Workmen compensation insurance is primarily bought by an employer so as to compensate the employees / workmen and their dependant family for the loss of income caused due to workplace injuries or death. Compensation is required to be paid as per the provisions of the Workmen Compensation Act, 1923. As per the Act, the employer is legally liable and it is the employer’s duty to compensate the losses incurred by the worker who suffers an injury or dies in the workplace accident.
When a worker is hurt, he/she has the right to claim workmen compensation benefit from the employer irrespective of who is at fault. An employer can get immunity or coverage against these statutory liabilities by availing workmen compensation insurance policy offered by the insurance companies.
The workmen compensation system is a ‘no-fault’ benefits system. In this, workers are eligible to receive the compensation from the employer in case the workplace accident results in an injury, death of or disability to workmen no matter who is at fault. Workmen compensation insurance policy is also designed on the ‘no-fault’ principle. That means a worker injured at the workplace is entitled to receive the benefit regardless of one’s own fault. However, there are certain circumstances under which workmen may not be able to pursue workmen compensation benefits. These circumstances are:
- Intentional and self-inflicted injury at the workplace
- Workplace injury suffered while the worker was under the influence of alcohol or any intoxicating substances.
- Workplace accidents caused due to workmen not adhering to workplace safety rules and guidelines
- Injury due to fighting or horseplay at the workplace
- Unlawful act and violation of workmen compensation statute
As long as the worker is working and on job duties when the workplace accident took place, he or she is allowed to file a workmen compensation claim. However, if the cause of workplace accident is not completely employee or workers misconduct, courts may even favour the worker.
Additional Read: How to file a claim under Workmen Compensation Insurance?
Let’s take an example to understand this. Let’s assume that a worker has been doing overtime duties for a week. Under work pressure, the worker has a few drinks before heading out for the final delivery of the day. Let’s say, he meets with an accident on the way to the delivery location as he dozes off. This could be due to the alcohol effect or because he was tired. The accident has caused him a substantial injury for which he files a workmen compensation insurance claim. We can say, the accident was partially his fault. However, circumstances like this can result in the denial of a workmen compensation claim.
The worker can seek the help of a workmen compensation attorney in order to claim his rights to benefits. The worker can go through legal processes also. It’s important to note that the workmen compensation is based on the ‘no-fault’ principle and it is ideal for an employer to avail this insurance to safeguard the business against statutory liabilities.