WORKMEN COMPENSATION INSURANCE

 

WORKMEN COMPENSATION INSURANCE

 

What is it?

Workmen compensation/ Employees compensation policy covers legal liability under the Workmen Compensation/ Employees Compensation Act 1923 with subsequent amendments, Fatal Accident Act 1855 and Common Law. This policy shall also provide additional coverage for medical expenditure, occupational disease, compressed air disease and terrorism, subject to collection of additional premium

Who needs it?

Policy is required by all manufacturing/trading/servicing setups for all floor workers and office staff as well. Most of the contractors’/Sub contractors stands benefited by this policy. Policy can be taken by Individual/Public or Private companies/ Partnership firms or by any of business/Trading entity operating in the Country

Why do you need it?

Policy provides coverage against unforeseeable events such as disabilities due to workplace injuries, occupational ailments in course of employment, medical treatment for injuries and accidental death during the course of employment

Why us?

Our Workmen/Employee Compensation policy is comprehensive and flexible enough to fulfil your needs. We understand the importance of swift response and efficient service in handling claims, which makes it more practical to get Workmen/Employee Compensation Insurance directly from us.

What is included?

Basic covers include Accidental death, Permanent total or Partial Disability and Temporary total disability. Add on covers include Medical Extension, Compressed Air Disease, Occupational Disease, Terrorism and Sub Contractor Coverage

Get answers to common questions about marine insurance policy

What are the basic coverage provided under Workmen Compensation policy?

The policy provides coverage for accidental death, permanent total disability, permanent partial disability and temporary total disability

What addon covers are provided in Workmen Compensation policy?

• Occupational Disease
• Compressed Air Disease
• Contractor /Sub Contractor Coverage
• Terrorism Cover
• PAN India Location Coverage
• Medical Expenses (Per Employee Limit)
• Cashless for Medical Expenses

 

 

What is Permanent Total Disablement?

Permanent total disablement means such disablement of a permanent nature as incapacitates an employee for all work which he was capable of performing at the time of the accident resulting in such disablement

List of disablements is specified in the Workmen compensation Act

 

What is Permanent Partial Disablement?

Permanent partial disablement means, where the disablement is of a permanent nature, such disablement as reduces the earning capacity of an employee in every employment which he was capable of undertaking at the time of the accident resulting in the disablement

List of disablements is specified in the Workmen compensation Act

 

What is Temporary Disablement?

Temporary disablement means a condition resulting from an employment injury which requires medical treatment and renders an employee, as a result of such injury, temporarily incapable of doing the work which he was doing prior to or at the time of the injury

 

What is workmen compensation insurance?

The Workmen/Employee Compensation Insurance provides for payment of compensation to Employer on behalf of its employees in case of accidental injury to at workplace arising out of and in the course of employment and resulting in death or disablement

• Workmen compensation claims are for accidents within work premises and during working hours
• It also covers direct travel of employees from office to home and vice-versa
• At the time of injury, workman must have been engaged in the business of the employer and must not be doing something for his personal benefit
• Employer and employee relationship is an important prerequisite for issuance of workmen compensation (WC) / employee compensation (EC) policy

 

What legal liabilities are covered in Workmen compensation policy?

• Workmen Compensation Act, 1923 [As Amended through Employee Compensation (Amendment) Act, 2017], and subsequent amendments of the said Act prior to the date of issue of the policy.
• Fatal Accidents as per Fatal Accident Act, 1855
• Common Laws

 

How is Workmen Compensation policy different from ESIC (Employee State Insurance)?

• Construction site workers are excluded from ESIC coverage as per ESI Act but can be covered in WC policy
• Employees with wages above 21000 not covered in ESIC but there is no limit of wages under WC/ EC Act
• Seasonal Factories (Includes factories engaged Less than 7 Months) are not covered in ESIC, but can be covered in a Employee compensation policy
• Organization with up to 10 workers (20 in case of Maharashtra and Chandigarh) does not require to have ESIC registration however there is no restriction as to no. of workers in WC /EC policy
• Lower and flexible rates as compared to fixed ESIC Rates

 

What is occupational disease cover?

Occupational Diseases covers those diseases that are specified under Schedule III of Workmen or Employee Compensation Act

It covers those disease which arise due to nature of occupationEx. disease caused by use of toxic compounds

 

What is Compressed Air Disease cover?

Compressed air disease is one of the occupational illnesses covered under workmen compensation policy. It is a sickness attributed to the working environments where air pressure may be higher or lower than the normal surface air pressure

Ex. Underground or underwater works

 

What does Medical Extension add on cover?

Medical extension covers reasonable medical surgical and hospital expenses incurred by the Insured in connection with any case of injury of employee, if hospitalisation is for more than 24 hours

 

What is Terrorism Cover?

Any injury on account of terrorist activity within workplace is covered

 

What is covered under Contractor /Sub Contractor Coverage?

Contractor / Sub-contractor and their employees can be covered under this coverage

 

What is PAN India Location Coverage?

If the insured has more than 1 risk locations (operating branches or factories) across the country, PAN India coverage enables employer to take a single insurance policy to cover its employees in all the branches

 

What information is required for Claim intimation?

• Policy Number
• Insured Name
• Injured Name
• Date of Accident (Loss)
• Nature of Claim - TTD (temporary total disablement) / PPD (permanent partial disablement) etc
• Brief description of accident

 

What is the amount of compensation payable under Workmen Compensation policy?

Workmen Compensation is a statutory liability as prescribed under Employee Compensation Act which provides for amount of compensation as below:

Nature of Claim	Amount of Claim
Accidental Death	(50% * Wages * Age Factor) OR INR 1,20,000 Whichever is higher
Permanent Total Disability	Permanent Total Disability (60% * Wages * Age Factor) OR INR 1,20,000 Whichever is higher
Permanent Partial disability	Based on % disability / Loss of earning capacity prescribed by medical practitioner * Wages * Age Factor
Temporary total disability	Temporary total disability 25% * wages * No of days of absence/disability / 15

*As prescribed by central govt. notification, maximum amount of wages to be considered for compensation is INR 15000 per month

 

What basic information the Insurer needs to provide quotation?

• Nature of work / Occupancy
• No. of Employees
• Monthly wages
• Policy duration
• Risk Location Address
• Claim Experience of last 3 years with amount and count of claims

 

How Sum Insured is calculated in a Workmen compensation policy?

• Sum Insured is the total earnings of the employees in the organisation
• The Sum Insured is calculated on the basis of monthly wages of employees
• Wages includes basic salary, allowance, perquisites or any benefits provided to the employees (Other than reimbursable expenses made by employees)