Introduction
Parties responsible for an insured loss are now able to innovate in pleasing ways due to competition amongst compensation insurers. This has given rise to non-subscriber claims in Texas. Of note, non-subscriber claims allow Texas employers to escape the burdensome structure of a traditional workers compensation program. This article is designed to explain non-subscriber claims, their impact on injured workers, and how medical record review services can assist attorneys in dealing with these complex cases.
Claim designated as Non-Subscriber: Introduction to Concepts
• Non-Subscriber Claim: A non-subscriber claim emerges when Texas employers decide against having workers’ compensation insurance. This decision places them in jeopardy of being sued by employees that suffered injuries in the course of employment.
• Legal Framework: Texas Labor Code § 406.034 provides that non-subscriber employers lose some legal defenses and therefore, become targets of suits claiming negligence.
Subscriber versus Non Subscriber Claims Challenges
• Subscriber Employers: Employers that are in possession of workers’ compensation insurance are safeguarded from being sued in most cases. Employees are limited to recovering funds for medical services granted and a portion of income lost.
• Non-Subscriber Employers: Employees can make claims that fall under the category of General Damages which include, but are not limited to, pain and suffering, mental anguish, and in some cases, punitive damages. Texas Non-Subscriber Claims Landscape
Analytics and Developments
• Scope: Around a third of employers in Texas fall within the non-subscriber category, resulting in nearly 75,000 non-subscriber claims per year.
• Trends: Businesses looking to control expenses and potential liabilities will likely continue this trend of non-subscribing to employees’ compensation coverage.
Industries with Non-Subscriber Employers
• Construction: Due to the likelihood of large claims being filed, high-risk non-subscriber employers are more frequent in these industries.
• Retail: Increased non-subscribing activity from major retailers such as Amazon and Wal-Mart affects thousands of their employees.
Retrieving a Non-Subscriber Claim
Employees Actions
- Verify Employer Status: Employees can check if their employer has workers’ compensation coverage by accessing the Texas Department of Insurance – Division of Workers’ Compensation website.
- Go Through Employment Records: A lot of non-subscriber employers inform their employees about the coverage option during the on boarding process.
Observations of Non-Subscriber Claims
• Indicators: In cases where the employer does not provide workers’ compensation insurance, they may provide other disability programs that will interfere with the claim.
The Role of Medical Records in Surgery Review
• Accurate Claim Documentation: Medical records relevant to the case are just as important as doctor notes for proving non-subscriber cases. Our company makes sure all pertinent medical history is reviewed and properly reported.
• Trend Assessment: Lawyers can study a number of cases and form conclusions about particular types of injuries and their results, which can help prove their point in front of a judge.
Frequently Asked Legal Questions
• What is the non-subscriber employer’s obligation? Non-subscriber employers do have a legal responsibility to create safe workplaces and may be negligent for not doing so.
• In what way can negligence be established? Attorneys need to prove that the employer’s behavior or lack of it has a direct link to the employee’s injuries.
Case Studies
Case Study 1: An Employee Injured in a Construction Site
• Overview: One employee working on a construction site got seriously injured as a result of falling off some scaffolding.
• Challenges: Claiming the employer was a non-subscriber, so there were no standard workers’ compensation benefits, made the claim harder to prove.
• Solutions: The attorney received the claim through his non-subscriber employer. He contacted our company, and we provided him with the medical records of the employee’s injuries and treatments.
Case Study 2: Retail Incident Injury Claim
• Summary: A retail employee filed a claim for injuries resulting from slipping and falling on a wet floor.
• Challenges: A non-subscriber injury claim involving a major retail chain resulted in a complicated legal dispute.
• Solutions: The lawyer used our services to collect medical documents and other evidences, including the statements of the experts, to prove negligence.
Conclusion
Non subscriber claims in Texas is an area which requires particular attention from lawyers of hurt employees, especially when combined with our medical records review services. Legal experts will be sure that all relevant case documents are readily available to raise and substantiate legal arguments.
