IRDAI License Number: IRDAI/INT/ISNP/2022/250

Workmen Compensation Policy

Epoch Insurance Brokers Private Ltd.
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Workmen Compensation Policy
Introduction
Who can take this Policy?
Coverage
Add on Covers
Basis of Sum lnsured
Exclusions
Introduction

Workmen’s Compensation Act 1923 provides compensation to employees in event of death or bodily injuries or occupational diseases caused to an employee by accident arising out of and in course of employment.

The employer is liable to pay compensation to the employee or their dependents in accordance with the provisions of Workmen Compensation Act, 1923/ Employees’ Compensation (Amendment) Act 2009 for personal injury or death of the employee by accident of disease contracted while discharging duties

The policy under Table-A covers   

1. Workmen’s Compensation Act, 1923/Employees’ Compensation (Amendment) Act 2009
2. Fatal Accidents Act, 1855
3. Common Law

The contractual staff working in factories/ projects falling in a preview of ESI Act 1948 can be insured separately under Table-B covering
 
1. Fatal Accidents Act, 1855
2. Common Law

Who can take this Policy?

The Policy should be taken by Employer/Principle/Contractor for whom the employee/labor are working.

Coverage

WC Policy Covers the following perils:

  • Death
  • Permanent total disablement
  • Permanent partial disablement
  • Temporary disablement
  • Additionally, legal costs and expenses incurred with our consent
  • Policy can also be extended to include medical expenditure for necessary treatment

Add on Covers

The policy can be extended to cover Medical expenses against additional premium.

Basis of Sum lnsured

Sum Insured is directly linked with the Salary of Employees.

Exclusions

The policy does not cover: 

  • Contractor’s liability towards employees
  • Any Contractual liability
  • Injury not resulting in death

i) caused by accident directly attributable to workman being under the influence of alcohol or drugs.

ii) willful disobedience by the workman of orders and rules expressly given to secure the safety of the workmen

iii) willful removal or disregard by the workman of any safety devices  provided for the safety of workmen

  • Any injury or disease directly attributable to War and related acts

Why Choose PolicyLo.com

Professional and Experienced Team
Professional and Experienced Team
Customized Solutions
Customized Solutions
Strong Relationship With Insurance Companies
Strong Relationship With Insurance Companies
Service Commitment Ontime Everytime
Service Commitment Ontime Everytime
Technological Edge
Technological Edge
Additional Services Offered
Additional Services Offered
Competitive Premium
Competitive Premium
Single Window Solution
Single Window Solution

Important Points to remember while Buying the Policy

Adequate Sum Insured - To Avoid Underinsurance

Maintain Muster Register

  • Maintaining the Muster Register brings more clarity that how many workers were on the site/plant/work location on a specific day.
  • It is also fulfill the basis requirement in case of claim, as Muster Register can be asked for claim proceedings.
Ensure that assets should be covered under the right entity/company

Maximum Number of Workers to ensure covered at any point of time

  • There should be proper monitoring that number of workers should not exceed the number of workers covered in WC Policy.
Risk Location/s should be properly mentioned

Minimum wages should be taken as per law

  • Parameters for minimum salary slab should be followed.
Downloads
Proposal Form
Proposal Form  
Policy Wordings
Policy Wordings  
Claim Form
Claim Form  
Key Documents
General Claim Intimation Format
General Claim
Intimation Format
Immediate Action Client Should Take
Immediate Action Client
Should Take
Indicative General Documents
                            for Settlement of Claims
Indicative General Documents
for Settlement of Claims

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Claim Case Study - 1

1
Situation
Situation

Employee of a garment manufacturer while travelling due to official work met with an accident and eventually died in hospital.

2
Challenge
Challenge

Client had a WC Policy but never claimed under the same and paid the compensation to the employee out of their own pocket.

3
Solution
Solution

We apprised the client about the coverage under this policy. We advised him to procure and present the requisite documents to the insurance company which, in turn, helped the client to get the reimbursement from the Insurance company.

4
Advisory/Conclusion
Advisory/Conclusion

We streamlined the process and conducted a awareness session at clients end . The same was greatly appreciated by the client.

Claim Case Study - 2

1
Situation
Situation

A client dealing in specialized engineering equipment sends his Employee to its client at various location for explaining usage of the machinery to various users.

2
Challenge
Challenge

while working on the machine at the clients end, his palm was injured badly and entire palm has to be cut off. Insurance company denied the claim, reason being that the employee was working at a different location.

3
Solution
Solution

The case was put forward to the insurer and argued that the insured employee was travelling for the employer due to work and the incident has occurred during course of employment and has nothing to do with the exact location as there was no change in nature of work.

4
Advisory/Conclusion
Advisory/Conclusion

The client was advised to give full description of nature of work so that such anomalies do not occur.

