Florida workers’ compensation insurance

Whether or not sole proprietors, independent contractors, and other self-employed individuals are required to have workers’ compensation insurance depends on the nature of the work being performed.

The State of Florida requires that even self-employed workers in the construction industry carry workers’ compensation insurance. If you’re in an industry that has less risk of workplace injuries and you have no employees, you might still decide that it’s a good idea to have coverage.

Even though you have medical insurance, if you get injured on the job, workers’ compensation coverage can help with lost wages and other expenses that would not be covered under your regular medical policy.

To save money on workers' comp insurance, it's important to make sure you classify your employees correctly. Employees with desk jobs or other jobs with a low risk of injury cost less to insure. This also helps you avoid misclassification fines.

In some cases, small business owners can choose to buy pay-as-you-go workers' compensation. This type of workers' comp policy has a low upfront premium, and lets you make payments based on your actual payroll instead of estimated payroll. It's useful for businesses that hire seasonal help or have fluctuating numbers of employees.

Finally, a documented safety program can help lower workers' comp costs. A safer workplace means fewer accidents, which helps keep your premium low.

Each state has certain nuances to its workers’ comp law, and Florida workers’ compensation is no exception. However, there are some general concepts as to how the process works.

If an employee is injured on the job, it’s likely that costs will be incurred that need to be covered by workers’ comp insurance. Costs could include:

• Hospital or other ongoing medical bills
• Ambulance transportation
• Temporary total disability payments
• Permanent disability payments

After a work-related injury or illness, the employee can make a claim against the employer’s workers’ compensation insurance policy. If accepted by the insurance company, the employee could receive funds to cover medical expenses and a disability payment plan.

Employers that operate without the required workers’ comp coverage risk civil penalties. Usually, that means that the business would be subject to a stop-work order that requires all operations to stop until it complies with the law and pays a penalty. The fee is typically equal to twice the insurance premium the employer would have paid for the preceding two-year period.

If the employer does not comply with a stop-work order, the action could result in criminal charges. You could also be subject to a stop-work order if:

• Payroll is understated or concealed
• Employees’ duties are misrepresented or concealed
• There is any attempt to avoid paying workers’ compensation premiums

If an employee dies as a result of a work-related accident within one year of the date of the accident or within five years of continuous disability, death benefits could be owed to the employee’s survivors. The family of the deceased employee could be entitled to:

• Up to $7,500 to cover funeral expenses
• Education benefits to a surviving spouse
• Up to $150,000 in compensation benefits to dependents (paid at up to 66.67% of the decedent’s weekly wage)

In some cases, an employee might try to negotiate for a larger workers’ comp settlement.

If an injured employee decides to escalate a claim to a larger settlement negotiation, the employer should remain involved in that discussion to reduce liability in a lawsuit if one arises.

Before an insurance company will settle a claim, it will ask the employee and his or her attorney to calculate the total amount of anticipated related expenses.

The insurance company won’t simply pay a settlement based on all of these calculations. Often, the insurance company and the employee’s attorney will spend some time negotiating before reaching a settlement that is agreeable to all parties. If they can’t reach an agreement, there could be a hearing or lawsuit.

Statutes of limitations are designed to protect against claims that are filed too long after an injury has occurred. Florida laws state that an employee cannot claim benefits, receive medical treatment, or sue for lost wages if the period is more than two years from the date of injury.

There are a few exceptions to the two-year statute of limitations:

• If the injured worker is a minor
• If the injured worker is mentally incompetent
• If the worker was misled by the employer about coverage entitlement
• If the insurance carrier did not properly inform the worker of his or her rights
• There is no statute of limitations in Florida for care associated with medical prosthetic devices

The primary regulatory agency for Florida workers’ compensation claims is the Division of Workers’ Compensation, which is a part of the office of Florida’s Chief Financial Officer.

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