Most employers call it "the workers' comp policy." Its full name is the Workers Compensation and Employers Liability Insurance Policy, and the second half of that title is a separate coverage with its own insuring agreement, its own exclusions and, unlike workers' comp, its own dollar limits.
The distinction matters when something goes wrong. Workers' comp benefits are set by statute and paid without regard to fault. Employer's liability is lawsuit coverage for the injury claims that can still reach the employer despite workers' comp. HR and payroll teams who read the policy as a single coverage are often surprised by what it does not do. This guide walks through the standard policy part by part, using the NCCI policy form (WC 00 00 00 C) that is used in many states, with notes on where state forms and practice differ.
Workers' compensation is a trade. Employees receive medical care and wage-replacement benefits for work injuries without having to prove the employer was at fault. In return, workers' comp is generally the employee's exclusive remedy against the employer: the employee cannot also sue the employer in court for the same injury.
The exclusive remedy is broad but not absolute. Employers still face lawsuits arising from employee injuries in several recurring situations:
The Indiana Compensation Rating Bureau summarizes the purpose this way: these claims exist despite exclusive remedy, and employer's liability provides defense and damages coverage for them. Part One handles the statutory benefits. Part Two handles the lawsuits.
Before the coverage parts, look at the Information Page (sometimes called the declarations page). Its items control how the policy applies:
Almost every coverage question starts here. A state missing from Item 3.A or 3.C, or limits lower than a contract requires in Item 3.B, are the most common gaps HR finds when it actually reads the policy.
Part One is the statutory coverage. Under the standard form, the insurer agrees to "pay promptly when due the benefits required of you by the workers compensation law" of the states listed in Item 3.A.
Key features:
Part One also contains a clause that employers often miss. Under "Payments You Must Make," the employer is responsible for any payments above the regular statutory benefits that arise because of:
If the insurer pays those amounts on the employer's behalf, the employer must reimburse it. In states that impose penalties or increased benefits for those situations, the policy does not absorb them.
Part Two is the lawsuit coverage. Under the standard form, the insurer agrees to "pay all sums that you legally must pay as damages because of bodily injury to your employees," provided the injury is covered by Part Two.
The conditions:
The damages covered expressly include, where recovery is permitted by law:
The insurer also has the right and duty to defend suits for damages covered by Part Two, and defense costs are paid in addition to the limits. The duty to defend ends once the applicable limit has been paid.
Unlike Part One, Part Two has stated limits, shown in Item 3.B. There are three:
|
Limit |
What it caps |
|
Bodily injury by accident, each accident |
All damages for injury to one or more employees in any one accident |
|
Bodily injury by disease, each employee |
All damages for disease to any one employee |
|
Bodily injury by disease, policy limit |
All damages for disease, regardless of how many employees |
The standard limits are commonly $100,000 each accident, $100,000 disease each employee and $500,000 disease policy limit. The Indiana Compensation Rating Bureau publishes those values as standard limits, and higher limits are available for additional premium. Contracts, umbrella policies and lenders frequently require higher limits, often $500,000 or $1,000,000 for each, so compare your Item 3.B to every contract that specifies employer's liability.
The standard form lists twelve exclusions. Grouped by theme, Part Two does not cover:
Two of these matter most to HR. The employment practices exclusion means a wrongful termination or harassment claim from an injured employee is not an employer's liability claim, even if it follows a workplace injury. And the intentional injury exclusion intersects with state laws that allow employees to sue employers for intentional or substantially certain injuries; how those claims are treated varies considerably by state, and the policy's language and any state endorsements control.
Part Three extends coverage to states listed in Item 3.C. If the employer begins work in one of those states after the policy starts, the policy responds as if that state were listed in Item 3.A. Two conditions matter:
Part Three cannot extend into states where private insurers are not permitted to write workers' comp. That is one reason employers with employees in North Dakota, Ohio, Washington or Wyoming need state fund coverage there and, because those funds are widely reported not to include employer's liability, separate stop-gap coverage. Our guide to monopolistic states covers that set-up.
The rest of the policy is about what the employer must do.
Part Four: Your duties if injury occurs. Tell the insurer at once of an injury that may be covered; provide the immediate medical and other services required by law; give names and addresses of the injured and witnesses; forward all notices and legal papers promptly; cooperate in the investigation and defense; do nothing that interferes with the insurer's right to recover from others; and do not voluntarily make payments or assume obligations except at your own cost. That last point is why paying claims "off the books" is risky.
