Document NEZGxK2NQVZQvg7kDQNJ70EMD

WORKMEN'S COMPENSATION AND INSURANCE To apply the premium discount plan, first the total premium is calculated in accord ance with the provisions of the manual (This premium is the standard premium discussed under the topic heading "Retro spective rating" in this chapter ) The first $1,000 of this standard premium is charged m full without discount The next $4,000 is subject to a discount that vanes by state and by type of earner The next $95,000 is subject to a different rate of discount, and the premium over 9100,000 is also subject to a different discount Most states have approved the premium discount plan on an interstate basis, so that premiums developed in all these states taken together are vised to develop the dis count Table 11-E shows discounts that prevail TABLE 11-E DISCOUNTS APPLICABLE UNDER PREMIUM DISCOUNT PLAN Standard Premium (Dollars) First Next Next Over 1,000 4,000 95,000 100,000 Stock Comers None 9 0% 14 0% 105% Nonstock Carriers None 3 0% 60% 8 5% Loss and expense constants Workmen's compensation policies involv ing small premiums ore proportionally more expensive to handle than those involv ing larger premiums To make up for this difference, a special charge is added to poli cies with premiums of less than $500 per year One charge, called an expense constant, is usually $10 Similarly, the loss experi ence on a small risk is generally more unfavorable than on larger risks To offset this difference, a loss constant is applied in most states designed to equalize the loss experience of the small and large risks In no case will the loss and expense constants make the final premium more than $500 Thus, if the loss and expense constants for a particular risk total $25, this charge would be added to any premium that is not over $475 To a premium over $475, only enough of the loss and expense constants would be added to bnng the premium to $500 Occupational Disease Compensation laws are limited not only to persons and employments included, but also to injuries covered In some states, injuries resulting from the employee's intoxi cation, wilful misconduct, or gross negli gence are excluded Coverage may also be limited by definitions or lists, or both The usual definition of a compensable injury is one "arising out of and m the course of the employment " Most of the early laws covered only "occidental in juries '' Some laws omitted the word "ac cidental" but specifically excluded occupa tional diseases Under a few laws, however, the term "injury" or "personal injury" has come by definition or by court interpretation to in clude occupational diseases Nearly all the states have amended their laws to embrace occupabonal diseases either by listing them in a schedule or by general inclusion The important distinction between an ac cidental injury and an occupational disease is that an accident occurs at a specific time, ordinarily discovered readily, and usually leaves no question as to the particular em ployer in whose employment the accident occurred On the other hand, occupational diseases may develop slowly, unknown to the employer and employee until disability occurs The disease usually develops over an extended penod of time during which the employee may work for different em ployers with similar exposures It is now generally recognized that occu pational diseases should be compensated, and some provision for domg so is made m all but one of the states Some of the laws list the diseases that are included, others cover all occupational diseases In recent years, there has been increasing use of general coverage In the case of occupational diseases, the amounts of compensation for disability or death, medical care, or coverage are usual ly the same as those for accidental injuries except with respect to silicosis, asbestosis, and other dust diseases So that employers can obtain information relative to occupational diseases suffered bv applicants for employment, some states have placed considerable responsibility upon the employee An employee in these states is penalized for false representation, for fail- 11-17