Term

Definition

Family Medical Leave Act (FMLA)

federal statute that protects a worker's job during certain family member illnesses

Federal Coal Mine Health and Safety Act of 1969 (Coal Act)

national program enacted to address shortcomings in state WC approaches to coal miner’s injuries and occupational diseases; included both an inspection component (like OSHA) and a limited benefits program

Federal Coal Mine Health and Safety Act Coverage Endorsement

endorsement to WC policy that provides coverage for the Federal Coal Mine Health and Safety Act

Federal Employees Compensation Act (FECA)

federal statute, enacted in 1908, providing WC benefits to civilian federal government employees – the U.S. government funds and administers FECA through the Office of Workers Compensation (OWCP), so no private insurers are involved

Federal Employers’ Liability Act (FELA)

federal statute that predates state WC statutes and applies to railroad workers only – cases are decided on the basis of employer liability under common law, not a WC no-fault scheme

Federal Employers Liability Act Coverage Endorsement

endorsement to WC policy that provides coverage for the Federal Employers Liability Act

fellow servant rule

common-law defense used by employers before WC laws were passed -- if an employee was injured due to the carelessness of a fellow employee, the fellow worker was responsible, not the employer

fighting

for WC, fights between employees cause various compensability issues

final premium

determined after the policy period ends; the premium shown on the information page is an estimated premium

fine

in most cases, term used interchangeably with WC penalty

fixed costs

for underwriting purposes, costs not affected by the amount of losses

first named insured

when a WC policy contains more than one named insured entity, the first one is responsible for paying the premium and also represents all insureds in some other matters

first report of injury (FROI)

state-specific form required to be sent to the claim administrator and, in some cases, the state when a worker alleges a work-related injury, illness, or disease

flat dividend plan

same as standard dividend plan

FMLA

see Family Medical Leave Act (FMLA)

foreign national

for WC, a person from the U.S. who temporarily resides outside of the U.S. during a work assignment

foreign voluntary coverage endorsement

extension of WC coverage to a foreign national

formal hearing

usually the last opportunity in WC systems to present evidence; held in front of a hearing officer, administrative law judge (ALJ) or trial court judge; in most states, the formal hearing is the equivalent of a trial and follows specific rules of procedure

formula reserves

reserves based on some formula rather than the outcome of a single claim based on the facts of that specific claim (sometimes called actuarial reserves)

forum shopping

slang term for the tendency of 1)  some injured workers to choose the most generous state in which to file a WC claim, or 2) some employers to try to force the claim to the least generous state-- in some instances, more than one state is willing to accept the claim

fraud

The intentional presentation of false information to obtain a WC benefit (worker fraud, medical provider fraud) or withhold a benefit (employer fraud, adjuster fraud)

FROI

abbreviation for First Report of Injury; for WC, this abbreviation is typically used in conjunction with EDI requirements

fronted program

insurance that includes a fronting arrangement

fronting

same as fronting arrangement

fronting arrangement

contractual arrangement where an insurer writes coverage for an entity (either an employer or another insurer) that, in turn, reinsures substantially all of the exposure

functional impairment benefits

wage replacement benefits based strictly on reduced physical function, with no consideration of loss of earning capacity