Workers’ Compensation vs. Health Insurance: Which Will Cover Your Injury Costs?

Workers’ compensation is a special type of insurance and New York law requires most employers to purchase it to protect their employees. However, it is not necessarily the employee’s only means of protection.

If an employee is injured at work, workers’ compensation may provide coverage for medical bills and possibly other benefits. But the employee’s personal health insurance might also provide coverage for medical bills. If the on-the-job injury is a work-related auto accident, the employee’s auto insurance may also provide medical payments up to a certain limit.

Learn more about how the benefits from worker’s comp compare to those from health insurance.

NY workers comp overlapping coverage

If you’re hurt on the job, filing a workers’ compensation should always be your first priority, because:

  • Private insurance may exclude coverage for work-related injuries.
  • Worker’s compensation procedures include notice requirements, so you need to make sure your claim is filed in a timely fashion.

In the insurance and benefits industries, managing these overlaps in coverage is sometimes referred to as coordination of benefits. There are some things to keep in mind if you are facing this type of situation.

Managing worker’s compensation and other benefits

Each situation will be different, but there are some general guidelines to keep in mind when dealing with a work injury.

  • Each type of coverage has its own rules (or policy terms). Your claim needs to comply with each that may apply.
  • Worker’s compensation usually provides more comprehensive benefits than those found under private health insurance.
  • If the injured employee receives other government benefits, such as Social Security or Medicaid, there could be further coordination of benefits issues. Speak with a professional to prevent problems with coverage.
  • No matter how many sources may provide compensation for an injury, the employee may only recover once – there is no double-dipping allowed.
  • Insurers and government agencies have what is called a right of subrogation, which lets them seek reimbursement for what they have paid out on your claim from third parties or other insurers who are legally liable.
  • If you seek more than one type of benefit, be careful not to jeopardize the other benefits. If you are not sure workers’ compensation will cover your injury, make sure the doctors you see are in your health insurance network, in case you need to rely on that policy for your treatment.

When do I need a New York workers compensation lawyer?

When work injury claims become complicated by multiple coverages, seek help from a dedicated NY workers comp lawyer who can coordinate your benefits, ensure your obligations as a claimant are met, and manage subrogation claims.

The dedicated attorneys at Aronova & Associates represent injured workers from Manhattan to Long Island and throughout the greater NYC area. We take the time to understand your injuries, address your concerns, and aggressively pursue maximum compensation on your behalf. Call today to schedule a free consultation.

Contact Us

Ready to Work for You

Aronova & Associates is a firm for all New Yorkers. Our services are available in multiple languages and tailored to the needs of every client.  The first step in providing you with the help you need is a free consultation to discuss your case. When you’re ready to talk, we’re ready to get to work for you.

This field is for validation purposes and should be left unchanged.

Disclaimer: The submission of our contact form does not form an attorney-client relationship. You may not rely upon this information as legal advice.