How to file a claim under Workmen Compensation Insurance?

A Workmen’s Compensation policy covers the financial liability suffered by the employer if the employee suffers from any physical harm during the course of his/her employment. The policy helps the employer cover his financial liabilities as stated under the Workmen’s Compensation Act, 1923. The policy covers the liability faced when a workman suffers the following consequences – 

  • Death
  • Permanent total disablement
  • Permanent partial disablement
  • Temporary total disablement

Moreover, the legal costs incurred by the employer are also covered under most Workmen’s Compensation plans.

In case of a claim, the following process should be followed by the employer to register the claim with the insurance company – 

  • The insurance company should be informed of the accident as soon as it happens
  • If the accident occurs in the factory premises of a manufacturing facility, the supervisor of the facility should also be informed immediately
  • The claim form should be filled in and the relevant documents pertaining to the claim should be attached with the claim form and submitted to the insurance company
  • The employer should contact the workmen compensation commission and submit the compensation payable to the employee. On submission  of the compensation, the commission would issue a claim receipt which should be submitted to the insurance company
  • If a notice is sent by the workmen commission, the same should be submitted with the insurance company
  • Insurance companies would arrange for an inspection of the claim
  • After inspection is done, the inspector would file a report based on which the insurance company would pay the claim.

All the bills relating to the claim are required to be submitted to the insurance company along with the following documents –

  • A declaration report
  • Any claim related report required by the insurance company
  • All medical bills relating to disability suffered and a medical certificate which mentions the reason of disability and its expected duration
  • In case of permanent disabilities, an agreement paper would be required, which would be executed between the employer and the disabled workman as per the rules laid down under the Workmen’s Compensation Act. A medical certificate certifying the disability would also be required
  • In case of death of the workman, additional documents would be required by the insurance company which would include the copy of the death certificate, copy of the post-mortem report, witness statements if they are available, copy of police FIR, Form A of the Workmen’s Compensation Act which should be filled in and signed either by the insurance company or by the employer.

The employer should follow the claim process properly and submit all the relevant and required documents pertaining to the claim so that the Workmen’s Compensation policy pays the liability faced by the employer.