Sometimes an employer will suggest that an injured worker apply for group health insurance benefits instead of workers’ compensation benefits , or it might seem like a good idea to apply for group health insurance benefits in addition to workers’ comp. However, this is not a good idea.

Group health insurance policies generally exclude payment for any benefits for work-related injuries; they might even require the injured worker to state in writing that the benefits being provided are not a result of a work-related injury. Also, most group health insurance policies usually require that the injured worker pay a portion of the medical expenses, whereas workers' compensation pays 100% of an injured worker's reasonable and necessary medical expenses. The group health plan is also entitled to reimbursement from the workers’ comp insurer for work-related injuries and can put a lien on settlement funds until they are paid. If you are able to use group health insurance instead of workers’ comp insurance for medical bills, you will lose the value of wage loss and permanency benefits, as most group health insurance policies do not provide for lost wages or disability benefits.

(Reviewed 9-08)