Purchaser: Employers Program: Workers’ Compensation Insurance Description: Workers’ compensation is a state-regulated insurance program that pays medical bills and replaces some lost wages for employees who are injured at work or who have work-related diseases or illnesses.
Many Texas employers carry workers’ compensation coverage. Texas employers may choose whether or not to maintain workers’ compensation insurance. Employers who have opted not to carry workers’ compensation may provide alternative protection to employees for on-the-job injuries, but are not required to do so.
Workers’ compensation benefits include:
- cost of medical care to treat a work-related injury or illness;
- income to replace a portion of wages lost because of a work-related injury or illness;
- death benefits to replace a portion of lost income for eligible family members of workers killed on the job; and
- burial benefits to pay some of the deceased worker’s funeral expenses.
In calendar 1998, the Texas Department of Insurance (TDI) reported that insurers paid about $1.2 billion in workers’ compensation losses. Of that amount, TDI estimates that 59 percent –more than $700 million–was for medical costs. Temporary disability payments are a part of the direct payments.
Texas Total Amount spent: Calendar
YearDirect
Losses
PaidPercentge
Medical
PaidMedical
Benefits
Paid1987 $2,029,878,657 43.11% $875,100,168 1993 $1,662,083,080 58.70% $975,668,363 1997 $1,090,999,272 59.76% $651,988,171 1998 $1,185,185,789 59.13% $700,789,376 Note: These figures are from a Texas Department of Insurance Property and Casualty program report.
Average medical cost per Texas Workers’ Compensation Case: $781 in 1998
Sources: Texas Workers’ Compensation Commission and Texas Department of Insurance