Navigating Employee Health Crises: What Are HR's Legal Responsibilities and Best Practices?

Dear All,

I came across a difficult situation in my organization that I would like to share with all of you. In my company, one of our associates, named Mohd Muzaffar, complained about chest pain while working the night shift. He is the type of employee who tends to dramatize situations and create scenes. During the night, we admitted him to one of the best hospitals regarding his problem. The doctor diagnosed it as a major heart attack requiring surgery. However, other renowned heart specialists we consulted stated that surgery was unnecessary. The company has covered all costs so far and intends to transfer him to a different hospital for better care.

His family caused a scene on the spot at 12:30 in the night, demanding that the company take full responsibility for the patient. After seeking advice from our legal advisor, we learned that the company's responsibility extends only until the patient's admission and covers the benefits of the $50,000 insurance we have for our staff members.

The surgery took place yesterday, and the company bore all the costs. My question is, what legal obligations does the company have, and how should I, as an HR person, handle situations like this in the future? Please advise me on dealing with such situations from legal, trade union, and overall perspectives.

With warm regards,
Ranjeet

These all depend upon the policy of the company. There are companies which seldom care for such incidents once the employee is admitted to the hospital and the relatives of the employee have arrived. Certainly, small companies cannot bear such heavy expenditure. At the same time, big companies can. Legally, an employer has not many responsibilities. If the employee is covered by ESI, the employer's liability is limited to his act of hospitalizing the employee and formalities connected with informing the ESI authorities. In such cases also, employers can be more sympathetic and go beyond their responsibilities.

It should also be understood that the trade unions which fight for their demands also have the same responsibility in such cases as do the employers. Therefore, if the relatives of the employee create a scene, it should be taken as their reaction towards management and should not be taken as a claim that the employer should take care of all expenses connected with hospitalization just because the employer gave him employment. And by such an act of giving employment, the employer never takes such uncertain responsibilities.

However, on humanitarian grounds and depending upon the financial position of the employer, a policy shall be framed to help the employees who meet with such unfortunate events. A group insurance policy will certainly help the employer a lot to solve these issues.

Regards,
Madhu.T.K

Dear Ranjeet,

First of all, tell us what his job profile was and whether he was covered under ESI. If he is covered under ESI, you do not have any responsibility. If he is not covered under ESI, then does a heart attack have any relation to the nature of his work? Under the Workmen Compensation Act, he has to prove to benefit that his heart attack has a direct relation to the work he was performing. It means he got a heart attack due to work pressure; otherwise, he is not entitled to anything.

Regards,
JS Malik

Dear Madhu Sir and Malik Sir,

Thank you for the replies. He is working in the kitchen department as a chef. In addition to this, their salaries and perks are so high that they are not covered under ESIC. However, we have taken a ₹50,000 mediclaim policy for the staff members of grade.

Madhu Sir, could you please provide some information about the group insurance policy, whether it is Group Linked insurance or something else. Please explain. Also, could you please draft a sample of a termination of services letter for a confirmed employee and for apprentices. I would be highly obliged to you.

Regards,
Ranjeet

Dear Sir,

I had a confusion. We have a couple working in our unit. Both of them have submitted the medical and child education reimbursement forms for the same children and dependent parents. Can both of them claim individually for the same child or parent? Prompt action will be highly appreciated.

Regards,
Ranjeet

For details about group insurance, please contact any financial adviser, preferably of LIC of India. By means of group insurance, you can get an exemption from contributions towards the Employees' Deposit Linked Insurance of EPF as well.

If my understanding is correct, both husband and wife cannot claim LTA and medical expenses on the same trip and for the same medical expenses incurred. However, if these two benefits are part of their salary, you have to provide LTA and Medical allowance to both of them regardless of for whom the expenses were incurred. However, the benefits will be taxable in the hands of one of the recipients. In such circumstances, it is advisable to adjust the salary of either of them to include the element of LTA and Medical to avoid paying them separately.

Termination letter formats are available on this site. Since it depends on the situation, please provide details on the circumstances leading to termination, such as termination as per policy, termination for misconduct after undergoing a process of disciplinary action, etc.

Regards,

Madhu.T.K

Since group insurance does not cover hospitalization expenses, a medical claim policy from any reputable insurance company would be ideal to meet the expenses of hospitalization.

If due to the pressure of work, which causes a heart attack out of and in the course of employment, then he is eligible for compensation for a heart attack, whether by ESIC or the Workmen Compensation Act. Your company has a defense expressed in the Workmen Compensation Act as well. But practically, you have to adhere to the humanitarian aspect rather than the legal angle, which does not give you any respite because you have to bear the cost as he was taken to the hospital from the worksite. Therefore, his work has contributed to adding a burden on the heart and caused the attack is an interpretation by the law and in any court. Even the Trade Union will defend his case as this is related to the social security of the employee.

It would be better if you claimed money from the insurance company because the company has very little liability, even though they are given a tax rebate. So the employer should not be bothered by minor expenses for the operation, whatever the amount may be, as life is more precious than money. Employers normally have tendencies to spend most of the profits on company infrastructure to show expenses instead of paying taxes.

You should take this opportunity as tax-saving expenditure and also a humanitarian approach of the company to improve industrial relations and employees' faith in the organization as well.

Partho

Dear All,

Thank you for your valuable inputs. Madhu Sir, I require a termination letter in the case of apprentices for absconding cases. This is the first time I have encountered this situation, and I am not familiar with the legal complications involved.

Regards,
Ranjeet

If an apprentice is not reporting, send a letter to his residence with a copy marked to the Apprentice Adviser/Training Officer of the RI Centre (Related Instruction Centre) under whom he has been registered as an apprentice. The letter shall be the same as used in the case of other employees as follows:

"You have been absent from training without notice since .... (date).... As you know, abstaining from training is a violation of the terms of the apprentice contract. Your non-reporting shall be deemed as you are not interested in continuing with the training. As such, your training contract stands terminated automatically. However, you are hereby given an opportunity to be heard, and you are required to explain why your training contract with us should not be terminated and why action for recovering training costs already incurred by us should not be initiated against you. Your written explanation should reach the undersigned within 2 days.

Sd/-
Regards,
Madhu T.K.