EMPLOYEE MOTOR VEHICLE ACCIDENTS WC or Auto Insurance? BY DEBORAH HANDRAHAN WCT SUPERVISOR, AND PETE SHEFFER VICE PRESIDENT AND DIRECTOR OF INSURANCES, NHADA When an employee is injured in a motor vehicle accident while working, there is frequently confusion as to whether a workers’ compensation claim should be filed. Some employers believe that it should be handled through auto insurance. However, the employees’ injuries must be handled like any other employee injury in the workplace, an Employer’s First Report of Injury must be promptly filed with NHADA WCT, and the injured employee must seek treatment within the company’s managed care network. As in any workplace injury, a call to the NHADA WCT nurse case manager, Marta Silakka, immediately after the injury occurs will ensure that the injured employee receives the most appropriate medical attention possible. The purpose of workers’ compensation is to provide prompt payment of medical bills and disability benefits for employees who are injured in the workplace. When an employee is involved in a motor vehicle accident, no matter how minor is seems at the time, the police must be called to the scene and a police report should be filed. The police will investigate the cause of the accident and determine liability. This is crucial for NHADA to obtain reimbursement of payments made on the injured employee’s behalf from the responsible driver. When a motor vehicle accident occurs in the course of their employment and they sustain injuries, both a workers’ compensation claim and an auto insurance claim should be filed. If the police determine that the other driver is at fault, then the NHADA WCT member should put the responsible insurance carrier on notice of the damage to their vehicle and put the auto carrier on notice that their employee was injured and has sought medical attention. The auto carrier will then open a property damage claim to pay for the member’s damaged vehicle and a bodily injury claim to pay for the injured employee’s injuries and pain and suffering. Frequently, there are different adjusters assigned to each claim. Auto liability cases can be long, drawn-out claims. The auto carrier generally will not make payment on a claim until medical treatment has been concluded, and the injured party has attained maximum medical improvement. At that point, they will negotiate a settlement with the injured employee or their attorney. When the injured employee settles their claim with the auto insurance company for the driver responsible, they will be compensated for their medical bills, lost wages, pain and suffering, and possibly their spouse’s loss of consortium. Workers’ compensation would have already paid the medical bills and, when applicable, 60% of the lost wages relating to the auto accident, and therefore would have a lien against the auto settlement. The injured employee is required to pay back workers’ compensation for the payments that were made on their behalf. The NH Workers’ Compensation Statute, RSA 281-A:13, provides the workers’ compensation carrier or self-insured with this lien. If the injured employee does not pursue a claim against the responsible driver, then RSA 281-A:13 has a provision that allows the workers’ compensation carrier or self-insured to take over the claim 18
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