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Workmen's Compensation

It is Mandatory by Law

Workmen compensation is mandatory in many countries even if the organization has only one worker. It is mandatory to cover employees under worker’s compensation insurance.

Affordable

A good, active safety program will not only keep your employees safe, but it will also save your extra expenses. Make sure you use methods to lower the chance of accidents. This will help you to get a worker’s compensation insurance at an affordable premium amount.

It Helps Protect the Employees

It helps the employer to protect the most valuable asset of the organization, i.e. employees. In a situation where the job profile involves certain risks that can cause injury or causes the death of an employee, this insurance policy works like a shield and protects the employer against heavy expenses incurred due to handling workers’ liability. Remember, with workmen compensation, you can ensure safety for your employees or workers at an affordable price and limit your liabilities against any adverse situations.

Workmen Compensation Insurance in India

This insurance is mandatory under The Workmen’s Compensation Act, 1923, in India. It is important for both the employee and the employers. In India, for all manufacturing units with more than 20 employees, having a Workmen's Compensation Insurance is mandatory to have insurance benefits for workers or employees as per the Employees’ State Insurance Act, 1948. Likewise, for all companies or manufacturing units with less than 20 employees, it is important to ensure Workmen’s Compensation Insurance according to the Workmen's Compensation Insurance Act, 1923 and Indian Fatal Accidents Act, 1855.

Importance of Workmen Compensation for Employee

This policy helps the employers to avoid the extra expenses incurred in case any worker meets any unfortunate events while working in the organisation. Workmen compensation insurance bears the cost incurred due to treatment on behalf of the employer.

As an employer, you are liable to pay compensation in case of death, permanent total or partial disability and/or temporary disability. However, you would not need to pay any compensation in case of the death or disability of the employee due to the influence of alcohol, drugs or other intoxicating substances. You’re also not liable to pay any compensation in the event when the employee wilfully disobeys or disregards the safety or security rules or regulations stipulated by you or management.

The Workmen’s Compensation Act 1923

First piece of legislation towards social security Deals with compensation for workers who are injured in the course of duty Benefits payable under the Act:- Employer is liable to pay compensation as per Act if personal injury is caused to workmen by accident resulting in:-

  • Death
  • Permanent Total Disability
  • Permanent Partial Disability
  • Temporary Total Disability

Other benefits payable under the Act

Employer is also liable to pay for following due to accident:-

  • Medical Expenses
  • Funeral Expenses

Accident should arise out of and in course of the employment

If workmen contracts occupational diseases listed out in the Act, the illness is deemed to be injury by accident arising out of and in the course of the employment The name ‘Workmen’s Compensation Act’ has now been replaced with the ‘Employee’s

When is an Employer Liable to pay compensation?

Death of Disablement from personal injury due to accident must be caused to workmen by accident arising out of and in course of employment.

  • Arising out of employment :- Refers to cause of Accident
  • In course of the employment :- Refers to Time, Place & Circumstances of Accident

There should be a casual relationship between the accident and the employment. Employment is the cause & Accident is the effect Minimum 3 days disablement is mandatory for any claim for disability under the Act For occupational disease contracted because of employment it is provided the employee should have been employed for a continuous period of 6 months

When an Employer is not Liable to pay compensation?

  • If the injury does not result in total or partial disablement for a period exceeding 3 days.
  • If the worker is under the influence of liquor- drinks or drugs at the time of the accident.
  • Wilful disobedience of rules and orders given to secure the safety of the workmen.
  • Wilful removal of any safety device provided for the safety of the workmen.

Workmen’s Compensation Policy

  • Some key exclusion
  • War, nuclear perils
  • Contractual liabilities
  • Occupational diseases
  • Fines & Penalties :-
    No insurance policies will pay for fines and penalties although awarded by the court. This has to be borne by client only.

Why Claims Get Rejected ?

Prior Period Exclusion

Claims pertaining to a period before the policy inception date are not covered. If there is a break in the renewal of the workmen compensation policy, then the coverage date is reset to the start date of the new insurance. We prevent this by ensuring timely renewal.

Known Issues

Claims that come about from an issue that was known before the insurance was bought are rejected. The insurer will cross examine the case closely to see when the company became aware of the matter. This can be addressed by clearly describing any known issues when you buy your first Workmen compensation insurance cover.

Inconsistent And Unverifiable Accident Reports

Insurers will reject a claim if there are contradictory reports on the accident or lack of information. Typically, insurers will compare worker, employee and police reports on an incident. There is greater scrutiny of cases where the claim was filed after a worker was terminated or laid off.

How to Get a Quote?

  • You can get quotes for your organization/group workmen compensation insurance plan online with few clicks, by following these steps :-
  • Step 1: Decide the Sum Insured for each employee/member
  • Step 2: Fill in the information in the Calculator.
  • Step 3: If you had been using a Workmen Compensation Insurance Policy, enter the claim ratio for the last year.

Documents Required Getting The Policy ?

  • Following documents are needed to avail Workmen Compensation insurance :-
  • Proposal Form
  • Declaration Form
  • Reports as required by the Insurer
  • Any other Document as required by the insurer

How to file a claim?

  • Workmen or Employee Compensation Insurance compensates eligible workers as per the act if they meet with an accident at workplace or while on duty. The claim process is as follows:
  • Give immediate written notice to the insurance company about the death or disablement of the employer.
  • Intimate the Factory Inspector if the accident happens in a manufacturing plant
  • Furnish all information and documentary evidence to the insurer as needed or asked by them.
  • Deposit the compensation payable to the employee with Workmen Compensation Commissioner. Obtain their receipt and submit the same to Insurance Company.
  • If any notice is received from W.C. Commissioner, send the same to Insurance Company
  • Cooperate with the investigator appointed by the insurance company.
  • At the same time, following documents need to be submitted.

General for all type of claims

  • Claim Form duly filled in & signed.
  • Claim Bill.

Temporary Disablement Claims

  • Medical Certificate regarding Cause & Duration of Disablement.
  • Medical Bills.

Permanent Disablement Claims

  • Medical Certificate regarding Disablement.
  • Memorandum of Agreement as per W.C Act between Insured and the injured workman.

Fatal Claims or Death Claims

  • Death certificate.
  • A copy of post Mortem report.
  • F.I.R / Final Investigation Report.
  • Form A of W.C. Act duly completed by the Insured.
  • Statement of Witnesses, if any.