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Paying the injured worker's medical bills

Are you able to pay an injured worker's medical bills instead of reporting it.

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I have an employee that got hurt, missed no time but has medical bills. Can I pay the medical bills?

Some states have approved what is called "Ex-Medical" coverage, which allows payment of medical-only claims by employers. This isn't allowed in Massachusetts largely because all the relevant statutes, including MGL c. 152, § 30 states: "The insurer shall furnish to an injured employee adequate and reasonable health care services . . . "

Some employers would like the ability to pay small medical claims themselves in order to keep those losses out of their experience rating calculations, but it turns out that such experience is actually relevant to the likelihood of having future claims. So, keeping the information out of the calculation would make the rating system less accurate.

Every employer MAY require the insurer to put them on a small deductible plan; taking that option would require them to pay per claim deductibles up to the prescribed limit and get the up-front premium. But, claims still count for purposes of experience modification because use of that information has been determined to be actuarially sound.

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