Sudden Employee Death at Work: What Documents Are Needed for Family Claims?

Request for Guidance on Post-Mortem Procedures and Documentation

I am requesting further information regarding the procedures related to an unfortunate event. One of our company employees passed away suddenly due to a heart attack. We promptly took him to the hospital and informed his family members, who also arrived at the hospital. Despite the doctors' efforts, they declared him brought dead and recommended taking him to the government hospital for a post-mortem examination. The family members consented to the post-mortem procedure. With these formalities completed, there is a need to address the following as an HR professional:

It was an unforeseen incident. What documents should be provided to the family members? What forms are required for claiming PF, ESI, accidental insurance, dependents' pension, and funeral expenses?

Thank you.

The unfortunate employee died in harness due to a heart attack, I think. To support a claim for any compensation, the following documents are required: (1) Post-mortem certificate, (2) F.I.R., and (3) Death certificate.

Accident Report Submission for Deceased Employee

If the deceased employee was covered under the ESI Act, 1948, and was on duty at the time of a heart attack, you can submit an Accident Report to the appropriate Branch Office of ESIC to which he was attached, along with a copy to the Factories Inspector/Labour Department concerned.

Heart Attack as Employment Injury

Sometimes, depending on the circumstances, heart attacks suffered on duty are also treated as accidents arising out of and in the course of employment. To establish this, copies of the Post-Mortem Report, treatment papers, etc., are required. After submitting the Accident Report, you can discuss the issue with the Branch Office, ESIC. The case is to be decided by the Branch Office Manager or Regional Director, ESIC of the area. If the case is accepted as employment injury, only then may the dependents receive dependent benefits (pension). This depends on the facts of the case, including the post-mortem report, treatment papers, medical opinion, and records of the employer. If the matter is not admitted as an employment injury, no dependent benefits (pension) will be payable by ESIC. In that situation, it may be checked whether the employer has taken out any medical insurance policy for the employee.

Claiming Funeral Expenses

An amount of Rs. 10,000/- as Funeral Expenses can be claimed from the Branch Office to which the employee was attached.

Obtaining Necessary Forms

The copy of the accident report can be either downloaded from the website of ESIC or obtained as per the online procedure. The form for claims of funeral expenses can be obtained from the appropriate Branch Office of ESIC. You can also consider filing an FIR with police authorities if required by the Labor Department/Hospital, etc., as suggested by one of the senior members in the above columns.

After narrating the mishap that happened in the middle of the deceased's duty, you asked about the documents to be prepared for the purpose of obtaining his legal dues arising from the termination of his employment. Whether his work was of a simple nature involving no stress or strain, whether the sudden aggravation of the undisclosed pre-existing disease was the sole reason for his untimely death and not his employment, and which Act—whether the ESI or the EC Act—is applicable for compensation, if claimable, are questions of fact as well as questions of law. If a claim for compensation is made on the grounds of the employee's death due to an employment accident or not, these documents are essential even otherwise.

Regards

I am surprised to know that the employee's body was sent for a post-mortem. If it was a natural death, no post-mortem is required. In this case, there may be suspicion surrounding his death. Please ensure all documents such as the reporting time, shift, time spent working on dangerous machinery, hours worked prior to this day, complaints of any uneasiness to his supervisor, last conversation with his colleague, and any relevant medical history are gathered. This information might be helpful in case there are findings regarding his suspicious death.

Postmortem is definitely required if the case is registered with the police, and an FIR is made. It is to avoid any future complications that may arise due to the cause of death. File an accident report if he is covered under ESI.

Dear Members, The queriest asked for what forms are required to claim PF, ESI benefits, etc. The queriest needs to have the following forms filled in by the nominee of the deceased and submit them to the respective authority:

PF Death Claim
Form 20

Pension Claim
Form 10-D

Insurance Fund
Form 5-IF

ESI Dependent Benefit
Forms 15, 16, 23 & 24

ESI Funeral Expense Claim
Form 22

Gratuity Claim
Form J

Separate forms have to be filled in by each nominee under the Pension Scheme. To avail of ESI Dependent Benefit, it must be established that the death was a result of employment injury. Mr. Harsh Kumar has rightly said that sometimes, depending on the circumstances of the case, heart attacks suffered on duty are also treated as accidents out of and in the course of employment. The queriest needs to submit an accident report in Form 16 to ESI online and a hard copy to the ESI Branch Office immediately, providing the reason for the delay in submitting it. They need to maintain an Accident Register in Form 15.

