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Employer shall be liable before the Court of Law to pay compensation, in accordance with the provisions of Workmen Compensation Act, 1923, for personal injury or death or disease contracted specified therein as an occupational disease peculiar to that employment in Part A Schedule III of Workmen Compensation Act 1923, caused to a workman by accident arising out of and in the course of employment.
‘Personal injury’ under the Act means physiological injury. It may be external, or it can be internal also.
All employees working for the employer/ insured. In case of contract labour the liability of the principal is absolute though he may not be the actual employer. e.g For The Security Gaurds provided by a security agency, the liability under WC Act also falls on the Principal.
For purpose of calculating any claim the monthly wage taken into account are the actual wages subject to maximum of Rs.4,000/. Wages includes all allowances and cost of perks.
The Employer need not pay compensation – in respect of any injury caused by an accident which is directly attributable to
In cases of death or permanent Total Disablement of a workman, the above defences are not available to Employer.
If any disease is prescribed in the Act as “Occupational Disease”, the illness is deemed to be an injury. If the Employer defends the Claim, such expenses are also payable.
Policy may be extended to cover Medical expenses incurred by the employer by payment of additional premium as per Workmen Compensation policy.
The Company shall not be liable under the policy in respect of:
The Claim under WC Act arises in case of any injury (fatal & non-fatal) / decease arising out of and in course of his employment.
IN case of an accident invoking liability under WC ACT the employer/insured needs to take following steps:
For preferring a claim he needs to submit us the following Documents to enable us to proceed with investigation of the case:
The investigator is appointed to verify the records wage Bills/ Employment records and any shortfall in premium (i.e under-declaration of Wage Bill or No. of employees) till date plus a reasonable premium for future needs to be necessarily deposited before the claim is settled. In case of glaring difference between the initial declaration and the actual figures are detected, the claim may even be prejudiced.
In the event of claim, the Insured must inform the insurer in writing & request for a Claim Form
In case of death and Permanent disablement claims, the claim would be processed only after the full compensation is deposited before the Commissioner
Shall mean the employees total remuneration paid or fallen due for payment including overtime, value of board and/or lodging, housing accommodation bonuses and all other perquisite privileges or benefits in kind or money, received by the employees from the employer in connection with their employment.
As specified under Workmen Compensation Act, 1923.
The Sum insured available under the policy. Whichever is less.
The amount of claim payable under WC Policy is strictly governed by the WC ACT and depends upon two factors:
An amount equal to 50% of the monthly wages of the deceased workman multiplied by the relevant factor.
An amount of Rupees eighty thousand whichever is more.
An amount equal to 60% of the monthly wages of the injured workman multiplied by the relevant factor.
An amount of Rupees Ninety Thousand whichever is more.
In case of an injury specified in the ACT, such percentage of the compensation which would have been payable in case of Permanent Total Disablement as is specified therein as being the percentage of the loss of earning capacity caused by that injury.
In case the injury is not specified in ACT, such percentage of the compensation payable in case of permanent total disability as is proportionate to the loss of earning capacity(as assessed by the qualified medical practitioner) permanently caused by the injury.
(where more injuries than one are caused by the same accident, the amount of compensation under this head shall be aggregate but not so in any case as to exceed the amount which would have been payable if permanent total disablement had resulted from the injuries.)
A half monthly payment of the sum equivalent to 25% of the monthly wages of the workmen, if the disablement is for more than 3days. This will continue during the period of disablement or 5yrs. whichever is shorter.
THE WC Claim needs to be deposited necessarily with WC Commissioner of the Area, unless order to the contrary are obtained from him. The discharge of WC Commissioner is sufficient discharge for us.