You may be surprised to find out that, in Texas, companies ARE NOT REQUIRED to carry insurance that covers injuries to their employees while on the job. Smaller companies often have insurance that covers any personal injury or property damage that they may cause while they are operating their business but, this type of insurance does not cover injuries to its own employees. Therefore, there is often confusion about whether injured workers are receiving the benefits they deserve.
If you are injured on the job, you may be facing one of a few possible scenarios:
- Your Employer has NO INSURANCE at all! Generally, this means if you get injured because of your employer’s negligence, you could only sue him or the company directly and recover from what assets your employer or the company may have, depending on how the business is set up with the State;
- Your Employer only has a General Commercial Liability Policy! This type of policy does not provide coverage for injuries to employees or contractors;
- Your Employer is a Texas Workers’ Compensation Subscriber and has insurance to cover injuries to employees. This means you will be covered but, the Workers’ Compensation rules are very specific and you may need help making sure you get the right treatment and benefits before you are sent back to work!
- Your Employer is a NON-SUBSCRIBER. The Company has its own insurance plan (Not Texas Workers’ Compensation) that provides benefits and covers injuries to employee while on the job. These are Non-Subscriber Employers. There are several companies that have their own insurance plans that cover injuries to employees. Some examples are: Stripes, Wal-Mart, Kroger, Academy, Home Depot, Target, La Michoacana Meat Market, HEB, and many other well-known companies in Texas.
Figuring out if you have benefits can be a difficult process and often times employers are not so willing to cooperate and help you figure it out. Therefore, if you are injured on the job, it is important you take the proper steps to make sure you haven’t affected your ability to claim your benefits.
If you have been injured on the job and you work for any of the NON-SUBSCRIBER employers listed below, call Sandoval & Waldman!
- Home Depot
- La Michoacana Meat Market
- Dairy Queen
- Tejas Tubular
- Gretna Machine Shop
- C & L Carriers
- Cardinal Logistics
- Palais Royal
Find out more here! Work Injuries Under Non-Subscriber Plan
ERISA Work Injury Plans
The Employee Retirement Income Security Act (ERISA) is a federal law that regulates and establishes oversight for private health insurance coverage by establishing rules and minimum standards that are meant to protect plan participants. Generally, under ERISA, employers are enabled to create employee benefit plans that provide coverage for injuries employee have on the job. These coverage plans are not created or subject to Texas Workers’ Compensation laws. Therefore, Texas employers who provide coverage under these ERISA plans are generally referred to as Texas Non-Subscribers.
Within the ERISA plan documents, Texas Non-Subscribers usually provide certain notice about the difference between coverage under a non-subscriber insurance plan and Texas Worker’s compensation. The following are some of the usual disclosures made:
- The company will disclose that they do not have workers’ compensation insurance coverage
- The employee is not entitled or eligible to receive workers’ compensation benefits under the Texas Worker’s Compensation Act;
- The company may have benefits for the employee;
- The employee should contact the company representatives to determine the availability of benefits for work-related injuries or occupational disease;
- The employee could have rights under the common law of Texas should the employee have suffered a work-related injuries or occupational disease (Negligence claim);
- The company is required to provide the employee with coverage information in writing when the employee is hired or, at any point that a company changes from coverage under the Texas Worker’s Compensation Act to a Non-subscriber policy
- Any dispute related to a work-related injury is subject to arbitration;
- Any dispute between the Summary Plan Description (SPD) and the Plan Document will be resolved in favor of what is found in the Plan Document.
Therefore, if you are injured on the job or suffer from occupational related disease, it becomes urgent that you notify your employer immediately. Many ERISA plans require that an injured employee notify their employer within 24 hours of the incident or, before the end of that work day. If the employee fails to notify the employer and REPORT the injury in writing, the employee’s benefits could potentially be denied by the ERISA plan administrator, who is another company that is responsible for managing the benefits under the ERISA plan.
Relationships Between Lawyer and Client are Based on Trust!
At Sandoval & Waldman, PLLC, you will speak directly with an attorney like Steve Waldman. Right away, you’ll find that you can trust them to represent you. We pride ourselves on being available to discuss your legal issue on the phone or in person, determine quickly whether we believe we can help you and, if we can’t, we will try to offer some guidance to you and your family so that you can continue with your lives with peace of mind, knowing you’ve spoken to a lawyer.
When a family member is killed or seriously injured because of someone else’s negligence, there are many questions that require answers! We have the answers.
If you or a family member have been involved in a serious accident with serious injuries, call a lawyer you can trust, a lawyer you can speak to, and a lawyer who will make every effort to give you and your family the answers they deserve.
Protect Your Rights. Protect your Family. Call us today at 713-688-4878 for your Free Accident Consultation Today. Remember, your initial consultation is free, and you don’t pay unless you win.