The spouse of an employee sues the employer for loss of companionship and care resulting...

CPCU 500 coverage analysis stresses identifying who is making the claim, the legal theory involved, and which insuring agreement responds. Workers Compensation and Employers Liability Insurance contains two distinct parts that address different obligations. Workers Compensation Insurance applies to the employer’s statutory duty to pay workers compensation benefits to an injured employee under the applicable workers compensation law. Those benefits are typically exclusive and are paid to or for the benefit of the employee, not to third parties bringing separate tort claims.

A spouse’s lawsuit for loss of companionship and care is a classic “loss of consortium” or “consequential damages” claim. It is not a statutory workers compensation benefit claim by the employee; rather, it is a civil claim by a third party alleging damages that arise because of bodily injury to the employee. That type of claim is addressed under Employers Liability Insurance, which covers sums the employer becomes legally obligated to pay as damages because of bodily injury to an employee arising out of and in the course of employment, including certain derivative claims brought by others. In other words, the injury is to the employee, but the damages being sought are a consequence of that injury.

Other States Insurance is designed to extend workers compensation obligations to states not listed in Item 3.A. when conditions are met; it does not convert a third-party consortium claim into a workers compensation benefit. Therefore, the applicable coverage is Employers Liability Insurance.