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Can I use health insurance if workers’ comp denies my claim?

On Behalf of | Apr 29, 2022 | Workers' Compensation

If you suffer an injury during the course of your normal work activities or if you become ill because of conditions in the workplace, what is the most appropriate course of action you should take? Certainly, seeking medical attention as soon as possible is advisable, but you may have concerns about paying for treatment for your recovery. Fortunately, laws in Minnesota and most other states require employers to provide workers’ compensation insurance for their employees.

Ideally, your employer should have your best interests in mind, including the goal of obtaining quality medical care for you so you can get back on the job or providing you with other workers’ comp benefits if your injuries are disabling. What are your options if this does not happen? Should you file a claim with your personal health insurer?

What’s the difference in coverage?

Receiving a notification that your employer’s workers’ compensation insurer has rejected your claim for benefits can be devastating. The reasons why an insurer may deny or minimize a claim are not always legitimate, so you should not accept the decision at face value if you believe you have a valid claim.

Nevertheless, you may already have medical bills coming in. Perhaps you are unable to work because of your illness or injury. The thought of trying to pay for those bills with no income can be stressful enough to hinder your recovery. However, turning to your health insurance may not be the answer for several reasons:

  • Many private health insurance policies will refuse to cover work-related injuries.
  • Your health insurance will not cover lost wages if you can’t work after your accident.
  • For temporary or permanent disability benefits, you must purchase an additional policy, but these benefits are included in workers’ compensation.
  • If a work injury results in death, workers’ compensation will cover funeral costs, but health insurance does not.
  • Workers’ compensation also provides rehabilitation benefits after a catastrophic injury, but your health insurance probably will not.

If workers’ compensation denies your claim after a workplace accident or illness, turning to your personal health insurance is not always the best idea. This decision might leave you inadequately covered for the benefits you need. It may also complicate any claim you might have if the accident is the result of a third-party or negligent employer. Instead, it is wise to consult with a legal professional to determine the options that are available to you to ensure you have the best chances for recovery.