Exclusive remedy

Settling workplace injury claims while avoiding costly lawsuits.

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What is an exclusive remedy?

The exclusive remedy is a provision found in workers’ compensation insurance policies. It clearly states that if a worker is injured on the job and is receiving benefits from workers’ compensation, they cannot sue their employer for that injury.

In other words, the workers’ compensation benefits are the “exclusive” or only remedy for the worker. This provision simplifies the process and provides a direct path for compensation, eliminating the need for potentially lengthy and costly lawsuits.

How exclusive remedy works

The exclusive remedy provision is mutually beneficial and serves as a compromise between employers and their workers.

  • Employees receive compensation faster. It ensures employees seek compensation for work-related injuries exclusively through the workers’ compensation system. They receive prompt and assured financial support without the need to prove fault or engage in lengthy legal proceedings.
  • Employers are protected from employee injury lawsuits. By limiting legal options, businesses can protect themselves from costly legal battles. These lawsuits can drain resources, disrupt operations, and tarnish the company’s reputation.

Legal considerations for exclusive remedy

If you’re a business owner with employees, you need to understand your business insurance’s exclusive remedy clause to remain compliant with local and state workers’ compensation laws. Some legal and regulatory considerations include:

  • State laws: Each state has its own laws about exclusive remedies. Make sure your business follows these laws.
  • Coverage details: Understand the limitations, injury definitions, and payment amounts in your state’s workers’ compensation insurance laws.
  • Exceptions: There are exceptions to the exclusive remedy rule, like employer misconduct or safety rule violations. Be aware of these for effective risk management.
  • Beyond workers’ compensation: You might face claims from third parties or non-employees, which aren’t covered by workers’ compensation. Consider additional liability insurance for these situations.
  • Documentation: Keep accurate records of injuries and benefits to show you follow the rules.

How to maximize exclusive remedy provisions

The benefits of exclusive remedy are managing risks effectively while keeping legal costs in check and your employees happy. To do this:

  • Seek legal advice: Get guidance from insurance law experts to understand exclusive remedy provisions and find any gaps in coverage.
  • Review the insurance policy: Go through your insurance policy, particularly the exclusive remedy provisions. Know your rights and obligations as the insured.
  • Understand laws: Familiarize yourself with your local workers’ compensation laws and how they relate to your policy.
  • Talk to your insurance provider: If you’re unsure about any provisions, ask your insurance provider for clarification.
  • Train employees: Educate your employees about exclusive remedy provisions, how to report injuries, and how to file claims.
  • Keep policy up to date: As your business evolves, regularly review and update your policy to ensure it stays in line with laws and meets your needs.

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Issuance of coverage is subject to underwriting. Not available in all states. Please see the policy for full terms, conditions and exclusions. Coverage examples are for illustrative purposes only. Your policy documents govern, terms and exclusions apply. Coverage is dependent on actual facts and circumstances giving rise to a claim. Next Insurance, Inc. and/or its affiliates is an insurance agency licensed to sell certain insurance products and may receive compensation from insurance companies for such sales. Policy obligations are the sole responsibility of the issuing insurance company. Refer to Legal Notices section for additional information.

** Coverage examples are for illustrative purposes only. Your policy documents govern, terms and exclusions apply. Coverage is dependent on actual facts and circumstances giving rise to a claim.

Any starting prices or premiums represented before an actual customer quote are not guaranteed and are representations of existing premiums of active policies as of December 6, 2023. To the extent permitted by law, applicants are individually underwritten, not all applicants may qualify. Individual rates and savings vary and are subject to change. Discounts and savings are available where state laws and regulations allow, and may vary by state. Certain discounts apply to specific coverages only.