If the death occurred in a factory, the queriest needs to submit the Accident Report to the factory inspector immediately, giving the reason for the delay in submitting it. They need to maintain an Accident Register under the Factories Act. Please find out the form numbers of this Report/Register from the state rules.

Essential Documentation and Procedures Following an Employee's Death

In any case, a post-mortem report followed by a Death Certificate from the Municipality are the primary pieces of evidence required. These documents are essential for any purpose, including death relief payments in respect of the deceased. Regardless of the reason for death, if the death occurred in the course of employment or while on duty, compensation is inevitable, whether under ESI or EC.

If the deceased was working in a Factory/Shop, other formalities should have been complied with. For dependents, it is advisable to pursue the case in consultation with a learned advocate. HR should do what is necessary as per the law: check for nomination filed by the deceased for PF while he was alive, collect the final settlement forms 10B & 19, Pension (for the family)/DLI, full and final settlement from Salary, Leave encashment, Bonus, Gratuity, and Group Insurance if any, and Employees' Death Relief Fund if applicable. Necessary forms can be downloaded from various websites.

Dear,

Please tell us if an employee joined on March 18, 2017, and he passed away on April 16, 2017, is he eligible for EPF pension benefits?

Eligibility for Pension Benefits

Was the deceased a member of an EPF account and did he contribute towards his PF & DLI account? Prima facie, it appears that he is not eligible for the pension facility as his qualifying service is less than one month. In all probability, the employer might not have opened his EPF/EPS account and remitted the contributions.

For pensionary benefits, a member should have contributed for at least one month. It is the employer's responsibility to ensure compliance. This case needs further examination with facts and settled case laws, and there might be a way to help the dependents of the deceased.

Extract from the EP Scheme Rules

Here is the extract from the EP Scheme rules about membership/eligibility as per the rule:

"6 A Retention of membership: A member of the Employees' Pension Fund shall continue to be such a member until he attains the age of 58 years, avails the withdrawal benefit to which he is entitled under para 14 of the Scheme, dies, or the pension is vested in him in terms of para 12 of the Scheme, whichever is earlier."

14. Inserted by G.S.R. dated 22nd February 1999 (w.e.f. 6.3.99)

Option for Joining the Scheme

(1) Members referred to under sub-para (c) ...

Pension to the Family on the Death of a Member

(1) Pension to the family shall be admissible from the date following the date of death of the member if the member dies while in service, provided that at least one month's contribution has been paid into the Employees' Pension Fund, or after the date of exit but before attaining the age of 58, from the employment having rendered service entitling him/her to a monthly member's pension but before the commencement of pension payment, or after the commencement of payment of the monthly member's pension.

Note: Cases where a member has rendered less than 10 years of eligible service on the date of exit but has retained the membership of the Pension Fund and dies before attaining the age of 58 years shall be regulated under sub-paragraph (8) of paragraph 12.

(2) (a) The monthly widow pension shall be:

(i) In cases covered by clause (a) of sub-paragraph (1), equal to the monthly member's pension which would have been admissible as if the member had retired on the date of death or Rs 450/- or the amount indicated in Table 'C', whichever is more.

(ii) In cases covered by clause (b) of sub-paragraph (1), equal to the monthly member's pension which would have been admissible as if the member had retired on the date of exit or Rs. 450/- per month or the amount indicated in Table 'C', whichever is more.

(iii) In cases covered by clause (c) of sub-paragraph (1), equal to 50 percent of the monthly member's pension payable to the member on the date of his death subject to a minimum of Rs. 450/- per month.

(iv) In all cases where the amount of family pension sanctioned under the Ceased Family Pension Scheme, 1971, and is paid/payable under this scheme is less than Rs. 450/- per month, the amount of family pension in such cases shall be enhanced to Rs. 450/- per month.

(b) The monthly widow pension shall be payable up to the date of death of the widow or remarriage, whichever is earlier.

Note: In cases where there are two or more widows, family pension shall be payable to the eldest surviving widow. On her death, it shall be payable to the next surviving widow, if any. The term "eldest" would mean seniority with reference to the date of marriage.

