Work Related Diseases Are Not Covered Under Occupational Accident Insurance

Author: Admin  |  Category: Insurance

By Ed Sneineh

Occupational Accidents insurance refers to coverage for work associated accidents that come about in the course of a individual’s occupation. Occupational accidents insurance may not cover any diseases that are not affiliated with accidents.

Occupational accidents account for over 90% of occupational disabilities in America. In most cases the injured staff is allowed for compensation under state laws. Workers compensation is a coverage that is mandated by law for all wage paying employers which hire people as ’employees’ ‘independent contractor’.

Workers compensation and occupational accidents coverage typically deals with the following details:

– All medical payments for medical care that are reasonably needed to remedy or soothe the injury.

– Temporary Total Disability (TTD): Pay for benefits while the insured staff is in recovery.


– Temporary Partial Disability (TPD). Pay for benefits when the insured worker is not completely cured but is performing some light tasks.

– Permanent Partial Disability (PPD). Provides income payments to an injured employee who incurs a permanent disability but can perform light functions.

– Permanent Total Disability (PTD). Provides income payments to an injured worker who is ruled to be incapacitated to work completely.

– Survivorship Benefits including death benefits for surviving spouse and family members.

– Vocational rehabilitation to enable the injured staff get gainful vocation through rehabilitation programs to improve employment skills or education or vocational training.

Similarities and differences between workers compensation and occupational accidents insurance.

Workers compensation is a coverage that is required by law. Workers compensation policies are created with certain minimum limits and coverages pertaining the matters listed above. The coverage along with provisions, conditions, and exclusions of the policy are closely observed by certain governmental bodies in each state. Also the government observe very closely, and does intervene in the claim paying practices. Workers compensation insurance companies work within strict legal and competitive environments. Occupational accident insurance, on the other hand, is not mandatory and its terms and provisions related to the above factors are dictated by competitive forces, not legal requirements per se.

Workers compensation insurance covers both work related accidents and work related diseases. Occupational accident coverage covers only accidents.

Rating for workers compensation coverage is based on class code (degree of risk involved with the job), insurance limits and estimated annual payroll. However, rating of occupational accident insurance is based on class code and coverage limits. Wage is not a factor in a factor in deciding rates for occupational accident policies.

Rationale for occupational accident insurance.

In situations where companies are not mandated to have workers compensation and where the class of job is too risky and where projected yearly wage is too high, some businesses may find it beneficial to get occupational accident policies instead of workers compensation. A leading example is a trucking company that recruits independent owner operator truckers. Occupational accident for truckers can be challenging in some states because some jurisdictions have ruled those as “employees” that must be covered under a workers compensation policy, not under an occupational accident policies. For that reason, occupational accident policies may not be helpful to cover independent contractors who can be looked at as ’employees.’

Some insurers give valuable enhancement to their occupational accident policies such as ‘Contingent Liability”. In occupational accident insurance, contingent liability kicks in when and if the employer is sued for accidents covered under their occupational accident polices, but it was decided later that workers compensation was mandatory to cover the case. In that case the occupational accident policy will provide coverage tantamount to workers compensation.

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Health Insurance Guide

Author: Admin  |  Category: Insurance

Health has always been uncertain. We can try our best to keep fit, but after a certain age the expenses on health do increase. Its better to keep ourselves insured under a Medical Plan to make sure that our medical expenses are taken care of.If we talk about Individual Health Insurance Plans in US, they are designed to help an individual and their families access care and cover the medical cost of receiving medical services from any physician, hospital or other provider.There are different types of Medical Plans: Indemnity Health Maintenance Organization Preferred Provider Organization Point of Service Plan Exclusive Provider Organization Consumer-DrivenHealth Insurance Portability and Accountability Act (HIPAA) Privacy Protected Health Information.Under HIPAA Privacy, unauthorized individuals cannot ask or inquire about any clinical or personal health information when counseling participants about their Medical Plans.Indemnity Plans These plans are sometimes called Free-for-Service Plans, where: An individual pays the medical care provider directly for services Files claim to be reimbursed by the PlanAn Individual can seek care from any doctor or hospital and receive benefits.Hospital precertification is required for some services in order to receive the highest level of benefits.This plan: Pays reasonable and customary deductible coinsurance amounts, up to an out-of-pocket maximum Rely on Utilization Management to control costsHealth Maintenance Organization (HMO) An HMO provides prepaid benefits for most health care needs with no bills or claim forms. It provides services through a selected group of doctors, hospitals and other providers who are under contract to the HMO. To choose an HMO option, an individual must live or work in an area supported by the HMO network as defined by their home ZIP Codes. An individual choose a Primary Care Physician (PCP) from a list of physicians They pay copayment (instead of deductibles) each time they visit a provider Services rendered by the PCP or from a provider referred by PCP is reimbursed HMOs provide preventive care and rely on Utilization Management to control costsPreferred Provider Organization (PPO) A PPO is a network of contracted participating physicians and hospitals that agree to render their services at discounted rates.PPOs maintain networks of participating doctors and hospitals; however, individuals are not required to choose a PCP to coordinate their care. They have the choice of using in-network and out-of-network providers, using in-network providers offers higher benefits though.Point of Service Plan (POS) POS Plans have networks of participating doctors and hospitals that provide medical care at negotiable rate. Individuals living in a POS service area, according to their home ZIP Codes, are eligible to join the plan and must choose an in-network PCP or facility from the list of providers Using in-network providers offer the highest level of benefitsExclusive Provider Organization (EPO) EPO Plan resembles to HMO. Benefits are provided within a specific contracted network of physicians and hospitals with no out-of-network benefits available. Individual chooses a PCP from the list of physicians Individual are required to pay a predetermined copayment (instead of a deductible) each time they visit a provider. Services rendered by PCP or by a provider referred by the PCP will be reimbursed EPOs provide preventive care and rely on Utilization Management to control costs

