Employee Road Accident: What Are His Legal Entitlements and Salary Rights During Recovery?

Dear Seniors,

One of our employees met with an accident on the road while coming to duty. He is currently hospitalized in our tie-up cashless mediclaim hospital (he is not covered under ESI because he earns Rs. 17,000 per month). He has been working with us for the past 6 years.

Query Regarding Employee's Legal Entitlements

Now, my query is: the doctor has advised that "he needs to take rest for at least 6 months." During this period, does the company need to pay him any salary, and what are his legal entitlements from the company?

Thank you.

The employee is entitled to the salary for all those six months, subject to the medical results. How that salary will be paid depends on what the labor law of your country says. He got into an accident when he was on his way to work; some companies have insurance for such kinds of accidents. Currently, what he needs to do is to inform the company about the accident officially by writing a letter and attaching the ED.

The employee can approach the court as per the Workers' Compensation Act, and he can very well get the expenses incurred for the treatment. If the company has taken insurance for their employees, then the insurance company will cover it; otherwise, the company has to pay him from the company's pockets.

In this case, you have to contact your Mediclaim Party. During this period, the mediclaim party will pay the salary for that employee.

Note: There is a specific procedure to follow.

Regards,
Vinay

If the employer has taken a WC policy, then the employee can benefit from the insurance company. The duration of the employee's leave should depend on the policy.

Thank you.

He will receive medical facilities as per your mediclaim policy. Regarding leave, he can avail of medical as well as earned leave as per your leave rules.

If the employer has a Workers' Compensation (WC) policy, then they should file a claim under such a policy. Otherwise, the employer will have to bear all hospital expenses for the employee's medical treatment and should also pay six months' salary, along with any accrued leave (Sick Leave and Paid Leave) balance in the employee's account.

If the company has a policy for accidental insurance for employees not covered under ESIC, he will benefit from it. Otherwise, there are no other options available.

Regards

I may be wrong, but still... I think the situation depends on whether the injured person is a 'workman' or in the managerial cadre. Only a 'workman' can get benefits from the employer. Of course, mediclaim, insurance, leave at credit, or any contingency benefits allowed by the employer would be available.

I would be grateful if seniors can throw more light on this.

1. Since he is out of ESI and comes under a mediclaim policy, he may receive hospitalization benefits depending on the nature of the policy and its terms and conditions. How old is the policy?

2. If he is covered under a Group Personnel Accident Policy (Risk), he may receive a good amount for the stay prescribed by the doctor with relevant documents.

3. I don't think there will be any obligation from the company to provide any extra benefits to the injured other than those formulated or prescribed by the company, since the accident happened outside the office or the factory premises as you said. Again, it depends on the policy of the company.

Regards,
Sriranga

Since the employee is covered under Mediclaim, the entire hospitalization amount will be taken care of by the insurance company. As mentioned by a few members, if the terms and conditions of the insurance policy include compensation for hospitalization, then the employer does not need to worry; even the salary will be paid by the insurance company. If the insurance does not cover workmen's compensation, there is no legal obligation to pay the salary for six months. However, on moral grounds, the company can choose to pay or adjust the employee's leave.

Best Regards,
Saji

Compensation and Benefits for Work-Related Accidents

Unless the accident has occurred during the course of employment and is incidental to employment, the concerned employee cannot claim compensation under the Workmen's Compensation Act. Moreover, only workers are covered under the said Act. Furthermore, not all employees are covered under the ESI Act. However, he will receive medical facilities for his treatment as per your Mediclaim Policy/Group Insurance Policy. He can avail leave for the purpose of his treatment as per the rules of your company. Additionally, on humanitarian grounds, management can deviate from the rules with the approval of its Board of Directors as a special case.

By the clause doctrine of notional extension, you may give compensation to the concerned employee. However, you have to check if that person always comes by the same route. If the said person is consistently using the same route, then you may provide benefits under the "notional extension." In such a case, you can calculate the compensation based on disability as per the Employees' Compensation Act, 1923.

Alternatively, if your company has accident insurance, please inquire about the same.

Feel free to ask any queries regarding this matter.

Regards, Amar Shinde