(3) Monthly children pension: If there are any surviving children of the deceased member, falling within the definition of family, they shall be entitled to a monthly children pension in addition to the monthly widow/widower pension. Monthly children pension for each child shall be equal to 25 percent of the amount admissible to the widow/widower of the deceased member as a monthly widow pension payable under sub-paragraph (2) (a) (i) provided that the minimum monthly children pension for each child of the deceased member shall not be less than Rs. 150/- per month. Monthly children pension shall be payable until the child attains the age of 25 years. The monthly children pension shall be admissible to a maximum of two children at a time and will run from the oldest to the youngest child in that order.

(e) If a member dies leaving behind a family having a son or daughter who is permanently and totally disabled, such son or daughter shall be entitled to payment of monthly children pension or orphan pension, as the case may be, irrespective of age and number of children in the family in addition to the pension provided under clause (d).

(4) (a) If the deceased member is not survived by any widow but is survived by children falling within the definition of family or if the widow pension is not payable, the children shall be entitled to a monthly orphan pension equal to 75 percent of the amount of the monthly widow pension as payable under sub-paragraph (2) (a) (i) provided that the minimum monthly orphan pension for each orphan shall not be less than Rs. 250/- per month.

(b) In the event of death or remarriage of the widow/widower after sanctioning of widow/widower pension, the children shall be entitled in lieu of the monthly children pension, to a monthly orphan pension from the date following the date of death/remarriage of the widow/widower.

(c) The monthly orphan pension shall be admissible to a maximum of two orphans at a time and shall run in order from the oldest to the youngest orphan.

(5) (a) A member who is not married or who does not have any living spouse and/or an eligible child may nominate a person to receive benefits as laid down hereinafter provided that in the event of his/her acquiring a family subsequently, the nomination so made shall become void. In the event of the death of the member, such a nominee shall be entitled to receive a monthly pension equal to the monthly widow pension, as admissible under sub-clauses (I) and (ii) of clause (a) of sub-paragraph (2).

(aa) If a member dies leaving behind no spouse and/or an eligible child falling within the definition of family and no nomination by such deceased member exists, the widow pension shall be paid under sub-clauses (I) and (ii) of clause (a) of sub-paragraph 2 either to the dependent father or dependent mother as the case may be. On grant of Pension to such dependent father and in the event of the death of the father pensioner, the admissible pension shall be extended to the surviving mother lifelong.

(b) If the deceased member had not rendered pensionable service on the date of exit from the employment which would have made him entitled to a monthly member's pension under paragraph 12, but had opted to retain the membership of this Scheme under sub-paragraph (8) of paragraph 12, the nominee or the dependent father or the dependent mother as the case may be shall be entitled to return of capital as provided in sub-paragraph (1) of paragraph 13.

Guarantee of Pensionary Benefits

None of the pensionary benefits under the Scheme shall be denied to any member or beneficiary for want of compliance of the requirement by the employer under sub-paragraph (1) of paragraph 3 provided, however, that the employer shall not be absolved of his liabilities under the Scheme.

Payments on Exercise of Option

Beneficiaries of the deceased members of the Employees' Family Pension Scheme, referred to in sub-para (1) of paragraph ...

Pardon me for not aligning paragraphs properly due to lack of time. Please verify with the employer about his EPF/EPS status and continue this post so that further guidance could come from learned members.

Dear Member,

An EPF-covered employee is eligible for benefits provided under EPS. Please ask specific questions by providing all relevant details. If the employee is covered under ESI, their family is eligible to claim funeral expenses of Rs. 10,000. Please do not make fun of the death of an employee. Kindly review your question once again.

Thank you.

Employee is eligible for EPS provided he is covered under EPF Act. If covered under ESI, eligible for Funeral expense of Rs10,000/-. Please ask specific questions giving all details. Please do not ask casual hypothetical questions in this forum.

---

Definitely, dependents of the deceased will receive a pension if contributions are deposited in EPFO, even for just one month.

Death Benefits for Dependents of Deceased Employee

An employee, working as a security guard at night, died due to cardiac arrest. He was married and is survived by two children and his parents. Please help. How can his dependents avail death benefits from ESIC and EPF? Is a family pension applicable from ESIC, since the employee expired on duty? What forms and documents are required to be submitted by dependents? What is the immediate action to be taken by the employer on behalf of dependents to expedite the claim process? The employee had served for more than three years on a contract at client premises.

The client and contractor both want to help the dependents and provide the maximum possible relief. Request members to guide. Thanks.