Workmen Compensation

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The workers’ compensation (WC) insurance policy safeguards organizations from the threat of expensive legal suits and financial liabilities. Employees’ compensation insurance policy is the other name for it. Let’s look at the rights of the company after the loss under Workers Compensation Insurance.

Rights Of Employers Under WC Policy

The companies/employers that purchase the insurance policy enjoy the following rights:

  1. Right to request the insurance provider to contest the claim in court. In cases where the injury is unrelated to work or the employee is not as injured as he/she claims, the case can be contested. However, since the insurer has already accepted the liability for the claim, it may not comply with the employer’s request. There are some insurances that have a “Duty to Defend” clause. In these insurances, the insurer must defend your case if you ask them to.
  2. An employer can pay monetary compensation to the injured employee/family. However, an employer can’t reach the insurance company for reimbursement of the amount paid due to work-related injury or illness unless the courts have specifically made an award.
  3. Even if the company has workers’ compensation insurance, it can initiate an internal investigation to find out the exact reason behind the accident.
  4. The employer has the right to attend all dispute resolution proceedings pertaining to an employee’s claim and relevant evidence about the disputed
  5.  Access the files related to the settlement of the claim electronically.
  6. An employer has the right to report suspected workers’ fraud to the insurance company
  7. An employer has the right to get information related to the proposal about the settlement of a claim or any administrative or judicial proceedings. It can get information related to the claim resolution, after making a written request to the insurance company.
  8. An employer can also contest the failure of the insurance company to offer sufficient accident preventive cover.
  9. An employer also has the right to get return-to-work coordination services as required, to facilitate an easy return of the employee to employment.

Read More: Who Should Buy Workers Compensation Policy?

Covered loss under Workers Compensation Insurance

Case: 1

A 28-year old Rajiv Saxena’s right leg got under the machine when he worked in a clothing mill. Due to the accident, he permanently lost his right leg. The owner of the mill agreed to compensate him under a workmen’s compensation insurance policy. Though the insurance policy could not compensate for the emotional loss of his family, it helped in covering the financial loss to some extent. The owner also asked the insurance company to grant him rights so that he can electronically access the claim settlement files of Rajiv. Also, the mill owner assigned a new job role to Rajiv as per his current state.

Case: 2

Employer’s workmen’s compensation also proved helpful in the case of Swati Malhotra. It covered medical bills and lost wages for the time she was unable to work. While still receiving disability payments, she joined another company. She concealed her new job from the old employer and reported she was still disabled. Besides, she signed a statement to that effect to her old employer’s workers’ compensation insurance policy. However, some of her colleagues from her old company came to know about her new job due to social media posts. These colleagues informed the HR department of their company. This information was then passed on to the workmen’s compensation insurance provider and it also requested to file a case against Swati.

Read More: How Is Premium Estimated for Worker’s Compensation Insurance?

Case: 3

Rama Nagarjun has been working as a civil engineer in R.W Construction in Pune for the past four years. He felt a pull in his leg last month and it got worse over the weekend. The hospital diagnosed his problem as a slipped disc and a minor fracture in the leg. He was discharged after 10 days and advised of complete bed rest. He informed his company and the employer decided to bear the entire hospitalization expenses from the “Employee Welfare Fund”.  It deals with employee monetary needs like a child’s education, marriage, hospitalization, home renovation, buying a vehicle, etc.  Though the company showed a good gesture by recouping medical expenses, it can’t ask its workmen’s compensation insurance provider to reimburse the amount.

The above cases are examples of how an employer can use his legal rights to protect himself from unjust practices and financial liabilities and incurred loss under workers compensation policy.