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What workers' compensation insurance covers

Last reviewed September 15, 2026

Pays an employee's medical bills and part of their wages when they are hurt at work, whoever was at fault, and in return the employee generally cannot sue you. Arizona, Nevada, Utah and Idaho each require it at their own employee threshold and run the system differently.

What workers' compensation insurance does

Medical benefits

The policy pays all reasonable medical treatment for a work injury or occupational illness, with no deductible and no copay for the worker, for as long as treatment is related to the injury. Which doctor the worker sees is governed by state rules: some states let the employer or carrier direct care initially, others let the worker choose. The carrier pays the provider directly, and the employee never receives a bill for covered care.

Wage replacement

After a waiting period set by the state, an employee who cannot work receives temporary disability payments, a fraction of their average weekly wage up to a state maximum, until they return to work or reach maximum medical improvement. Light-duty work reduces or ends these payments and is the single most effective thing an employer can do to hold down a claim; a return-to-work plan written before anyone is hurt is worth having.

Permanent disability and death benefits

When the worker reaches maximum medical improvement with a lasting impairment, the policy pays a permanent partial or permanent total disability benefit under a schedule set by the state. Vocational rehabilitation pays for retraining where the worker cannot go back to the old job. If a worker dies from a work injury, the policy pays funeral costs and a benefit to the surviving spouse and dependent children. These benefits are fixed by statute, and the policy pays whatever the state's schedule says with no limit chosen by you.

Employers liability

Part Two of the policy covers the lawsuits the exclusive-remedy bargain does not stop: a spouse's loss-of-consortium claim, a third-party suit where a manufacturer sued by your employee turns round and sues you, and claims in states where the injury falls outside the compensation system. It carries limits per accident, per employee for disease and per policy for disease, and contracts and umbrella carriers usually ask for higher limits than the standard ones.

Other states and the monopolistic exception

The policy lists the states where you have employees and pays under each state's law. Adding a state before you hire there matters, because a worker hired in Nevada and injured in Utah is a Utah claim. A few states, none of the four we serve, run monopolistic state funds where the coverage has to be bought from the state; Nevada, Utah, Idaho and Arizona all have competitive markets where private carriers and, in some, a state-chartered fund write the coverage.

Covered and not covered

Covered

  • Medical treatment for a workplace injury or occupational illness, with no deductible for the worker
  • A share of lost wages after the state's waiting period
  • Permanent impairment benefits under the state schedule
  • Retraining when the worker cannot return to the old job
  • Funeral costs and dependants' benefits after a work-related death
  • Your defence and damages in lawsuits the exclusive remedy does not bar, under employers liability
  • Injuries to employees working temporarily in another listed state

Not covered

  • Injuries from intoxication or a deliberate self-inflicted act, in most states
  • Injuries on the commute to and from work, with exceptions for travel that is part of the job
  • Independent contractors who genuinely meet the state's test, and their own workers
  • Wages above the state maximum weekly benefit
  • Fines and penalties for failing to carry coverage before the policy started
  • Employees in a state not listed on the policy
  • Owners and partners who have not elected coverage

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