Navigating Compensation and Support After an Employee's Severe Accident: What Are the Options?

Ashok Maloo
One of our employees met with an accident while returning home after finishing his duties in the office. He sustained severe head injuries and received treatment at a private hospital, which cost around 10 lakhs. The expenses were covered by his family, and now the bills have been submitted to ESIC for claims. The accident occurred in July 2013. After recovering, he partially lost sight in one eye and also experienced memory loss, struggling to recall his family members. The doctors have indicated that they have completed their part, and the employee may or may not regain his memory, rendering him unable to work.

Key Points to Consider

- Our office is located in Tamil Nadu.
- The employee is directly employed by the company and has served for more than 10 years, making him eligible for ESIC and EPF benefits.
- Our employment falls under the Shops and Establishment Act.
- The employee holds a valid license, and the vehicle is covered by insurance.
- The lorry responsible for the accident could not be traced.
- An FIR has been filed with the police.
- ESIC procedures have been completed for the reimbursement of medical bills.

From the employee's perspective, it is essential to understand the benefits and compensation available, the relevant acts, and the procedures to follow. As an employer, it is crucial to be aware of liabilities, compensation under applicable acts, and the necessary procedures. From an HR standpoint, specific actions need to be taken. For the employee's family, exploring social welfare schemes or labor welfare funds may be beneficial.

Please provide a detailed response.

Thank you.
Harsh Kumar Mehta
Clarification on Accident Report Submission to ESIC

You have not clarified whether your Principal Employer has submitted the Accident Report to the appropriate Branch Office of the ESIC immediately after the occurrence of the accident. Kindly refer to Section 51C of the ESI Act, 1948, which clarifies accidents that happen while traveling in employers' transport.

In such circumstances, the Insured Persons, if the case is admitted as that of Employment Injury, are entitled to disablement benefits as provided under the said Act. However, the acceptance of the accident case depends upon the facts of each case.

Kindly check if such options have been examined by your factory/establishment. You can discuss the matter with the Branch Manager of ESIC in your area.

With kind regards,

Regards
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