Workmen’s Compensation Insurance Policy/WC Policy - Definition, Coverage, Compensation, Exclusions, Cost, Add-On Covers, Claims Process, Companies, Quotes

What is a Workmen’s Compensation Insurance Policy? - Definition

A Workmen’s Compensation Insurance Policy (WC Policy), also known as Employee’s Compensation Insurance Policy, is a type of Insurance Policy which protects the Employers from the Legal Liability to provide compensation to employees if they suffer from Death or (Permanent or Partial) Disablement because of a Work-related Injury or Illness. The Policy provides coverage to the Employees under the Workmen’s Compensation Act, 1923, the Fatal Accidents Act of 1855 and the Common Law.

What are the Coverages under a Workmen’s Compensation Insurance Policy?

A Worker’s Compensation Insurance Policy provides the following coverages:

1. Death: A Workmen’s Compensation Insurance Policy provides compensation to the Employee’s family if the Employee dies due to Workplace-related injury or Illness.
2. Permanent Total Disablement: A WC Policy provides compensation to the Employee if he suffers from a Workplace accident that results in Permanent (Total or Partial) Disablement.
3. Permanent Partial Disablement: A WC Policy provides compensation to the Employee if he suffers from a Workplace accident that results in Permanent Partial Disablement.
4. Temporary Total Disablement: A WC Policy provides compensation to the Employee if he suffers from a Workplace injury that results in Temporary Total Disablement.
5. Occupational Diseases: Some employees are exposed to harmful chemicals in the workplace which might result in diseases which are unique to their work environment. The Policy provides compensation for Occupational Diseases as well.
6. Medical Expenses: A Workmen’s Compensation Insurance Policy provides compensation for Medical Expenses that arise because of a Workplace-related injury or illness.

What is the compensation amount payable under a Workmen’s Compensation Insurance Policy?

The Compensation Amount payable under a Workmen’s Compensation Insurance Policy is as follows:

What are the exclusions under a Workmen’s Compensation Policy?

A Workmen’s Compensation Policy typically does not pay damages on account of the following:

1. Only those employees that are workman as per the Workmen’s Compensation Act, 1923 are covered under this policy
2. If an Injury or Accident happens due to a Civil War, then the Disablement/Death is not covered under WC Policy
3. If an Injury or Accident happens on account of Nuclear risks, Insurrection, Mutiny, then it is not covered
4. Any Liability arising out of the virtue of a specific Contractual agreement s not covered under WC Policy
5. Diseases mentioned in Part C of Workmen’s Compensation Act – 1923 unless specifically covered as an Add-On
6. Any Injuries or Illness caused by Willful disregard of Safety Rules and Regulations by Employees is excluded under WC Policy

What is the Cost of a Workmen’s Compensation Policy?

The Premium for a WC Policy depends the risk profile of the business that the employer is operating in as well as the monthly wages of the employee. The premium will be higher for a high risk business and lower for a less risky business. The Cost of a Workmen’s Compensation Insurance Policy also depends on additional factors as follows:

1. Salaries of the Workmen
2. The Number of Workmen required to be covered and insured under the WC Policy
3. The Nature and Riskiness of the Workmen’s Job
4. Risk Location of the Company’s operations
5. Safety measures employed by the company
6. Prior Claims Experience of the business

What are the Add-On Covers under a Workmen’s Compensation Insurance Policy?

A Workmen’s Compensation Insurance Policy offers the following add-on covers:

1. Medical Extension: The Medical Extension Add-On Cover under a WC Insurance Policy pays for treatment expenses of any injury sustained by an employee at the work premises.
2. Occupational Diseases: Prolonged exposure to occupational hazards also results in Diseases and Illnesses specific to various industries. Diseases that can be covered under the Occupational Disease Add-On Cover of a Workmen Compensation Insurance Policy include Pneumoconiosis caused by sclerogenic mineral dust and silico-tuberculosis. Bagassosis, Bronchopulmonary diseases caused by cotton, flax hemp and sisal dust (Byssinosis), and Acute Pulmonary Oedema of High Altitude.
3. Sub-Contractors Cover: There are situations where a Contractor hires a Sub-Contractor to do a certain portion of the project work. In such cases, the Contractor can opt for the Sub-Contractors Add-On Cover which provides coverage to the employees of the Sub-Contractors as well under the Workmen’s Compensation Insurance Policy.

What are the Benefits of Workmen’s Compensation Insurance Policy?

