Road Accident During Commute: Can an Employee Claim Temporary Disablement Benefits?

Asking for help to provide a copy of the judgment where compensation is allowed by the High Court/Supreme Court in the case of an accident during the course of employment. An employee, while coming to the factory from the normal route of residence to the factory, met with a road accident (hit by a tractor trolley) and remained hospitalized for 45 days. Will the employee get a temporary disablement amount for the days of accidental absence?

As per the Workers' Compensation Act, the employee is eligible for a temporary disablement amount for the number of days absent. Please provide supporting documents to obtain benefits from the insurance company, as they are denying this benefit on the pretext that it does not fall under employment. Please support with a judgment.

Normally, when the notional extension theory is satisfied, you should receive compensation. It is not the insurance company that decides whether to pay or not; the authority to decide such cases is the Workmen Compensation Commission. Therefore, approach the Workmen Compensation Commission and lodge a complaint for the same. Please ensure that the time and place of the accident match the normal time and route you travel to come to work.

In my opinion, the theory of notional extension may not be applicable in this case. This is because it depends on the geographical location of your factory and the route should be exclusively used to access your factory only.

Hence, your case may not be considered favorably by the WC commissioner. Nevertheless, making a representation to the WC Commissioner will be worth trying.

Regards,

MVK

Notional Extension and Compensation

Notional Extension will apply when the accident takes place on the same route along which the employee travels to the factory and back home, and during the same time when they normally travel for work and from work.

Therefore, if the spot where the accident has occurred is on the same route, and if the time of the accident is within the same time they usually pass through, then the notional extension will apply, and the compensation, as applicable, will have to be paid.

I disagree with Mr. Madhu in this case. The notional extension doctrine is accepted in ESIC but not under the WC Act. There have been cases under it.

The main issue here (as it seems from the post, but not clarified) is that the company has a WC Insurance policy, and the insurance denied the claim. The company wants to pay, but the insurance refused it.

So, first, someone needs to study the insurance policy and the terms under it. It probably has a specific clause on what constitutes an employment injury. If the term is covered, and the insurance company refuses to pay, then the company needs to file a complaint under IRDA, Consumer Protection Act, etc. They can also help the employee file a claim before the Motor Insurance Tribunal for the accident as it involved a motor vehicle, and he would be covered under third-party liability.

However, the employee was out of duty for only 1 1/2 months. I think the company can pay his salary on humanitarian grounds. I don't think it makes a serious dent in the company’s cash flow.

Incidentally, when we renewed our WC policy this year, we paid a premium almost double our earlier policy because it covered accident and Mediclaim so that such a gap is avoided.

Saswataji, please share verdicts that state that notional extension applies only to ESI and not for workmen's compensation. In my understanding, the Workmen (Employees) Compensation Act is the primary legislation concerning accidents during and in connection with employment, and the role of ESIC is only to cover such accidents by collecting premiums through contributions. ESIC will accept notional extension because it is there under the Employees' Compensation Act.