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Home > Texas Occupational Accident | Occupational Accident Policy Benefits

Q. 11. What Type of Benefits Does an Occupational Accident Policy Contain ? 


Typical Plan Highlights:

  • Combined Single Limit (CSL) of $1,000,000.00 up to $6,000,000.00 with an aggregate limit of liability of up to $25,000,000.00 per accident.
  • Benefit Period of one two or 3 years
  • 7/28 Elimination period of disability
  • CSL is the aggregate of expenses incurred for Medical, Disability and Accidental Dismemberment and Death Benefits.   
  • Employers Liability including defense costs.  
  • Insured by respected A Rated or Better Insurance Companies. 


AN OCCUPATIONAL ACCIDENT PLAN HAS FOUR KEY BENEFITS:


1. ACCIDENTAL DEATH AND DISMEMBERMENT:

In the event of an on- the- job accidental death or dismemberment, the plan will pay up to $150,000 to the Employee or his beneficiary.Burial: The plan also pays a burial benefit of $5,000.All other occurrences of dismemberment are paid in accordance with a policy schedule. 

2. WEEKLY DISABILITY:

If an employee earns $8.50 per hour or greater; benefit equals 70% of his hourly wage If an employee earns less than $8.50 per hour; benefit equals 75% of hourly wage. Maximum weekly disability benefits range from $600 to $1,000 per week. This benefit is described as a 7/28 benefit. This simply means that benefits are paid after a waiting period of 7 days and if the disability extends beyond 28 days, the first seven days are paid for retroactively.

3. MEDICAL EXPENSE COVERAGE:

The plan pays for a range of medical expenses incurred as a result of an on the job accident. The plan pays 100% of expenses after a deductible. Coverage is for usual customary and reasonable charges for medically necessary services ordered by a physician. Please refer to the policy for exclusions.

4. EMPLOYER'S LIABILITY:

 This covers amounts paid to obtain a release of liability or settle a claim for workplace negligence brought by a covered employee as the result of a covered injury.Amounts paid to satisfy a judgement for an Employer Indemnity claimDefense costs and expenses related to an Employer Indemnity claim
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