Workers' Compensation Claims: How to Handle Cases of Death or Permanent Disability?

What is the claim process for a Workers' Compensation policy if an employee is deceased or permanently disabled during work? Additionally, what is the calculation process?

The amount of compensation payable depends on the wages and the age of the deceased. The decision will be made by the officer concerned of the Labor Department.

For a deceased employee, the nominee, and for permanent disablement, the nominee or the employee will appeal to the EC Commissioner for compensation. If insurance is present, there will be three parties involved - the Employee/nominee, Insurer, and PE. In the absence of insurance, the parties involved are the Employee/nominee and Employer. The Commissioner will make an award for compensation based on facts, evidence, documents, etc., following the guidelines set under the Act.

Insurance and Compensation Responsibility
In cases where insurance is in place, the Insurer is responsible for paying the compensation. In the absence of insurance, the employer bears the responsibility for compensation.

Regards, S K Bandyopadhyay (WB, Howrah) CEO-USD HR Solutions

Wage Limit for Workmen Compensation Calculation Attached herewith is the document detailing the wage limit for workmen compensation calculation.

I think that the question relates to the claim process in the event of permanent disablement or death of an employee covered by an insurance policy specifically taken under the EC Act, 1923 due to an employment accident.

Claim Process for Permanent Disablement or Death

In such a situation, first, the employer has to officially inform the insurer about the accident. After the treatment is over, the employee has to submit his claim for compensation to his employer with a disability certificate issued by a registered medical practitioner. In the case of death, the dependents have to file the claim with a death certificate.

In actual practice, insurance companies do not come forward to settle such claims directly. Therefore, the employee or his dependents are required to file a claim before the area Commissioner for Employees' Compensation against the employer and the insurance company together with copies of proof of employment, FIR if any, hospital documents relating to the treatment taken with bills if the treatment expenses are incurred by the employee, disability or death certificate, legal heir certificate, etc. The Commissioner would conduct a quasi-judicial inquiry and dispose of the claim accordingly.

As the procedure involves some minimum legal formalities, it is better to engage the services of an advocate from the very beginning.