1. Legal Compliance: A Workmen’s Compensation Insurance Policy ensures that employer comply with the statutory liability to provide compensation to employees for a Workplace related death or Injury under the Workmen’s Compensation Act, 1923.
2. Financial Support: A WC Policy provides compensation to the employees and dependents because they suffer a loss of earning capacity on account of a Workplace related Death or Injury.
3. Medical Expenses Reimbursement: Employers can opt for Medical Extension Add-On cover which reimburses the medical expenses that are incurred in case the employee is hospitalised for any injury suffered in the course of his/her duty.

What is the Claims Process under a Workmen’s Compensation Insurance Policy?

The Insured needs to follow the below mentioned steps to file a Claim under an Inland Transit Insurance Policy:

1. Intimation: Intimate the WC Claim to the Insurance Company as soon as possible. Additionally, in case of a Death Claim or a Permanent Disablement Claim, the Employer needs to inform the Workmen’s Compensation Commissioner (WC Commissioner) about the injury/death.
2. Submit Details: Submit the necessary details such as Policy Number, Date and Time of Accident, Description of the Accident etc. The Insurer will provide a Claim Reference Number.
3. Document Submission: Submit the required documents such as Claim Form, Employer’s ID Proof, Wage and Attendance Sheet of last 3 months (including the accident month) etc.
4. Claim Investigation: The Insurance Company will appoint an Investigator to investigate the Death or Disablement, verify the circumstances related to the accident etc.
5. Claim Assessment and Settlement: The Insurance Company reviews the facts of the case and assess the Claim based on the Policy Terms and Conditions. If the claim is approved, the Insurance Company will settle the claim and transfer the Claim Settlement Amount via NEFT Transfer.

What are the documents required to file a claim under a Workmen’s Compensation Insurance Policy?

Following Documents are Required to make a Claim under a Workmen’s Compensation Policy:

1. Duly Filled and Signed Claim Form
2. Copy of Wages Cum Attendance Register prior to Date of Accident at least for 3 months
3. Medical Papers, Medical Bills, X-Ray Report and any other documents relating to treatment
4. Declaration for Total Number of Employees present at the Time of Accident
5. Employers Sick Leave Certificate
6. Fitness Certificate from Attending Doctor
7. Grade/Category of Injured Employee

Which Insurance Companies provide a Workmen’s Compensation Insurance Policy in India?

The list of Insurance Companies providing a Workmen’s Compensation Insurance Policy in India are as follows:

1. Iffco Tokio General Insurance Company
2. Bajaj Allianz General Insurance Company
3. GoDigit General Insurance Company
4. ICICI Lombard General Insurance Company
5. United India Insurance Company
6. Tata AIG General Insurance Company

What is the Workmen Compensation Act 1923?

The Workmen Compensation Act 1923 provides compensation to employees for injuries, occupational diseases or illnesses arising in the course of their employment. The Act makes it the liability of an employer and mandates the employer to provide compensation to the employee if the employee suffers from an employment-related injury or death. If an employee suffers a workplace related accident or injury (even death) for any of the above reasons, the employer can be held liable. The Act aims to provide financial support to Employees and their family members in case of workplace-related accidents or injuries. The Workmen’s Compensation Act, 1923 operates on a No-Fault Basis, meaning that the employees do not need to prove negligence by the employer in order to receive compensation.

Is a Workmen’s Compensation Insurance Policy mandatory in India?

Yes, The Workmen’s Compensation Insurance Policy is mandatory for all employees who classify as a ‘Workman’ under the Workmen’s Compensation Act 1923.

Get Best Quotes for Workmen’s Compensation Insurance Policy with Qian!

Employers are responsible for the safety of their employees and It is the duty of the employers to provide a safe and hygienic working environment to the employees so that they can discharge their duties without any adverse impact on their health.

Many Employees work in dangerous circumstances in the course of their job and sometimes things go wrong with the employee and an accident occurs resulting in Employees losing their lives or becoming permanently disabled. This results in the families of such workers facing financial distress. In such cases, a Workmen’s Compensation Insurance Policy provides support by providing financial compensation to employees.

Qian is an experienced Insurance Broker for Workmen’s Compensation Insurance having served Corporate Clients across diverse industries over the years for their Workmen’s Compensation Policy requirements.

You can avail of a free 1 hour Workmen’s Compensation Policy Review with the experts at Qian to ensure that you are availing of a Comprehensive WC Cover for your Employees. You will also have the comfort of our experienced claims settlement team which will assist you in getting your claims resolved quickly. Our team will assist you with the Best Quotes for your Workmen’s Compensation Policy. Contact us now at insurance@qian.co.in or 022-35134695. We would be glad to assist you.

FAQs about Workmen’s Compensation Insurance Policy