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I don't want to file workers comp but insurance company sent me questionnaire
#1
Help!!
My 17 yr. old son who works "under the table" for a very small company recently got hurt at the job. While at the hospital we told the doctors that the accident happened at work, not realizing that it could possibly come back to the employer since we had medical insurance. We now have received a questionnaire from the insurance company indicating that someone else should pay the medical bills. Questions are asking about location of accident, give a description about what happened, was it work related etc. We do not want to go after the employer because we doubt he even carries workers comp insurance and my son was doing a "stupid stunt" and got seriously hurt with skull fracture and spent 3 days in pediatric ICU. Luckily he is fine now and we just want the medical insurance to take care of the cost.

Since there is no way to prove he works, due to being paid in cash, can we somehow get around this through insurance company.
 
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#2
some states do not require work comp insurance for "small employers" so there may not be a big problem.

if it is a state that requires coverage then it's not really you or your son's choice to divert coverage from the comp carrier to health insurance.
if there is a comp carrier and they reject the claim, then it is likely the health coverage will pay for it.
there are many ways to prove he works.
does your son's state require coverage?

there is no guarentee there won't be long term effects from such a serious injury.


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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#3
Thanks so much for your quick response.
We live in Florida and I'm not sure what the rules are for small companies. If the employer does not have workers comp insurance and the medical insurance company shows that it happened at work, I'm assuming that the medical insurance will not cover it and therefore bill us for the total amount. We would then have to sue the employer to pay the medical costs, is this correct?? This is what we are trying to avoid. He had nothing to do with my son's injury and he should not be liable. It's a terrible situation all the way around.

We were thinking about saying that my son was helping a friend at his work and while "working" this accident happened. What do you think??

I agree about the long term affects, right now he does seem fine but his memory retention is foggy at times. School will start soon and we will continue to watch if his grades become affected. He is a good kid and has always been in AP classes doing well. He made a stupid mistake and I just want our health insurance to take care of it, just like any other injury.
 
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#4
I looked it up and per Florida requirements, if you have under 4 employees you do not have to carry workers comp coverage. This company only has 3 part time employees. Sooo if the employer does not have to carry workers comp coverage per state requirements would he still be liable out of his own personal or home owners policy??
 
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#5
with workers comp not required, I think you/your son need to discuss it with the employer and see how they want to deal with it.

giving a false history of the injury will make it very difficult to establish liability should there be later flare-ups or after effects. the employer may have other coverages that they would prefer using.
even though comp coverage is not required it is available to those that opt to include it in their general liability insurance.
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
The worry is that if we discuss it with the employer, even though he's aware of the accident/injury, he will fire our son and be very bitter about the issue. As it is, after the accident he somewhat "scolded" our son for playing around but due to his work ethic was willing to take him back. Our preference is to leave the employer out of it completely. However, if we say it occurred while helping a friend on 1 day of " work", without pay, even if the medical insurance looks into it, if the employer has no comp insurance I would hope he would be off the hook completely.

I'm really not so worried about medical flare ups/after effects as we will deal with that, what we are most worried about is a a 100k+ bill from the hospital to either affect us or the employer.

You have been extremely helpful!! Given our dilemma, what do you think we should do?? Be honest and give the company name/address and tell the employer and have our son get fired? Or…. say that our son was helping a friend load some materials and while "working" he fell/hit his head and the injury occurred? Would we still have to give the exact address or can we "play dumb"?
 
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#7
I'd still recommend letting the employer be part of the decision.
being afraid they'll react badly and not getting them involved is taking the decision away from them. if I was an employer I would not like that even if it's a problem for me.
it is the employer choice to act badly or not but your son owes them the opportunity to be responsible as well.
work injuries are the responsibility of both the employer and the employee.
trying to "protect" the employer buy hiding the problem rarely works out.
they might just surprise your son and do the responsible thing.
once the coverup begins it's difficult to stop.

speaking also as a parent you have to remember what values this incident is teaching your son:
when there is a problem do you face up or cover up?!
in the long run the right lesson now might help him avoid much worse predicaments when he's older.
you asked for my personal opinion.sorry if it's too preachy.
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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#8
No, I hear you and I appreciate your honesty. My husband and I have talked to our son on numerous occasions on how lucky he was that he has seemed to recover health wise and that he still has his job. His employer chalked it up to "doing stupid things at 17", and allowed him to continue his employment after her recovered.

We are truly good/honest people and our values are definitely to own up. However, as I said previously it is not the employers fault that our son did something stupid and got hurt. I worry about the collateral damage…ie. employer having to pay and our son losing a very good job. He gave our son this job on good faith and that he's a responsible kid, not to be sued or liable for anything. Of course I also worry about insurance fraud and being billed for 100k+.

Sooo, your suggestion is to own up to the truth on the questionnaire, talk to the employer, and go from there??
 
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#9
yes.
workers comp is no fault insurance.
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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#10
If the employer does not have workers comp insurance do you believe that the medical insurance will just pick up the cost or will the employer still be liable??
 
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