Part Five: Premium. Premium is determined by the insurer's manuals of rules, rates, rating plans and classifications. Remuneration is the most common premium basis, and it includes payroll for officers and employees doing covered work and also for any other persons whose injuries could make the insurer liable under Part One. If the employer has no payroll records for those persons, the contract price for their services and materials can be used, unless the employer proves their employers had coverage. That is how uninsured subcontractors end up on a premium audit. The premium on the information page is an estimate; final premium is determined after the policy ends using actual exposure. The employer must keep the records needed to compute premium and allow audits during the policy period and within three years after it ends.
Part Six: Conditions. The insurer may inspect workplaces, but the policy states that those inspections relate to insurability and premium and are not safety inspections. Other conditions cover long-term policies, transfer of rights and cancellation; the standard form requires at least ten days' advance written notice for cancellation by the insurer, but state law can require more and overrides conflicting policy terms.
|
|
Part One: Workers' Compensation |
Part Two: Employer's Liability |
|
What triggers it |
Work injury or disease covered by state law |
Lawsuit for damages arising from an employee's work injury |
|
Fault |
No-fault |
Liability must be established or settled |
|
Who claims |
Injured employee or dependents |
Employee, family members or third parties |
|
Amount |
Benefits set by statute |
Damages, up to the Item 3.B limits |
|
Limits |
None stated; statute controls |
Each accident, disease each employee, disease policy limit |
|
Defense |
Yes, for benefit claims |
Yes, in addition to limits until the limit is paid |
Reading the policy annually takes less than an hour and prevents most surprises:
For the payroll side of workers' comp, see our Workers' Compensation 101 guide for payroll professionals and our guide to how workers' comp premium is calculated. Because workers' comp sits alongside leave and disability obligations, our posts on integrating FMLA, ADA and workers' comp and short-term disability vs. workers' comp cover the overlaps. HR staff who want a structured grounding in the system can start with How Workers' Compensation Works.
Employer's liability, Part Two of the standard workers' comp policy, pays damages an employer is legally obligated to pay because of bodily injury to an employee arising out of employment, and pays the cost of defending those suits. The standard form expressly includes third-party-over claims, damages for care and loss of services, consequential injury to an employee's spouse, child, parent or sibling, and claims against the employer in a capacity other than employer. It is subject to the limits shown in Item 3.B of the information page and a list of exclusions.
No. They are two coverages in the same policy. Workers' compensation (Part One) pays the medical and wage-replacement benefits required by state law, regardless of fault and without a stated dollar limit. Employer's liability (Part Two) pays damages and defense costs when the employer is sued over an employee's work injury, which can happen despite workers' comp being the exclusive remedy in most cases. Employer's liability has stated limits and its own exclusions, including employment practices claims and contractual liability.
The standard limits are commonly $100,000 for bodily injury by accident (each accident), $100,000 for bodily injury by disease (each employee) and $500,000 for bodily injury by disease (policy limit), often written as 100/500/100. Higher limits are available for additional premium. Many contracts and umbrella policies require higher employer's liability limits, frequently $500,000 or $1,000,000 for each limit, so compare Item 3.B of your information page to your contract requirements. State practices and available limits can differ, so confirm with your agent.
No. The standard Part Two expressly excludes damages arising out of coercion, criticism, demotion, evaluation, reassignment, discipline, defamation, harassment, humiliation, discrimination or termination of any employee, and any personnel practices, policies, acts or omissions. Those claims are covered, if at all, by employment practices liability insurance, a separate policy. This matters after a work injury, because a retaliation or wrongful discharge claim from an injured worker falls outside employer's liability, and Part One makes the employer responsible for added benefits tied to unlawful discharge or discrimination under the workers' comp law.
Exclusive remedy bars most direct suits by the employee for the injury, but it has gaps. A third party sued by the employee can sue the employer for contribution or indemnity. Family members may have their own claims in some states. An employer can be sued in a different capacity, such as product manufacturer. Some states allow suits for intentional or substantially certain injuries, and some employers are not required to carry workers' comp at all. Which of these apply depends heavily on state law, which is why employer's liability coverage exists.
The state funds in North Dakota, Ohio, Washington and Wyoming provide statutory workers' comp benefits but are widely reported not to include the Part Two employer's liability coverage of a private policy. Employers there usually buy stop-gap employer's liability from a private insurer, commonly as an endorsement to the general liability policy. Confirm the position with the fund and your broker for each state where you have employees, and make sure the stop-gap limits satisfy your contracts and any umbrella policy.
The workers' comp policy is short, standardized and rarely read by the people who manage its consequences. Payroll feeds its premium, HR handles its claims and both need to know where Part One stops and Part Two begins. The How Workers' Compensation Works program gives HR and payroll staff the foundation, and our workers' comp FAQs and state pages (for example Texas, where most private employers may choose not to carry workers' comp) cover the state-level detail.

