This guide answers common questions relating to occupational insurance policies.
What is occupation accident insurance?
Occupational accident insurance (OAI) is a unique policy that function like a cross between workers compensation and long term disability. This insurance is common for truckers who operate as independent contractors for their employers. In general, the policies pay out a weekly or biweekly benefit in the event you are injured while performing services as an independent contractor for a company. The typical policy will pay for 2 years if you unable to perform the duties of your job and then continues paying only if you can demonstrate that there are no jobs that you can perform in the economy.
What about workers compensation?
These policies are different from workers compensation. Further, if you have an OAI policy, make sure to consult and attorney before you file a claim for benefits. Many policies have offsets that preclude the award of both types of benefits concurrently. The wise move is to find out how both policies interact with each other in order to maximize the available benefits.
What happens after 2 years?
Much like long term disability, policy holders often see their benefits severed after 2 years. The burden of proof is on the claimant to demonstrate that their impairments continue to qualify for benefits under the policy. Proving this to the insurance provider typically requires in depth reports from experts who can help the claimant prove the extent of their injuries. Simply going to the doctor typically results in denials of benefits.
How long do I have to appeal?
Whereas most long term disability policies only provide 180 days to appeal denials, many OAI policies do not have that time limit. This is largely due to the fact that the policies are not covered by ERISA. While a discussion of ERISA is outside the scope of this article, the point is that the claimant has time to find appropriate treatment and professionals to assist with their denial of benefits.
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