Texas stands alone among the 50 states in not requiring most employers to carry workers’ compensation insurance for their employees, and for years the system was in dire straits. Fortunately, in the years since 2003, the system has been improving. Workers’ comp is an insurance program that provides medical, rehabilitation, and income benefits for workplace-related injuries and illnesses. Employees benefit from workers’ comp by knowing that if they are injured on the job, they will have basic coverage without having to go through a lawsuit. Employers benefit because employees who are covered by workers’ comp generally cannot sue their employers for their injuries. The Texas workers’ compensation law enacted in 1913 allowed private employers to completely opt out of participation in the workers’ comp system, or “nonsubscribe.” Employers who opt out lose the protection of statutory limits on liability and may be sued for negligence by injured employees. For many years, according to the Insurance Journal, Texas medical costs per claim were high compared to other states, return-to-work rates were dismal, and satisfaction with care was low. Workers’ comp insurance costs were high and insurance was hard to find, so many employees were not insured.
How Texas Workers’ Comp Is Improving
Major changes occurred in 2005, when the Texas Legislature approved House Bill 7, which transformed the state’s workers’ comp system from one of the weakest in the U.S. to one of the healthiest. Reforms included abolishing the Texas Workers’ Compensation Commission and replacing it with the Division of Worker’s Compensation under the Texas Department of Insurance (TDI). Under the TDI, a Workers’ Compensation Research and Evaluation Group (REG) was created, which reports on the availability and affordability of workers’ comp insurance. In its most recent report, Setting the Standard, An Analysis of the Impact of the 2005 Legislative Reforms on the Texas Workers’ Compensation System, the REG examined data from 2005 through 2019 to create a picture of the changes that have occurred in the system. The report shows that there are now 312 insurers writing policies, with the top 10 insurance groups writing 76% of the market. The largest insurer, Texas Mutual Insurance Co., has a market share of 42% and $1.07 billion in premiums in 2019. Texas Mutual is the workers’ comp insurer of last resort to write voluntary business and compete in the marketplace.The Top Workers’ Comp Insurers in Texas
| Company | Market Share |
| Texas Mutual Insurance Co. | 42% |
| Travelers Group | 7% |
| Liberty Mutual Group | 5% |
| Zurich Insurance Group | 5% |
| Hartford Fire & Casualty Group | 5% |
| Chubb Ltd. Group | 4% |
| American International Group | 2% |
| WR Berkley Corp. Group | 2% |
| CNA Insurance Group | 2% |
| BCBS of MI Group | 2% |
Oversight of the Workers’ Comp System in Texas that Protects the Rights of Injured Workers
The Division of Workers’ Compensation (DWC) oversees the administration and operation of the Texas workers’ compensation system to ensure compliance with the Texas Workers’ Compensation Act, Texas Labor Code, and other regulations. According to Texas Labor Code section 402.021, the goals of DWC are to ensure that:- Each employee is treated with dignity and respect when injured on the job;
- Each injured employee has access to a fair and accessible dispute resolution process;
- Each injured employee has access to prompt, high-quality medical care; and
- Each injured employee receives services to facilitate their return to work as soon as it is considered safe and appropriate by their health care provider.
Other Improvements in Texas Workers’ Comp
While the workers’ comp market for the last 10 years has been profitable overall, according to the TDI report, rates for premiums have decreased, benefiting the public. In addition, according to the report:- TDI certified 30 networks covering 254 Texas counties to provide workers’ comp health care.
- While in 2001, Texas was among the highest nationally in terms of medical costs per claim, the current cost is about 24 percent less than the median cost of the 18 states in the analysis.
- Overall, TDI has received relatively few complaints about certified health care networks, with 80% of injured workers saying the “medical care for their work-related injury was as good or better than their routine medical care.”
- The waiting period to receive non-emergency medical care has been cut in half since 2011.