Insurance Claims While Driving an Employer’s Vehicle

Over 3 million vehicles in Pennsylvania are work vehicles.

We live in a mobile society where just about any goods or services imaginable can be delivered to our door. So, it is unsurprising to learn that thousands of employees work in jobs that require them to drive a company owned vehicle. They drive vehicles like delivery vans, eighteen wheelers, construction vehicles, buses, and cars owned by their employer.

With so many “employer-owned” vehicles on the Pennsylvania roads, it is not surprising that these, just like all the other vehicles on the road, are involved in serious accidents that result in fatalities and injuries. If you think a serious accident cannot happen while driving a company-owned vehicle, consider this.

There were 8,966,894 licensed drivers in Pennsylvania in 2017 and there was also 128,188 reportable traffic accidents. 59,287 of these accidents involving fatalities or injury to 81,749 people. The total loss for reported accidents is estimated at $18,110,235,775, which translates to $1,414 per Pennsylvanian citizen.

Focusing in on commercial vehicles, in 2017, the Pennsylvania Department of Transportation reported just under 12,000,000 million vehicles on the road. If you subtract all passenger cars, motorcycles, and motor homes, that roughly leaves the commercial vehicles on the road which total over 3,300,000.

The odds are simply too high for employer-owned (or “company-owned”) vehicles to avoid wrecks, even if they take extra precautions to circumvent accidents. For those driving an employer’s vehicle as part of your work, you may ask: If I am hurt in an accident while driving an employer-owned vehicle and it is not my fault, who pays for the medical expenses? Simple question, but as with many legal issues, the answer is a bit complicated.

In short, the answer depends on the specifics of your accident. But in general, the employer’s worker’s compensation insurance along with third-party claims should cover your losses if you were not at fault. Some think their personal, or even the employer’s, car insurance should cover their damages.

But this particular situation is a special case where a worker was required to drive a company vehicle to do their job, and they were hurt while doing their job. So, an employee was doing routine and expected work, and workers’ compensation insurance does cover drivers hurt while driving a “company vehicle.”

Workers’ Compensation Insurance

Most of us know that if we are hurt on the job while performing our required tasks, workers’ compensation insurance (“worker’s comp.”) will help to pay for the incurred losses. In Pennsylvania, there is a no-fault workers’ compensation insurance coverage, which means the workers’ compensation insurance pays if you were hurt doing your required job whether or not the accident was your fault and regardless of preexisting medical conditions.

Workers’ compensation is mandatory for most employers in Pennsylvania. Employers who fail to provide workers’ compensation coverage can be subject to employee claims and to criminal prosecution by the state. (Some employers are exempt from workers’ compensation coverage.

From the Pennsylvania Department of Labor and Industry website: “Exemptions include people covered under other workers’ compensation acts, such as railroad workers, longshoremen and federal employees; domestic servants (coverage is optional); agricultural workers who work fewer than 30 days or earn less than $1,200 in a calendar year from one employer; and employees who have requested, and been granted, exemption due to religious beliefs or their executive status in certain corporations.”) So, by state law, those driving employer-owned vehicles like delivery vans, buses, taxis, long haul trucks, or construction pick-ups for a living should be covered by their employers’ workers’ compensation insurance if they are hurt on the job performing necessary and routine tasks. This does not include driving to and from work, only when driving to perform your required job, such as making deliveries, pick-ups, driving to a meeting, etc.

But what does this insurance really cover?

Awell-known insurance company notes: “Workers’ compensation provides medical expenses, lost wages, and rehabilitation costs to employees who are injured or become ill ‘in the course and scope’ of their job.  It also pays death benefits to families of employees who are killed on the job.” Note that this does not include items like pain and suffering or loss of the enjoyment/quality of life (e.g. you may be housebound and can no longer coach for your kids, travel, or care for your parents, etc.).

If you are unfortunate and do find yourself injured in an accident while driving for work, there are some important things you need to know. First, you should immediately report any accident and the associated injuries as soon as possible to the employer, even if you did not miss any work. There is a statute of limitation for you to file a workers’ compensation claim, but you should not wait. For a workers’ compensation claim to be considered valid:

You must file a report within one hundred and twenty days of the accident.

If you wait over one hundred and twenty days, you will not be allowed to file a claim. Plus, the sooner you file an accident report, the sooner you can seek medical attention that should be covered by your workers’ compensation insurance. Also, this time limit is a bit complicated. If you wait over twenty-one days, the time you waited cannot be included as part of your claim. After twenty-one days, your claim of lost wages and other losses will start from the date you filed your claim. So, in general:

Report as soon as possible after an accident, even if you think your injuries are not serious.

