Wow, you have a heart about 10x too small. Cases like these give the Insurance industry a bad reputation. Pay the damn claim and focus on nabbing the REAL WC crooks.
Dear Insurance Chick,
Size (of the claim) doesn\’t matter. The concern here should be about the decision of the court. For as long as workers\’ comp has existed the trigger for coverage always has been the \”arising out of the course of employment.\” Coming back from lunch has always been deemed not to be a compensable exposure. What happens if somebody slips in the parking lot on their way to their desk. Would that now be covered? I just don\’t like the courts determing policy coverage.
I do like your name however.
Why wasn\’t this claim against the building owner? She probably would have gotten alot more money if she had gone against the building owner\’s liability versus the workers comp.
Oh they will subrogate! After the claim has gone through the experience mod! If the claim is on property owned or maintained by the employer it is a compensable claim. I bet she didn\’t have health insurance. Maine has 2 universal health care systems; Dirigo and Workers Comp. I have been in many hearings and have seen the Hearing officers face change when told there was no health coverage to pay the claim, if the WC claim is denied. Peoples Rebulic of Maine.
Sorry to tell you this, but this isn\’t just a Maine issue. I\’ve been in WC claims for many, many years and as far as I know whenever an employee is injured on the Employers premises, whether it is to and from work or returning from lunch, it has been deemed a compensable claim. And accepting WC benefits does not bar the employee from bringing action against the building owner. But it is probably the Aetna!
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I injured myself reading this article, so I, too, have a cause against Aetna!! You Maine commies really crack me up!!!
Injured yourself reading? Perhaps you should give your BRAIN a little more exercise.
Wow, you have a heart about 10x too small. Cases like these give the Insurance industry a bad reputation. Pay the damn claim and focus on nabbing the REAL WC crooks.
you suggested pay this claim and fight the phoney ones. slip and fall with prior back injury would seem to fit!
Dear Insurance Chick,
Size (of the claim) doesn\’t matter. The concern here should be about the decision of the court. For as long as workers\’ comp has existed the trigger for coverage always has been the \”arising out of the course of employment.\” Coming back from lunch has always been deemed not to be a compensable exposure. What happens if somebody slips in the parking lot on their way to their desk. Would that now be covered? I just don\’t like the courts determing policy coverage.
I do like your name however.
Why wasn\’t this claim against the building owner? She probably would have gotten alot more money if she had gone against the building owner\’s liability versus the workers comp.
Oh they will subrogate! After the claim has gone through the experience mod! If the claim is on property owned or maintained by the employer it is a compensable claim. I bet she didn\’t have health insurance. Maine has 2 universal health care systems; Dirigo and Workers Comp. I have been in many hearings and have seen the Hearing officers face change when told there was no health coverage to pay the claim, if the WC claim is denied. Peoples Rebulic of Maine.
Sorry to tell you this, but this isn\’t just a Maine issue. I\’ve been in WC claims for many, many years and as far as I know whenever an employee is injured on the Employers premises, whether it is to and from work or returning from lunch, it has been deemed a compensable claim. And accepting WC benefits does not bar the employee from bringing action against the building owner. But it is probably the Aetna!