Even with all the necessary safety precautions in place, workplace accidents still can happen – and at times, even a single mishap can have massive financial consequences for a company. This is why workers' compensation insurance is one of the most critical forms of coverage any business with an employee needs.
How does workers’ compensation insurance work?
Workers’ compensation insurance, sometimes referred to as workers comp coverage, is a form of business insurance that pays out the cost of medical care and part of the lost income of employees who get sick or injured while performing their jobs. It also protects the business owner from the financial liability of having to pay for expenses arising from work-related illnesses and injuries out of pocket.
Almost all states require businesses to take out workers' compensation coverage, with the rates and level of cover varying, depending on where and in which industry the business operates.
Each state sets workers comp premiums based on a range of factors. These include the employees’ job classifications – which reflect the riskiness of the work they do – and the company’s payroll and past workers comp claims – also called “experience modification” – according to Trusted Choice, a Virginia-based network of insurance agents and brokers.
The state also decides who handles and sells workers' compensation insurance policies. These may be state-run agencies, private insurance companies, or the state itself.
What does workers’ compensation insurance cover?
Workers' compensation insurance policies provide several types of coverages, including:
- Medical expenses: This covers the cost of medical treatment for the sick or injured worker, such as doctors’ and hospital visits, surgery, and medication. Depending on the state and industry, medical expenses related to COVID-19 may also be covered.
- Lost income: Workers' compensation coverage pays out part of the employee’s wage in the event they need to take time off from work because of the illness or injury they sustained. This serves to ensure that workers have a source of income while they recover.
- Ongoing care: Workers comp policies also help pay for the expenses incurred if the employee requires extended medical care due to a work-related injury or illness. This includes occupational and physical therapy, and other rehabilitation costs.
- Disability benefits: Employees who become disabled because of a workplace accident are eligible for full or partial disability benefits, which help cover medical bills and some lost wages.
- Death benefits: If the job-related injury or illness results in the death of an employee, workers' compensation insurance pays out for their funeral and burial expenses and provides financial benefits for their beneficiaries.
What is excluded from workers’ compensation coverage?
However, not all illnesses and injuries that occur in the workplace are covered by workers’ compensation policies. Among the incidents that are excluded from coverage, and can result in a workers compensation claim being denied, are:
- Accidents that happen while the employee is on the way to or going home from work
- Injuries sustained while the worker is intoxicated or under the influence of illegal drugs
- Injuries from recreational activities as these are not considered job-related even if they occur in the workplace
- Food poisoning while on lunch break from food bought or brought from home as breaks are also not viewed as work-related
- Other self-inflicted or intentional injuries
Employees of the federal government are also not covered by workers' compensation insurance as they already have coverage under the Federal Employees’ Compensation Act (FECA). This group of workers include:
- Civilians working in the executive, legislative, and judicial branches of government
- State and local law enforcement officers acting in a federal capacity
- Peace Corps volunteers
- Students in Reserve Officer Training Corps programs
- Federal jurors
- Members of the Coast Guard Auxiliary and Civil Air Patrol
How much does workers’ compensation insurance cost?
Just like in other types of insurance policies, premiums for workers' compensation coverage are determined using a range of risk factors. These include the type of industry, job classification codes, experience modification rating, and safety measures implemented.
Small businesses pay about $47 monthly, or about $560 annually for coverage, according to an estimate by Trusted Choice. The group noted, however, that this rate is “middle of the pack for small businesses.” For larger companies involved in riskier occupations such as construction firms, the cost can be much higher.
The table below shows a sample calculation of workers comp premiums for different industries done by the organization.
Median annual premiums
Construction and contracting
Food and beverage
Photo and video
Source: Trusted Choice
What are the largest workers’ compensation insurance providers in the US?
Direct written premiums (DWP) for workers’ compensation coverage across the country reached $52.25 billion in 2021 – a 2.1% uptick from the previous year, according to recent analysis by S&P Global Market Intelligence.
Of this figure, the 10 biggest workers’ compensation insurance providers in the US accounted for $22.4 billion, or 43% of the overall market, the latest market share report from the National Association of Insurance Commissioners (NAIC) has revealed.
Although there were no changes in the insurance companies included in the top 10 from the previous year, there was a huge shake-up in the rankings, particularly from the third to the ninth spot.
AmTrust Financial, meanwhile, made the biggest jump, leapfrogging four industry giants, including Berkshire Hathaway, to claim third place. Rounding up the top five are Zurich and Chubb, which both dropped a notch in the list.
Here are the 10 largest workers’ compensation insurance companies in the US by direct premiums based on NAIC’s data.