Also, you should keep in mind that you will likely be required to see a medical provider on your employer’s list within ninety days of reporting the accident. After the initial doctor’s visit, you may be not be limited to your employer’s list of approved doctors, even if your employer’s workers’ compensation insurer resists. You should try and get medical attention, from the appropriate care provider, as soon as possible.

The best worker compensation lawyers know how to help you get the best medical attention to ensure you heal properly.

Another reason to report an accident immediately is to speed the payment process. An employer has twenty-one days to approve and pay your claim or reject it. If you wait, you just add time to this process. Promptly reporting your accident also expedites the identification and collection of evidence to support your claim(s). The longer you wait, the less likely you are to find all the evidence and information.

If you need the help of a lawyer to fight for your claim, and in most cases you will, the lack of evidence can make the attorney’s job harder. So, report an accident and your injuries immediately! Not only do you need to recover your medical expenses, but many injuries mean missed work and lost wages. Workers compensation will help to cover your lost pay, but not all of it (the calculations to determine the amount is complex and you should consult with your attorney to ensure it was done correctly). The first seven days out of work are not be covered unless you miss more than fourteen days of work, and you will receive only a portion of your usual pay. In general:

You can expect two-thirds of the “normal” pay you received before you were hurt, or around $1,000 per week, whichever is less.

You should also remember that when you file a workers’ compensation claim, you normally relinquish your right to sue your employer. That does not mean you cannot sue or seek damages from a third-party who did injure you (more on this topic in a bit), but in general:

You give up the right to sue the employer when filing the workers’ compensation claim.

One other frequently asked question involves whether or not you can receive benefits from other forms of insurance like unemployment, social security, or disability insurance. In general:

You may be able to receive social security, disability, or other benefits to pay for your losses.

So yes, you can receive other insurance and benefit payments, but it may reduce the amount of your workers’ compensation payments. Therefore, it is a good idea to retain one of the best workers’ compensation law firms and discuss which combination of insurance coverages and benefits make sense for you to pursue in your unique situation. There are a few other specifics that you may want to know.

One other detail about workers’ compensation in Pennsylvania, you can collect for one hundred and four weeks. After that, you may be asked by the insurance company to undergo a medical examination. If you are found to be 50% disabled, then you will collect total disability benefits for life. However, not many are found to meet this criterion. Also, your employer can request a utilization review (UR) to examine the appropriateness of the care you are receiving. If you receive a UR request, contact the best workers’ compensation lawyer for help.

This is often an attempt to lower your benefits. The same advice goes for a petition to terminate. If you receive one, contact an attorney immediately to defend your rights. This is usually an attempt by your employer or insurance company to stop or reduce your payments. Finally, you may also be asked to be examined by a doctor they choose at a reasonable time and place. These medical examinations are sometimes referred to as IME’s. You are usually required to attend the IME, but there are exceptions. So, before appearing for this medical examination, consult with an attorney.

Third Party Claims

Workers’ compensation is not the only way to be compensated for your losses should you be injured on the job while driving a company vehicle. You also have a right to file a claim against anyone else who may be responsible for causing your injuries. The two different claims (workers’ compensation insurance and third-party claims) can be filed at the same time and do not preclude one another. Just to be clear, anyone other than you or your employer are often referred to in legal circles as third parties. So:

You can file a claim against all negligent third parties who caused your injuries.

A car that ran a red light, a truck that rear-ended you, or another vehicle sideswiping are all driven by other drivers, third parties. Also, if a part like your brake pads or tires failed and caused you to wreck, you may be able to file a claim against the manufacturer, another type of third party. Identifying a negligent third-party can be a complex task, and then you must “prove” the negligence. Usually, it is best to retain a knowledgeable attorney to help.

Assembling all the evidence and defending a claim such as this is difficult, if not impossible, for those not educated and trained in the law. Further, there has been quite a bit of activity concerning third-party settlements and workers’ compensation. Recently, rulings in the Pennsylvania courtshave made it clear that worker compensation carriers cannot file an action on their own against a third party who may have caused injury to one of their covered employees.

In other words, the right to file a claim against third parties lies only with the injured employee, not with the insurance company that paid the workers’ compensation claim. So why is that important? Well, the workers’ compensation insurance company is eager for reimbursement if the accident was caused by one or more third parties. In the past, they have tried filing third-party claims “on behalf” of the injured employee. But as already stated, the courts have ruled they cannot do this. However, you may want to pursue claims against a third party whose negligence caused you to be injured.

