By: John Fritts
TIS Insurance Services, Inc.
In general, most employers understand that compensation in the state of Tennessee will be allowed for an employee's injury if an incident occurs during work hours and as a part of their work-related duties. While that's true, it's also important to understand that certain circumstances surrounding the incident could result in your insurance carrier denying compensation for various reasons (2024 TN Code 50-6-110).
One such reason is referred to as "willful misconduct" . What exactly does this mean? Basically, an insurance carrier has the ability, by law, to deny a Work Comp claim if it is determined an employee willfully violated a company protocol. An example might include willfully refusing to use a safety device or failing to follow safety procedures if they have been properly trained to do a certain task.
We recently had a work-related injury denied by a carrier for this very reason and it's one of the few times (if ever) that we recall it happening. In a nutshell, the employee was attempting to climb down the wrong side of a scaffold while holding a shirt in one hand. He fell from the scaffold and landed on a fire hydrant below, resulting in significant injuries. After a thorough investigation of the accident and interviews with employees who were on the site, the carrier ultimately denied the claim due to the employee's "willful misconduct" . The basis for the denial was that this employee had recently completed safety training on scaffolding and fall protection, including signing the sign-in sheet to acknowledge his attendance. The fact that he had been properly trained and made the decision to descend the scaffold in a way that was against company safety protocols gave the carrier the ability to refuse the claim, per state statute.
I think most would agree that the lifeblood of any successful contractor is having a strong safety culture, and the goal is for all employees to get home safely each day. That said, based on what we've seen, it's a good idea to remind your team that going through the training is very important, but it's also important to follow those protocols, or there's a possibility your injury could be denied by the insurance company.
I've spent the past two decades focusing exclusively on insurance for the construction industry and would be happy to try to answer any questions you might have.
To connect with our local expert,
John Fritts,
TIS Insurance Inc.,
jfritts@tisins.com,
865-470-3739