Need Assistance

Need Assistance

FAQ's

PREMIUM
COVERAGES
CLAIMS
OTHERS
  • How is the premium rates determined for workmen compensation/employees compensation?
    Premium for a workmen compensation/employees compensation insurance is based upon multiple factors such as employer's industry classification, nature of work, number of workers, duration of the contract in case it is a contractual requirement and salary/wages of the employees/workers. Risk location, safety standards and past claim experiences are also key factors for determining the premium rates under worker compensation insurance.
  • What is the process of premium payment in the workmen compensation/employees compensation policy?
    Premium payment under workmen compensation/employee’s compensation can be done through cheque, net banking and NEFT transfer. If you want to start the coverage immediately visit the calculator section on our website, enter the details of number of workers, policy duration, location and occupation. After choosing the final option and insurance company just proceed to make the payment to the selected insurance company. Coverage will be effective immediately on realization of payment, if the risk is accepted by the insurer.
  • Will the premium change every year in workmen compensation/employees compensation policy?
    Workmen compensation/Employees compensation policy is bought for a year in case of a fixed setup such as manufacturing and also bought by the contractors for the limited period for the contractual projects. In both cases, premium will change subject to various factors such claim history, number of workers, type of occupation, location, duration of the project. It is better to go for an annual policy as it is  beneficial in terms of inconvenience and cost.
  • How is the premium for workmen’s compensation insurance calculated?
    The premium is based on the occupation of the employees, number of employees insured and their cumulative wage.
  • What is covered under WC Insurance?
    The policy covers statutory liability of the employer towards death or bodily injury to the employee due to accidents arising out of and during the course of employment.
  • What are the exclusion under WC Policy?
    • Injury/death caused whilst employee was under the influence of alcohol
    • Willful disobedience
    • First 3 days of disablement
  • Are occupational diseases covered under WC Insurance?
    Occupational diseases such as Pneumoconioses caused by Sclerogenic mineral dust and Silico-tuberculosis, Bagassosis, Bronchopulmonary diseases caused by cotton, flax hemp and sisal dust (Byssinosis) contracted during course of employment are coverable under the policy.
  • What are the coverage offered under a workmen compensation/employees compensation policy?
    The workmen compensation/employees compensation policy cover legal liability to all the employees under W.C. Act 1923, the Fatal Accidents Act, 1855 and at Common Law. The legal liability arising out of death or disability during the course of employment will be covered. Additionally, workers compensation/employees compensation policy also covers the medical expenses for the treatment of an injury sustained by the workmen due to any accident during the employment. This policy is now also known as Employee Compensation policy.
  • Are claim related to medical expenses covered under EC Insurance?
    Yes, by paying additional premium medical expenses can be covered under the policy.
  • How to file a claim in a workmen compensation/employees compensation policy?
    In case of an accident at the work site, employer should immediately inform the insurer about the incident and also intimate the local labour authority of the area. Next step is to submit the required documents such as claim form, medical reports, and compensation records to the insurer. During any claim, our claim team will guide you throughout the entire process starting from claim intimation to document submission till claim gets passed.
  • Can I file a claim under both WC Act and Common Law?
    Yes. Workmen Compensation/Employees Compensation policy covers both statutory liabilities and legal liabilities under common law. If an employee files a claim for accidental death and disability at workplace in a civil court, then any compensation awarded by the court will be paid under the Worker Compensation Insurance policy.
  • What are the scenarios under which a claim may get rejected under worker compensation policy?
    Under workmen compensation/employees compensation policy, apart from standard exclusions mentioned in the policy, insurer may reject a claim on various grounds such as if claim is not reported to the insurer within stipulated time, failing to submit all the necessary documents, submitting a claim pertaining to a period before the policy inception date, non-disclosure of known issues such as safety measures & declaring wrong occupation and if the risk is excluded.
  • What is WC Insurance all about?
    The policy covers legal liability towards employees under the Workmen Compensation Act 1923, the Fatal Accidents Act, 1855 and at Common Law. Legal liability arising out of death or disability during the course of employment is covered in the policy. This policy is now also known as Employee Compensation policy after passage of Employee Compensation (Amendment) Act 2017.
  • Why Workmen’s Compensation Insurance Cover is required for an Employer?
    This Policy protects your liability as an employer for employment injury (including death) of any of your employees who is a ‘workman’ as defined under Workmen Compensation Act.
  • Does an employee/worker has to contribute for workers compensation/ employees compensation policy?
    No. An employee/worker is not required to pay or contribute to the workmen compensation/employees compensation policy. Only the employer needs to buy the workmen compensation/employees compensation policy because as per the Workmen Compensation/Employees Compensation Act 1923, Fatal Accident Act, 1855 and common law an employer is responsible to compensate for any accident which result in death, injury or disability to an employee/worker during the course of their employment.
  • What are the advantages for an employer by buying a worker compensation policy?
    Workmen compensation/Employees compensation policy offers various layer of protection to an employer such as it covers statutory liability of an employer for the death of or bodily injuries or occupational diseases sustained by the workmen/employee arising out of and in course of employment as per Workmen Compensation/Employees Compensation Act 1923. Also, an employer can claim the premium paid for the worker compensation policy as a tax deduction.

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