Employer Liability for Non-Work-Related Medical Costs: Can We Recover Expenses?

Employer Liability for Non-Work-Related Medical Expenses

I just want to know if an employee working within factory premises has a heart attack or any other disease, like body pain, and the employer takes them to the hospital and covers the cost of treatment. The medical practitioner clearly states in the report that this is not a work-related disease or not caused by work. In this case, can the employer recover the money from the employee?

Additionally, after such treatment, if the employee does not survive and passes away (and the company is not covered under ESIC), would we be liable for compensation? Please provide an answer with supporting documentation.

If the reason for death is natural, compensation is not required. However, as a goodwill gesture for the work contributed by the employee during their service period, the employer may choose not to recover the hospital expenses incurred. The employer should clear the full and final settlement and also assist family members in obtaining provident fund benefits. Additionally, the employer may consider offering employment to one of the family members of the deceased employee, subject to feasibility. Please refer to the following web link: https://www.dnaindia.com/india/repor...ath-sc-1348277

Thank you for your valuable information. One of my doubts has been cleared, but I still have one remaining. An employee is experiencing a personal physical problem, and due to pain during working hours, the employer hospitalized the employee. As a part of duties, the employer paid the hospital bill of more than 50,000 INR. We have 10,000 and above employees, so how is it possible to pay for all? The doctor also mentioned in the report that this is a pre-existing problem of the employee.

Recovery of Medical Expenses

Is there any rule by which the employer can recover the medical expenses from the employee that occurred during working hours but were not due to workload or any other work-related cause?

I would suggest not recovering the hospital expenses for a company that employs 10,000 workers. Instead, you could consider passing a circular for voluntary contributions from all employees, with the employer also making a humanitarian contribution. The remaining contributions can be issued to the nominee of the employee after adjusting the expenses. It is important to clearly display the total amount of contributions received, employer contributions, adjusted hospital expenses, and the balance paid to the employee's family on the notice board.

With such a large workforce, I recommend proposing to your employer the idea of applying for term insurance and a Personal Accident Policy for all employees. The employer can either cover the total premium or partially recover it from employees after discussions and agreement. In the event of natural death or death due to an accident, the insurance company will provide coverage to the family, reducing the employer's responsibility and risk.

For term insurance, the monthly premium for good coverage is relatively low. I suggest consulting with an insurance professional for Group Term Insurance and Group Personal Accident Policy to determine the cost factors, and then submit a report to the Management for consideration.

Employer's Responsibility for Employee's Medical Expenses

The employer cannot recover the expenditure made for the treatment of an employee for ailments that occurred at the workplace. As you have mentioned, "Natural Disease" and "Medical practitioner Report after treatment" have no meaning at this juncture because one is employed after being declared fit by the doctor of the establishment. Now the question is, how did your doctor fail to diagnose the ailments during the pre-employment health check-up?

Compensation for Work-Related Ailments

The employer is bound to compensate the employee if the employee dies during the treatment of an ailment caused during working hours inside the premises; it is to be treated as "arising out of and in the course of his employment."

The above is in line with the Workmen Compensation Act. The EC/WC authority would decide whether the employee/legal heirs are eligible for compensation or not.