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Friend was told to use personal insurance
#1
Hello,

My friend was on a business trip in Mexico and fell down the stairs. She didn't want to go to a hospital in Mexico so waited 2 days until she returned to the US and went to the hospital here. She broke her arm.

Her employer is telling her to use her personal medical insurance rather than going through worker's comp. My friend doesn't want to "rock the boat" so she called the hospital today and gave them her insurance information because they were originally going through worker's comp.

Are there any benefits other than not having to pay the co-pay and deductible for going through worker's comp? Not having to use PTO for days off is one that comes to my mind but I'm not sure how that works. She's already missed one day of work (today) to go to the hand surgeon. They may have to do surgery on it so she might miss more day. I hate to see her use her vacation time for this if she doesn't have to.

What do you guys think? Is it worth pursuing?
 
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#2
The word "fraud" comes to mind. Why word one insurance carrier want to pay for what another should????

Now lets look at a worse case scenerio. Lets say she has to be off work for a few months while her body heals. What is she going to do for monies?????? Lets that she has nerve damage that does not heal. Who is going to pay for the meds. for the rest of her life???????

Lets not forget the key words. "POSSIBLE FRAUD".

In my oppinion, she is playing a dangerous game.
8-05, Micro laminectomy/disectomy. 10-05 lumbar fusion L5-S1. 2-07 exploritory surgery. 12-07 medical implant, Spinal Cord Stimulator. now receiving SSDI. After going back to school, I received my degree as a mechanical engineer. What can I say, it was the only way I had to beat the system. 
 
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#3
your friend doesn't get to choose how the injury occurred or who is liable.
her health insurance excludes work injuries unless it's denied.
sounds like her employer may not have work comp coverage.
comp pays disability as well as medical.
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
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#4
So you guys think that because she was on a business trip, it should count for worker's comp? Even if she wasn't working at the time? I think that is the debate here.
 
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#5
most likely yes but it depends on the state laws.
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
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#6
What was the reason she was out of town?

For a more specific answere. Her state would need to be known. WC is state specific.
8-05, Micro laminectomy/disectomy. 10-05 lumbar fusion L5-S1. 2-07 exploritory surgery. 12-07 medical implant, Spinal Cord Stimulator. now receiving SSDI. After going back to school, I received my degree as a mechanical engineer. What can I say, it was the only way I had to beat the system. 
 
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#7
alot more info is needed. Just being on a business trip doesn't mean it's a WC issue but it doesn't mean it's not. Turn it into WC and let them figure it out, if it's not covered by WC then they can turn it over to your insurance.
Rereading it you might need to find out if her insurance will even cover it since it happened outside the US. They might since the treatment is going on here but they might not. Sad to say some companies don't cover you if outside the US
 
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