Workmen Compensation

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As the workers’ compensation insurance policy safeguards organisations from the threat of expensive legal suits and large compensation as stated under the Workmen’s Compensation Act of India, the company who purchases the insurance policy enjoys the following legal rights. Note, it is also known as the workmen’s and employees’ compensation insurance policy.

  1. An employer has the right to request the insurance provider to contest the claim in court. It is possible to contest the claim for a variety of reasons like, the injury is not related to work or that the employee is not injured to the extent he/she is claiming for it. An employer can request the insurance provider to contest the claim, however, since the insurer has already accepted the liability for the claim, it is not necessary for them to comply with the employer’s request.
  2. An employer has the right to refuse to pay monetary compensation to injured workers and he/she can’t be sued for this.
  3. Taking the above point forward, an employer can pay monetary compensation to the injured employee/family. However, an employer can’t reach to the insurance company for the reimbursement of the amount paid due to work-related injury or illness.
  4. Even if the company has a workers’ compensation insurance, it can initiate an internal investigation to find out the exact reason behind the accident.
  5. An employer has the right to attend all dispute resolution proceedings pertaining to an employee’s claim and relevant evidence about the disputed
  6. An employer has rights to access the files related to the settlement of claim electronically.
  7. An employer has the right to report suspected workers’ fraud to the insurance company
  8. An employer has the right to get information related to the proposal about the settlement of a claim or any administrative or judicial proceeding related to the claim resolution, after making a written request to the insurance company.
  9. If required, an employer can also contest the failure of the insurance company to offer sufficient accident preventive cover.
  10. As per the situation, an employer 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?

Case: 1

A 28-year old Rajiv Saxena was working in a clothing mill when he lost his right leg after it got caught under the

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machine. Due to the accident, he permanently lost his right leg. The owner of the mill agreed to compensate him under workmen’s compensation insurance policy. Though, it was not feasible to curtail the emotional loss that his family had to endure after the accident, the insurance policy 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 new job role to Rajiv as per his current state.

Case: 2

Swati Malhotra was injured and her employer’s workmen’s compensation 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 and also 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 where she had written about it. These colleagues informed the HR department of their company, which later passed on the information to the workmen compensation insurance provider and 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. Last month, while working at the site, he felt a pull in his leg, which he ignored until it got worse over the weekend. He was rushed to a hospital where it was diagnosed as a slipped disc and minor fracture in the leg. After staying in the hospital for ten days, he was discharged and advised complete bed rest.

He informed his company and the employer decided to bear the entire hospitalisation expenses from “Employee Welfare Fund”, which was specifically created to deal with different monetary needs of employees like a child’s education, marriage, hospitalisation, home renovation, buying vehicle, etc. Though, the company showed a good gesture by recouping medical expenses, it can’t ask its workmen compensation insurance provider to reimburse the amount.

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