Direct written premiums: $3.5 billion
Market share: 6.8%
2020 ranking: 1st
Travelers is a global insurance carrier offering a range of coverages for individuals and businesses. It owns several insurance brands, including St. Paul Fire & Marine and USF&G, and provides workers' compensation insurance in almost every state, excluding Alaska, Hawaii, Ohio, North Dakota, Washington, and Wyoming. Travelers is the sixth largest property and casualty (P&C) insurer in the country, according to NAIC’s latest figures.
2. The Hartford
Direct written premiums: $3.3 billion
Market share: 6.3%
2020 ranking: 2nd
The Hartford is another global P&C insurer that provides coverage to more than one million small businesses. Its workers’ compensation insurance comes with a preferred medical provider network, prescription drug features, a needle stick reimbursement program, a nursed back to health program, and pay-as-you-go billing solutions. Clients also have access to programs that support employee health and well-being through special arrangements with Shoes for Crews, The Naturally Slim Program, Herman Miller, and Aurico.
3. AmTrust Financial
Direct written premiums: $2.4 billion
Market share: 4.7%
2020 ranking: 7th
AmTrust Financial is a niche specialty P&C insurance provider for small businesses, with an emphasis on workers’ compensation coverage. The insurer’s workers’ comp coverage is well-suited for artisan contractors, beauty shops, buildings-operations by owners or contractors, doctors and dentists, hotels, machine shops-light metalworking, private schools, professional offices, restaurants, retail stores, and wholesale stores.
4. Zurich Insurance
Direct written premiums: $2.3 billion
Market share: 4.5%
2020 ranking: 3rd
Zurich Insurance Group is a multi-line insurer that offers P&C and life insurance products and services in more than 210 countries and territories. The insurance giant’s workers' compensation policies offer workers access to a range of in-house managed care and return-to-work programs, as well as litigation management and recovery services.
Direct written premiums: $2.2 billion
Market share: 4.2%
2020 ranking: 4th
Chubb is the seventh largest P&C insurance provider in the US in 2021 and has operations in more than 50 countries and territories. Chubb Ltd., its parent company, is listed on both the New York Stock Exchange and S&P 500 index. The insurer offers workers’ compensation coverage for businesses of all sizes, plus excess coverage for companies that self-insure predictable losses but need coverage for catastrophic exposures.
Direct written premiums: $2.1 billion
Market share: 4.0%
2020 ranking: 5th
Liberty Mutual is a global insurer with more than 800 offices in 30 countries and territories around the world. It is also the fifth biggest P&C insurance provider in the US last year. The mutual insurer’s workers’ comp coverage helps injured employees obtain medications for work-related injuries without out-of-pocket expenses and access quality, affordable treatment from its network of local medical providers. Liberty Mutual also owns several insurance brands, including Safeco, Ironshore, and Golden Eagle.
7. Berkshire Hathaway
Direct written premiums: $1.9 billion
Market share: 3.7%
2020 ranking: 6th
Warren Buffett’s conglomerate, Berkshire Hathaway, owns several insurance companies that offer workers’ compensation coverage. These include Berkshire Hathaway Homestate Companies, which also provides injured workers access to in-house service teams and return-to-work programs; GEICO and Three Insurance, which offer workers’ comp coverage tailored for SMBs across the US; and Berkshire Hathaway GUARD Insurance Companies, which also provides a range of property and casualty products – including business owner’s policy, commercial auto, commercial umbrella, disability, homeowners, personal umbrella, and professional liability.
8. New York State Insurance Fund
Direct written premiums: $1.7 billion
Market share: 3.3%
2020 ranking: 9th
New York State Insurance Fund (NYSIF) is New York’s largest workers’ compensation carrier. As a self-supporting insurance provider, NYSIF’s role is to compete with other carriers to ensure a fair marketplace and be a guaranteed insurer for employers who cannot get coverage elsewhere. It also serves as a state fund for disability benefits, which insures employers against off-the-job employee injury or sickness that results in disability.
9. Blue Cross Blue Shield of Michigan
Direct written premiums: $1.6 billion
Market share: 3.2%
2020 ranking: 8th
Blue Cross Blue Shield of Michigan (BCBSM) is a non-profit mutual insurance company and an independent licensee of the Blue Cross and Blue Shield Association. It is Michigan’s largest health insurer, serving 4.5 million people in the state plus 1.6 million in other states. The company owns AF Group, which in turn owns several subsidiaries that write workers’ comp, including Accident Fund, United Heartland, CompWest, and Third Coast Underwriters
10. Old Republic
Direct written premiums: $1.3 billion
Market share: 2.5%
2020 ranking: 10th
Old Republic is a specialty insurer that writes a range of insurance solutions, including workers’ compensation for various industries, through its insurance brands. Among these subsidiaries are Old Republic Risk Management and Old Republic Aerospace.