Workers’ compensation covers your medical bills and some/most of your lost wages. But there may be about one-third of your pay missing and other things like pain and suffering are not covered at all. The good news is that you can include these other expenses, above and beyond the workers’ compensation coverage, in a third-party claim. But there is an obvious issue, you must be the one to file and defend the third-party claims in order to collect any compensation from a third party.

This process can become complicated and often it is recommended to hire the best workers’ compensation attorney you can find if you are in this situation.

But by filing third-party claims, you can augment the workers’ compensation payments and, in the end, collect additional monies to properly cover all of your losses.

There is another important thing to keep in mind, the insurance company has a right to be repaid with any money paid to you by a third-party claim. This right to be reimbursed is often called subrogation, and insurance companies are keenly aware of this right to be subrogated.

Insurance companies can and will recoup the money they paid to you if a negligent third-party claim pays for your losses.

Subrogation is done out of a sense of fairness and prevents double payment to you for the losses incurred by your injuries. It also makes the employer and/or the workers’ compensation carrier whole since you or your employer were not responsible for causing the accident.

At the same time, third-party claims must be prepared and presented carefully to cover all expenses in anticipation of repaying the workers’ compensation paid to you. And there may be other “hidden” expenses to cover, like legal fees. The best way to avoid making mistakes in filing your third-party claims is to consult with a workers’ compensation lawyer, and you should retain one when dealing with complicated claims that involve multiple insurance companies and hidden expenses.

The actual process of settling a third-party claim with your workers’ compensation insurer can also be involved and challenging. A good lawyer should be consulted before settling matters of import like this or signing any agreements. Also, you will be required tocomplete a form(LIBC-380 Third Party Settlement Agreement) and file it with the Pennsylvania Department of Labor and Industry.

An important note to this third-party settlement agreement is that it can be modified and further agreements can be attached to the form. For example, your employer or their insurance company can agree to a lesser amount than the one calculated by the form. Or, they might ask you to give them credits for certain items, reducing the amount you receive. So once again, the best workers’ compensation insurance attorneys can help you with this intricate agreement. Keep in mind that this agreement binds all the parties once it is signed.

You want to get it right! Another detail you should be aware of when settling a third-party claim with your workers’ compensation insurer is future credits. This is the allowance or credit the workers’ compensation insurance company gets for payments to be made to an injured employee in the future. While it is confusing, it gets worse. The Pennsylvania Supreme Court has recently defined what is considered a valid future credit.

Workers’ compensation companies are not happy about it because it limits them and some may still try to get you to agree to credits that are not included in the recent ruling. In summary, the court ruled that insurers can be subrogated for future credits for medical payments.

These credits reduce the amount paid to the injured employee. So, if you are hurt while driving a company vehicle, do not agree to a third-party settlement that has credits for future payments for anything other than medical payments. Look for help from the best workers’ compensation lawyers who can help you avoid this mistake. Also, all of this discussion to this point assumes you have won a third-party claim.

But before getting to a third-party settlement with your worker’s compensation insurer, you must file the third-party claim, and this claim needs to be paid to you. The whole third-party claim process is similar to filing a claim in any other automobile accident, but that does not mean it is easy or simple.

Most importantly, you need to prove negligence on the other party’s part, and this is hard to do. For example, you may need to prove a manufacturer made a faulty tire or another person ran a light and hit your vehicle. Every accident is different, but they do often involve more than one vehicle.

If you can prove the driver of another vehicle was negligent or a faulty part or mechanism failed, then you can file and should win a claim against the other driver or manufacturers. But collecting the evidence, making a case for your claim, and defending it is not something you can do without an understanding of the law and insurance companies.

There are a number of articles out there on what to do just after an automobile accident and the detailed steps on how to file a claimfor injuries sustained in the wreck. We will not duplicate all the information here. But note, you should never, never say anything at an accident scene that may implicate your guilt. People remember what you say and can twist your words, so you cannot use too much care in avoiding language that implicates your guilt in the accident.

Retain a Workers Compensation Attorney

In summary, developing a legal strategy to recover your losses after being injured while driving a company vehicle is complicated and every case is different. To recover all of your losses, a workers’ compensation claim along with third-party actions are often necessary and they must work in conjunction with one another. You will also need to be aware of the need to subrogate your workers’ compensation insurer. This is complicated and requires a keen knowledge of the law and insurance. So, if you are hurt while driving a company vehicle, seek help from one of the best workers’ compensation law firms. They will fight for your rights, focus and maximize your efforts, minimize mistakes, and take steps so that you are properly compensated for your injuries.

Free Consultations

    Home 9 Auto Accidents 9 Insurance Claims While Driving an Employer’s Vehicle