How does workers' comp work in Pennsylvania?

It's important for all Pennsylvania employer to know the basic rules and laws associated with workers compensation in Pennsylvania. Generally, all business owners in Pennsylvania who have one or more employee are required to purchase workers compensation insurance. This rule includes part-time employees and family members.

Their are several ways that a business can obtain workers comp coverage in Pennsylvania. The most common method is to purchase private insurance from an independent insurance agency such as Workers Compensation Shop.com. Larger, more financially stable companies may also self-insure their coverage in compliance with the Bureau's Self-Insurance Division. Finally, employers who are unable to find coverage from a private insurance carry may obtain coverage from the State Workers' Insurance Fund (SWIF). Employers may pay higher rates when buying coverage from SWIF.

Workers' Comp Rules & Information for Pennsylvania

PA Insurance Directives Regarding Covid-19

Consistent with “prudent insurance practices,” PA “encourages” carriers to consider the following: 1) relax premium payment due dates; 2) extend grace periods; 3) waive late fees; 4) allow payment plans to avoid lapse in coverage; and 5) to consider cancellation or non-renewal only after exhausting all other efforts.

Discretionary state order in effect from 03/30/2020 until the end of the state emergency.

State Orders Regarding Insurance Claims Related to Coronavirus

No current state orders.

State Fund Insurance in Pennsylvania

The PA State Workers Insurance Fund (SWIF) is the official State Fund for Pennsylvania. While insurance rates may be higher for coverage under SWIF, employers who are unable to get workers comp quotes from private insurance carriers will be able to purchase a policy from SWIF.

State Workers' Insurance Fund
100 Lackawanna Avenue
PO Box 5100
Scranton, PA 18505-5100
570-963-4635

What if I Don't Have Coverage in PA?

The PA Bureau of Workers Compensation actively pursues uninsured employers in the state. If workers compensation insurance is not continuously maintained the Bureau may file charges that result in fines up to $2,500 and up to one year in jail for each day of violation.

If an employee is injured while no coverage is in effect, the employer will be held liable for all costs associated with the claim including medical costs, lost wages, penalties, interest, and fees. Employees may also file suit against the employer for damages in excess to the amounts covered under a workers compensation policy.

Any individual or competitor may seek district attorney approval to file a private criminal complaint against any employer who fails to maintain workers comp coverage when they are legally required to have coverage.

PA Workers Comp Classification Codes

All classification codes in PA are determined by the PA Compensation Rating Bureau. This is not a government agency, but it is licensed and regulated by the Pennsylvania Insurance Department. Each employers' premium is based on its classification code, However, insurance carriers only have to file their rates with the state and, therefore, rates will vary tremendously by insurance company.

Reporting WC Claims Requirements in PA

Employers are required to report all injuries in PA to the insurance company immediately. When an injury causes an employee to miss a day of work, the employer (or insurance carrier) must also submit First Report of Injury electronically with the state within 7 days of the injury. Death claims must be filed within 48 hours..

Requesting Claims History in PA

Employers have a right to their claims information since it directly affects their experience ratting in Pennsylvania. Requests must be made in writing and either mailed or faxed to the PA Bureau of Workers' Compensation:

Records Section, Claims Management Division
Bureau of Workers’ Compensation
1171 S. Cameron St., Room 109
Harrisburg, PA 17104-2501
Fax: 717-783-6365 or 717-783-6366

More Programs and Options

We're always working with our insurance carriers to develop specialized programs for a broad range of industry class codes. Our Target Programs are designed to streamline the underwriting process and help ensure we offer the lowest rates available anywhere.

  • Contractors
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  • Janitorial Services
  • Transportation
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  • And More
Pennsylvania Work Comp Information

PA Exclusive Remedy

Pennsylvania law utilizes the Exclusive Remedy doctrine to govern workers compensation. This means that business owners who have workers compensation coverage in place are generally protected from most other suits by injured employees unless their is valid proof of willful negligence.

Let Workers Compensation Shop.com help your business navigate workers comp insurance in Pennsylvania.

What Does Workers' Compensation Insurance Cover?

...
Workers' comp coverage protects employees when injured. It makes good financial sense for both parties.
Injuries and accidents happen. A workers' comp policy is a no-fault system that pays for these accidents and claims. It's required by law in most states.
  • Loss of income for employees unable to perform job duties
  • Medical expenses for employees injured on the job
  • Retraining expenses for employees unable to return
  • Permanent injury or disability for lasting injuries
  • Survivor benefits if employees are killed on the job
Coverage does not protect employers from everything. Sometimes employees and employers can be negligent.
...
In some instances, workers' compensation coverage will not protect employers or employees from the legal liability resulting from a workplace injury.
  • Injuries resulting from a violation of the law
  • Incidents resulting from employees' use fo drugs or alcohol
  • Injuries that did not occur in connection with the job
  • Clear company policy violations
  • Injuries that did not occur in connection with the job

Workers' Comp Includes Employers Liability Insurance?

Employers liability insurance is an additional layer of coverage included as part of a workers' compensation insurance policy. Employers Liability is know as Part 2 of the policy. It adds two additional coverages for employers:

Employers Legal Liability and Legal Defense Costs

In todays world, there are a variety of reasons employees and third-parties sue employers for damages. Here a some common types covered by employers liability insurance:

Third Party Lawsuits

Your employee sues another party that may have contributed to the injury, In turn, the third party sues your business.

Consequential Bodily Injury

Another party or individual is injured while providing care for the injured employee.

Dual Capacity Legal Action

An employee files a claim but also attempts to sue the employer for being responsible in other ways outside of the employment relationship.

Loss of Consortium

A spouse sues for damages caused by the loss of companionship or relations.

Employers Liability coverage is not included with coverage in the four monopolistic states. Employers in these states can endorse this coverage onto their General Liability policy. That coverage is commonly know as Stop Gap Coverage.

Visit NCCI for more resources and information about workers' compensation class codes. Visit United States Department of Labor for more information about government agencies managing workers compensation insurance rates.

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