove the third-party was negligent, meaning they did something wrong or failed to do something that caused your injuries. A third party workers compensation lawsuit must prove:

  • You had a work-related accident
  • The third-party owed you a duty of care
  • The third-party failed in their duty of care
  • Your suffered injuries
  • The work-related accident caused your injuries
  • Whilst this may sound onerous, it’s why most claims are progressed with the help of an expert personal injury attorney. Simply put, the burden of proof is extensive because you’ll need to demonstrate that the third-party created a situation that led to your illness or injury, and if not for that situation, you would not have been hurt.

    Third-party elements that a plaintiff must demonstrate for a successful claim

    1. There is a duty of care between the plaintiff and the accused. Most of the time, duty of care is implied. For example, a property owner owes a duty of care to those entering the property. A manufacturer of a product has a duty of care to the consumer. A driver has a duty of care to everyone else on the road.

    2. That the defendant violated the duty of care. This second element means that a plaintiff must prove that the defendant has violated the duty of care that he owes the plaintiff. Based on the examples above, failure to keep property in reasonably safe condition, failure to design or manufacture a safe product, or failure to drive safely are examples of negligence.

    3. The breach of due diligence caused the accident and injuries to the plaintiff. This third element of a liability claim is to prove that the breach of due diligence was the immediate cause of the accident and the plaintiff’s injuries. For example, the plaintiff would not have suffered an accident if the defendant’s machines had not functioned incorrectly.

    4. The worker suffered losses. Finally, an injured worker who claims liability must prove that he has suffered actual damage as a result of his injury. This can include psychological injuries and disabilities.

    Examples of Third Party Claims

    Car accident during working hours
    You can be a professional driver, visit a customer, or just run an errand for your boss. However, if you were injured in a car accident for which you are not responsible, you may be entitled to file a lawsuit for damages against an employee and file a lawsuit or lawsuit against the person who caused the accident.

    Construction site accidents
    The general contractor is responsible for the safety of the construction site on construction sites. If you work for a subcontractor and are injured at work, you may have reasons to pursue the general contractor in a third-party lawsuit. For example, if you are a painter and suffer an electric shock due to unmarked live cables, the general contractor can be held responsible for your injuries if they failed to comply with OSHA regulations for power cables.

    Carelessness of the owner
    If you are working on a property that is not owned or managed by your employer, you may have reason to file a third party lawsuit against the owner if you are injured due to dangerous circumstances on the property.

    Defective products
    An employee who receives benefits from his employer’s employee liability insurance can also file a third-party lawsuit against the manufacturer of a defective product that caused the injury. This is known as a product liability lawsuit. The employee reimburses the employee’s remuneration and retains the remaining amount of the settlement amount or the prize money from the manufacturer.


    Author Since:  August 22, 2019

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