Tips About Health Care Services

Author: Admin  |  Category: Insurance

With the cost of providing a professional medical service to American families rising, it is not surprising that many people are looking for an affordable health care provider. Increasingly, workers are finding themselves on the receiving end from their employers who are reducing the services provided or passing on the increases. It was not that long ago that I had a fantastic health plan but all that has changed. The first we knew about it was when the company called a meeting informing of some changes including the switch to a cheaper health care provider.The excuse was that they were trying to ensure the new package would help everyone in the company. Many people I have spoken to are happy with the new insurance and that I am just as well provided for. I don not mind other workers benefiting but it costs me more now, almost twice as much more to have my family covered in the plan. OK, so many other people benefit, including my company, but my paycheck is considerably lighter now that the premium has doubled to keep my family on the policy.I liked the previous company and so far I am not as impressed with the new one although the health care plan does not seem that bad. The new affordable health care plan initiated by my company meant that certain workers found themselves a lot worse off financially with additional co-pays and expenses. You see, four years ago, I gave birth to a little girl and of course my old insurance paid for the whole of my hospital stay. Compare this to the new health care plan and I would be out of pocket by over 4,000 dollars.You also have to bear in mind that this additional expense is just the hospital bill and does not include the additional work fees I must now pay. The availability of affordable health care plans is on the increase which should help those less fortunate. Those less fortunate can now get free health care more readily and workers without health care are able to join special schemes. In principle, these plans are a good thing but there are always those that misuse it making the situation difficult for genuine cases.For many people desperately trying to improve their situation these affordable health care plans are a life-line but to others they are just an easy option. I get annoyed because it is the upright taxpayer who has to finance these schemes for the needy and not the state. By switching providers, it was my company that realized the true advantages of this low cost option and a number of employees. Having a reduced income seems to be the result of these work changes with only the company truly benefiting. We have a responsibility here in America to providing some sort of affordable health care for those that need it most.

Professional Air Conditioner Repair Is A Necessity

Author: Admin  |  Category: Insurance

byAlma Abell

Don’t wait until your air conditioner goes out on you to figure out that there is a problem with it. After all, living in southern Nevada can be quite miserable if you don’t have certain luxuries. One of these luxuries that every homeowner needs is an air conditioning unit that is functioning properly at all times. After all, you could easily get very sick if your home is too hot inside. Set up an appointment with an Air Conditioner Repair to have your air conditioning unit inspected on a regular basis. This way, you will hopefully be able to avoid any potential problems. Someone will come to your home and inspect your pump and your motor. They will also inspect the water lines to make sure that they are not leaking. This way, you won’t be wasting water.

This will put you in touch with someone who is knowledgeable when it comes to Air Conditioner Repair Waldorf MD. It will help you to understand more about what can be done to repair your air conditioning unit rather than replacing it. Usually, it can be fixed so that it is just as good as it was when it was brand new. Of course, some homeowners like to purchase a more energy efficient air conditioning unit. If this is the case, your AC contractor can help you to know which one would be best for your home. Once you have decided which one is best, he can also do the installation for you.

Early Intervention With Aba Training

Author: Admin  |  Category: Insurance

Early Intervention With ABA Training


G Butch

For many parents of a child with Autism or an Autism Spectrum Disorder, there are a large number of terms that are thrown at you rather quickly. While you are still struggling to come to terms with the diagnosis, it can be frustrating to have all of this information given to you quickly and before you can process it all. One of the terms you are likely to hear is early intervention. This term applies to the idea that catching and treating Autism early, through a method such as ABA Therapy, can make a significant difference in your childs chances of recovery. The truth is that early intervention truly does make a large difference.


It is important to understand that there is hope for children with ASD. Even if your child is older, ABA Training can have a remarkable impact and can change the lives of your child and your family as a while. Early intervention, however, does offer the most potential. When started early, during your childs most formative years, ABA Training offers significant hope of helping to rewire certain synapses in their brains, effectively teaching them how to learn and to think critically and creatively. ABA Therapy works through repetition and rewards. While this does mean that the same question is asked time and again until the child can answer without prompt, ABA Therapy is not rote memorization and children are eventually able to answer questions that they have not been provided the answers to. ABA Training works to teach children how to weight different stimuli in regards to importance, how to react and behave properly, and perhaps most importantly, how to critically think and come up with ways to solve problems and answer questions. Many people shudder when told that ABA teaches children to think or learn, but it is not insulting. Children with ASD are exceptionally bright and filled with potential, but they are born without the basic ability many of us have to express themselves or to show their creativity and independent thought. It is simply a part of their brains that did not develop and thus must be trained, and not a measure of inferiority or difference. Early intervention helps this rewiring to work by introducing it as the childs brain is still forming, often allowing them to enter school on time and maintain grades and behaviors on par with their peers. Early intervention through ABA Therapy is an excellent way to teach children. In fact, it is the only treatment covered by most insurance companies. Teaching children begins early and at home for all parents, but for children with an ASD,

Garrett Butch is the father of a 6 year old with autism and is the founder of Maximum Potential. MP’s courses in

ABA Therapy


ABA Training

were developed by 2 PhD BCBAs to empower parents and school systems and to provide effective and affordable training for school systems and parents.

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Early Intervention With ABA Training