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Workmans comp question

kpotter

Diamond
Joined
Apr 30, 2001
Location
tucson arizona usa
I have a really great employee who broke his hand yesterday at his house while moving furniture. I took him to urgent care and they sent us to a hand doctor. He has no health insurance. The quote to fix his hand is 20 grand they wont fix it till he pays. Can I put this under workmans comp.
 
No. If you both lie and say he did it at work both of you can face big fines and/or jail time for fraud. He needs to shed any assets and declare bankruptcy. Go hit a cop and they will fix it in prison?
Bil lD
 
Because Kevin found out what it was going to cost.

Twenty grand sounds like the "self pay" price (and in the medical field they say. "self pay = no pay.") If he had insurance the insurance company would bargain that down to four or five grand, maybe even less. I know he has little leverage, but it's worth a try.

Dennis
 
Call around to different facilities, some prefer being paid in cash so they don't have to deal with insurance companies and will give you a reasonable price.
 
Find an orthopedist or hand surgeon who owns his/her own surgicenter, not affiliated with a hospital. They are generally more willing to bargain.
 
No he was trying to get insurance, found it was too expensive then the thread got closed when we started trying to look for other options based on the fact that health care is considered only a political problem and ox was dead against it, guess that affects the income - back handers he gets from the inurance industry? Now were onto fraudulent means to provide health cover??? Spose thats not political so will be allowed to run??

IMHO you need to find a way of avoiding the insurance companies, can you not just pop down to mexico? Surely there’s cheaper and good medical options there??
 
every workman's comp claim filed against me was done elsewhere and therefore illegal - but they all went through - despite protest. of course that was the employee claiming. now if the owner got involved i suspect it would turn into a fraud
 
I have a really great employee who broke his hand yesterday while rearranging the shop. I took him to urgent care and they sent us to a hand doctor. He has no health insurance and we forgot to mention this happened at work. The quote to fix his hand is 20 grand they wont fix it till he pays. Can I put this under workmans comp.

I think this is what you meant to say...

If it is, than it is exactly what workman's comp is for. If not, get this thread deleted and try again.
 
If he was helping a friend move and got hurt then that homeowners policy could cover some but workman's comp would be dangerous.

We had an accident and many forms and signatures....These folks are always looking for such things and may figure it out.

If you were paying him to do something at his home and records existed if this being a normal thing then maybe but it will put you in cross hairs.

We maintain public safety equipment and in their locker rooms are posters indicating actions at company sponsored events where they may be but are not on the clock are private insurance....So it is a common "try"


Check the social services department as they may have guidance.

Given you have posted here it is now "public record" that is "discoverable" so no possibility now unless you have time stamped records indicating a work at home scenario that includes the tasks that could result in that injury.

Sent from my SAMSUNG-SGH-I337Z using Tapatalk
 
I worked for a large workers compensation insurance carrier for close to 14 years. In order for a claim to be covered under workers compensation, the injury must have happened AOE or COE - Arising out of employment or in the Course of employment, Believe it or not, insurance companies often investigate the circumstances of claims to see whether they arose from employment.

For an employer to put a claim under his workers compensation that he knows happened elsewhere would be a serious violation of the labor code. I sure wouldn't do that. The penalties are horrendous. I'd probably lend the fellow some money instead.
 
Actually - the Mexico idea is a very good option.


And BTW - you very well could find a Yankee doctor that is just fed up with the US BS.
Have had a cpl of family members go to Old Mexico for stuff before.

------------------

Think Snow Eh!
Ox
 
Kevin,
From all your time here on PM, you seem to be a stand up, knowledgeable guy.......enjoy your threads and posts very much............but WTH? Can't believe this question was even asked.......................................:willy_nilly:

You're in AZ...............go to Meheeco....................
 
That's going to effect your premium next time you renew, probably by a lot

Insurance fraud is bad ... I'll get that out of the way.

But a single claim on workers comp may not effect the premium at all. I've had all 10+ years with no paid claims and then had someone break their ankle jumping off a trailer. It was over $30k the insurance company paid out. And I had no effect on my premium.
 
That's going to effect your premium next time you renew, probably by a lot

You'd be surprised that it will most likely not increase it hardly at all. I know from first hand experience in my shop and with our w/c policy.

However, If you become a steady customer with them.........:D......................well that's a different story.
 
You have basically three choices:

1.) Let him handle his own broken hand....after all it didn't happen at work.

2.) Make a bunch of phone calls and attempt to negotiate a better price here in the US.

3.) Take/send him to Mexico.

Also, remember that open enrollment in the health care marketplace starts in November.

Families that make less than ~$60k get a subsidy to help pay their premiums. Get your people to sign up, get what subsidies they can, then just pay them enough extra each month to cover the premiums.

The only catch: somehow you have to make sure they actually continue to pay the premiums (with the extra money you give them) to keep their coverage...so when something like this broken-hand-at-home arises, it's not a problem.

It could be possible that your company can pay their premiums directly, to insure they keep the insurance and don't just pocket the money...?
 








 
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