Dear All, One of Our employees has died in a major accident while going to his site in an Auto Riksha which provided by the office. In this case, we have a workmen compensation Policy & Nagarik Suraksha Policy. We have already intimate both insurance agents through the official mail id.
Our Policy Agent doesn't know the procedure about the claim of workmen Compensation. Is there any court procedure? Who is responsible for filing the case and to whom?
Also what is the procedure of F&F in the case of Death? The employer already paid all the expenses includes Post Morten, FIR, ambulance other medical expenses.

From India, Pune
Hi Neha,
I appreciate the gesture of your office meeting the expenses post his tragic death.
For all purposes you should have the following documents, in sufficient numbers whatever possible:
1) FIR Copy
2) Death certificate (take care to mention the wife of the deceased employee therein)
3) Aadhaar card & PAN Card (of both the employee and the spouse, children)
4) Address & ID proof (some authorities may not accept PAN Card.
5) Bank SB A/c pass book
6) Nomination forms signed by the employee (check with your office, they should be in their files. (Gratuity claim, EPF & EPS, DLI (was he covered by ESI ?)
7) The spouse, wife of the deceased should take colour photos, pass port atleast 10 copies, a few with family-i.e.wife and all children.
8) Arrange with a Notary, an Affidavit declaring the wife is the legitimate recipient of all F & F settlement as heir and the children will have objection if the settlement is paid to the wife (mother).
I hope you won't mind, Pl.assist the wife so that she will collect and sign all the F&F settlement forms with all attachments so that the claims are processed smoothly without any hindrances.
You can also help to download the required forms from the website of EPFO/EPS & Gratuity portals.
Also pl.check whether the deceased employee was subscribing to any Life insurance policy, if yes claims should be processed in that office also.
If you would need any specific guidance pl.continue this thread.
Wish you hassle free process.

From India, Bangalore
Glidor
616

@NRK
the opener /operator of master policy i.e employer as well as nominee also has responsibility to intimate the insurance company within 24 hrs of such incidents, thereafter the insurance company deputes their TPA to visit and check the facts within 3 working days, they carry forms with them, which is to be filled and signed by the nominee, TPA shares their contacts along with officer details with the nominee for further developments queries,
if the agent is not aware of the formalities, he can ask his Development Officer to guide him to submit the claim and process
Annexures and requisite documents differ for different policies


Dear Neha,

When an Workman's compensation insurance policy is taken by the employer, the liability of the employer is automatically taken care of the Insurer u/s 13 of the EC Act,1923. If death or disability is caused to an employee due to an employment accident, the employer's primary duty is to inform the insurer with complete details. Normally insurance company will conduct an enquiry and verify the genuineness of the information and work out the compensation payable as per the policy conditions and arrange for disbursement of the amount to the affected employee. But in death cases, they will not pay the compensation directly to the employee or the employer but ask the dependent(s) to file a claim before the area Commissioner for Workmen's Compensation and upon the orders determining the compensation by the commissioner, the insurer would deposit the amount with the commissioner for disbursement.

In such a case the employer has to ensure the following:

1) whether the employee is covered under the policy and the accident occurred during the course of employment?

2) If yes whether the premium paid was on par with the actual or statutory minimum wages?

3) the employer should inform the dependent(s) file a claim before the commissioner.

4) when the claim is filed, he should appear before the commissioner when called and admit the facts of employment, accident, death and the insurance.

From India, Salem
KK!HR
1038

The Employee Compensation claim has to be made before the Commissioner /EC Act, giving full details required and the compensation amount. The amount is disbursed after due process is completed in the court of Commissioner.
From India, Mumbai
Dear Neha,
Senior Members have already explained and advised you in detail.
The legal heirs of the deceased may also get compensation under the Motor Accident Claim, provided they have sufficient documentary evidence.
Regards,
Suresh

From India, Thane

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