Employers’ Liability: A Primer
Agents very rarely experience an employers’ liability claim; but this does not mean this important gap-filling coverage should not be understood. There are employee-related gaps in the commercial general liability (CGL) policy and the workers’ compensation (WC) policy that make this coverage a necessity. This primer allows a much clearer understanding of this important yet neglected coverage.
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Workers’ compensation (WC) is the employee’s sole remedy to recover medical costs, lost wages and death benefits resulting from bodily injury arising out of the course of employment. However, there are bodily and financial injuries that fall outside workers’ compensation protection and which are excluded by the commercial general liability (CGL) policy – meaning there is a gap in protection. Part Two – Employers’ Liability Insurance dovetails to fill specific employee-related gaps between WC and the CGL. Although included as part of the workers’ compensation policy, employers’ liability (EL) is similar to and contains components of both the CGL and the WC policies. Part II shares slightly more similarities with the CGL than with WC. Let’s review the similarities between employers’ liability and the CGL and WC policies. Comparing Employers’ Liability with Commercial General Liability Employers’ liability and commercial general liability coverage both:
Employers’ Liability and Workers’ Compensation
‘Outside Party’ Before moving any further into the discussion of employers’ liability, the term “outside party,” used several times already and which is used several more times in the remainder of this discussion, must be understood in relation to the WC and CGL policies. For this discussion, “outside party” has two definitions based on whether the WC or CGL s being discussed. This difference must be clearly evident before moving forward. Workers’ compensation is a “three-known-party” policy: 1) the employer/insured, 2) the employee (the injured), and 3) the insurance carrier. All three are known from the beginning. Any individual or entity not qualifying as one of these known parties is considered an “outside party.” Commercial general liability coverage also involves three parties, but only two parties are known up front: 1) the insured (as defined in the policy); and 2) the insurer. The third party, the injured party is unknown, making them the “outside party” in a commercial general liability policy. Work Compensation and CGL Gaps Necessitate Employers’ Liability Insurance Employers’ liability protection is often mistakenly viewed as a throw-away coverage that is simply “tacked onto the workers’ compensation policy.” One reason may be that few agents have ever been a part of an employers’ liability claim. Understanding and focusing attention on workers’ compensation and commercial general liability is seen as a better use of the agent’s time. But the importance of this gap-filling coverage cannot and should not be overlooked. This is the tie that binds two major coverages together. The following paragraphs explore the exclusions that necessitate this coverage. Workers’ Compensation and CGL Provisions Workers’ compensation insurance benefits are statutorily mandated and restricted to costs directly assignable to a specific employee injured in the course and scope of employment. Coverage is not designed to compensate any outside party, only the injured employee or the employee’s dependents if the worker dies as a result of the work related injury or illness (death benefits are considered payments directly attributable to and solely for the “benefit” of the deceased employee not for the injury suffered by any outside party). Commercial general liability is different. Two exclusions found in ISO’s CGL policy preclude the extension of coverage to any party suffering bodily injury or financial loss as a result of an injury to an employee. These exclusions are:
Exclusion “e.” is designed to exclude bodily injury arising out of and in the course and scope of employment to any person qualifying as an “employee” and not already excluded by the workers’ compensation exclusion (exclusion “d.”). This is the “catch-all” employee exclusion. Employers’ Liability Coverages
Let’s review these for types. Do not confuse this with the third-party-over actions seen in contractual risk transfer situations where the injured worker sues the general contractor and the general contractor turns the claim over to the direct employer due to the contract in place. This “brand” of third-party-over has some of the same facets, but there is no contractual transfer back down to the direct employer. This is a fact-based issue. A quick story may allow for a better understanding. Between college semesters I worked for an assembly/manufacturing operation. During my tenure I witnessed a workers’ compensation claim in the form of a 15-year-old getting his hand caught in a large crimping machine. The kid (I graduated with his brother) developed a rhythm of putting in the blank, activating the machine and removing the completed piece. Finished parts were coming out very quickly; but somewhere along the way his timing was thrown off and he put the blank in at the precise moment he activated the machine. Thousands of pounds of pressure per square inch landed on this 15-year old’s hand; but because the machine was unable to make a full resolution it did not release, holding him tightly. The machine was not equipped with an emergency release mechanism and would not “let go.” As he frantically screams and cries, I’m standing there with no idea what to do. I don’t want to try to pull him out, the machine is far stronger than I am and I might case more injury. Everyone is frozen. Finally, the kid musters enough clarity to reach up and turn off the machine, at which point he is released. I catch him as he falls. He gets to his feet and takes off running with no clear destination. An older, more experienced worker grabs him and puts a tourniquet around his wrist to stop the bleeding. At the end of this ordeal, a 15-year-old kid had two of his middle fingers removed because they were crushed beyond repair. If there were sufficient grounds to prove negligence, he could have filed a products liability claim against the machine’s manufacturer claiming, among other