Insurance coverage Q&A: Workers' comp for chef hurt in pool at work event?

We have the following general question seeking your thoughts on its applicability as a workers’ comp claim vs general liablity. Information from what we know to date:

The insured is a major hotel chain that was having a ceremony at one of its properties with a pool. A chef that works for the hotel was at the party and dove into the shallow end and sustained a neck injury that required surgery. Currently, we do not have the medical or exact injury and, unfortunately, this is late notice reporting of the incident. Alcohol was being served at this event, but we are unaware if this was a factor in the injury.

The claimant is one of the hotel chefs and we assume he was not on duty but just attending the award celebration.

— Guam Subscriber

With respect to workers’ compensation, this question cannot be answered with any degree of accuracy for several reasons:

1. The facts of why the chef was attending the celebration are of major importance. For example, how was the invitation or request to attend the event presented to the chef? Since it was a culinary celebration for which the hotel received an award it’s possible that even if the chef’s attendance wasn’t mandatory, it was likely expected by the employer. Did the chef have the option to attend the celebration or was it expected of him? If attendance was mandatory or expected of the chef, then it is more likely that a court would decide that the bodily injury arose out of and in the course of the injured employee’s employment.
2. The policy relies on compliance with state law. We are unfamiliar with the laws of each state, so it is possible that there may be some guidance that would assist in determining if attendance at an employer’s celebratory event meets the state’s requirements for being a work-related event for purposes of coverage consideration.
3. The employee may have some negligence in his own injury that could have bearing on whether or not this was a work-related injury. Since he dove into the shallow end of the pool, were there signs prohibiting such an action?

There are just so many factors that could come into play in this claim that it is likely that it needs to be taken before the state’s workers’ compensation board for review and determination.

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