things, insufficient safety in the machine’s design and lack of adequate guards. Although a suit never materialized, had it occurred, the equipment manufacturer would have discovered that the guards designed to protect the worker had been removed to speed up production (a fact I learned later). With this information, the manufacturer could have sued the employer for acting improperly. This is an example of a third-party-over suit where an employer is sued by an “other party” as a direct result of an injury to an employee. Any liability to the “other party” would be excluded from the workers’ compensation coverage discussed previously; and coverage would also be excluded by the two CGL exclusions. Protection and payment can only be found in the employers’ liability policy. Loss of Consortium Depending on the seriousness of the employee’s injury, the family may suffer in ways that aren’t compensated or even compensable by WC. These include additional costs to hire outside help to provide the services that were provided by the injured employee, the loss of companionship (which does include sexual relations) and, in some jurisdictions, claims for emotional injury. For example, additional expenses are incurred because a lawn service has to be hired to care for the injured employee’s yard since he can no longer perform that task. Remember, a percentage of the lost wages are paid by the workers’ compensation policy, but additional expenses that didn’t exist prior to the injury are not contemplated by the workers’ compensation policy and must be paid by the employers’ liability section. Consequential Bodily Injury A work-related disease is the most common example of consequential bodily injury. If the employee contracts a work-related infectious disease that is subsequently spread to another member of the immediate family, this would be a prime example of consequential bodily injury covered by the employers’ liability policy. To qualify for coverage, the consequential bodily injury must be the direct result of a work-related injury suffered by the employee. Dual Capacity Employers may have business-related contact with their employees outside the employee-employer relationship. These additional relationships can be in the form of a product supplier, service provider or as the owner of a premises. Such dual persona creating this increased contact may subject the employer to liability for injury to an employee that may occur at work but which does not necessarily arise out of and in the course and scope of employment. Dual persona relationships create employer obligations to the worker independent of those imposed on them strictly as the employer. In essence, the exclusivity of workers’ compensation protection is waived in situations where the employer could be liable to the general public for the same injury. Two examples often used to demonstrate dual capacity are that of a ladder manufacturer and a tire manufacturer. In both examples, the manufactured product fails and causes injury to the employee:
In both situations, the injured workers, or their heirs, could sue under the dual capacity doctrine to recover amounts outside the benefits payable under the workers’ compensation coverage. In instances such as these, the employer ceases being the employer and steps into a second role (a second persona) as a product supplier. The logic is, since the general public could have been exposed to the same injury, the injured employee can access the same redress for injuries suffered as any member of the general public. Health care workers can also be subject to dual capacity relationships. Doctors and nurses injured in the course of employment may be cared for at the medical facility in which they work. Once the hospital or medical facility undertakes to provide care to an employee that is also available to the general public, it has taken on a second persona (that of service provider) and potentially subjected themselves to the dual capacity doctrine. Employers’ Liability – Exclusions, Monopolistic States and Limits Twelve employers’ liability exclusions are found in the National Council on Compensation Insurance’s (NCCI’s) workers’ compensation and employers’ liability policy. These exclusions are (contains material copyrighted by NCCI):
Monopolistic States Only four monopolistic states remain in operation: North Dakota, Ohio, Washington and Wyoming. Insureds with on-going operations in one of these states must purchase workers’ compensation protection from the state and must find an alternate means to secure employers’ liability coverage (remember, employers’ liability applies only to 3.A. states). Three methods available to fill this protection gap to which employers operating in monopolistic states are subject are:
Regardless of which method is chosen, extending employers’ liability coverage to employees in monopolistic states is of utmost importance. As has been discussed, employers’ liability fills key gaps between the workers’ compensation policy and the protection offered by the CGL. A Word about Limits Standard limits offered by the employers’ liability policy ($100,000 Each Occurrence Bodily Injury, $100,000 Each Occurrence for Employee Disease with a $500,000 Employee Disease Aggregate) are just too low. Increasing employers’ liability coverage limits is relatively inexpensive. Five hundred thousand dollar across the board limits ($500,000 / $500,000 / $500,000) increases the entire policy premium about 2 percent (varies depending on the carrier), and increasing coverage to $1 million / $1 million / $1 million adds only around 3 percent to the standard premium. And anytime the umbrella carrier is willing to extend benefits over the employers’ liability coverage that opportunity should be taken. Closing Out Redundancy is the rule in this article. Employers’ liability coverage is a key gap filler between the CGL and the WC forms. Don’t ignore it. Understand the coverage provided, the existing exclusions and the need to have appropriate limits. Most agents have never experienced an employers’ liability claim, but most agents have never experienced a total fire loss either. Having not experienced something doesn’t mean it can’t or won’t occur. The lack of experience is no excuse for ignoring such an important coverage. Last Updated: July 10, 2026 |
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