Can I Seek Compensation for a Work-Related Accident Without an ESI Report?

Hello all, I need clarification on one thing: I met with an accident while traveling home from the office, and my ESI got rejected because they did not provide ESI from the date of joining. Additionally, my HR has not prepared an accident report for ESI. Now, can I file a case against them for compensation under the Indian Compensation Act? If there are any other applicable acts, please help with this clarification as I was involved in a major accident and incurred significant expenses.

Thanks & Regards,
Kowshik R

If you were not given ESI coverage, the employer cannot file an accident report. If you are entitled to ESI but there was non-compliance on the part of the employer, they are responsible for taking care of medical expenses, loss of earnings, loss of earning capacity, and other damages.

Recovery of compensation through the Workmen Compensation Commission following the Employees' Compensation Act will, however, depend on your industry, your role, etc. This is because the Employees' Compensation Act does not have universal application but is applicable to such kinds of industries and persons employed therein as mentioned in the Act. At the same time, ESI is applicable to all industries and all employees subject to the number of employees employed and wages, respectively.

Hello, sir. Thank you for the reply. They have given ESI benefits, but I joined in January 2023 for cost-saving reasons. They didn't provide ESI and PF from January. After I followed up with them, they started providing it from May 2024.

Accident Benefits and Reporting Requirements

For accidents, the contributory requirements are not applicable. Therefore, you will receive accident benefits. However, the HR should submit the accident report online and send a copy of the same, along with a sketch of the road spotting the accident site, to the Branch Office.

Notional Extension of the Workplace

The theory of notional extension of the workplace applies only if the place of the accident falls under the same route along which you commute home, and the time of the accident should correspond with the time you left the office. If there is a significant deviation from the time indicated in the accident report for the "time at which the injured left the plant," the report will be rejected.

Ok sir, thanks. However, the timeline for the accident report has passed, so I asked HR about it. He is saying he doesn't know about these things that need to be provided. Therefore, I went to the ESI office and inquired. They mentioned that the timeline for the accident report is 3 days, but in some cases, they may accept it within 1 month. Unfortunately, I had an accident 6 months ago.

Yes, there is a time period within which the accident report needs to be submitted, and it is 3 days in normal cases. However, under exceptional circumstances, delayed submission of the accident report will be admissible, but in no way can a report of an accident that took place 6 months ago be accepted. As the compensation from ESIC was not received due to the negligence of the HR person, he should take responsibility for it. This should be considered dereliction of duty, and the HR Officer is solely responsible for that.

Please ensure that as soon as the accident happened, you had sent a communication stating that you were involved in an accident while returning home from the plant/office. If this was done, your duty is over, and the rest should be ensured by the HR Officer only.

Yes sir, my HR only came to the spot and admitted me to the hospital. Then, my parents requested some advance amount from them as I am in a coma and have spent too much money. However, the company didn't pay anything. Can I file a complaint against them?

Filing a complaint may make them hostile and even make your career a little bit difficult. Explain the matter to HR, highlighting their failure and dereliction of duty, and request a settlement. This should cover costs plus reasonable compensation, such as a percentage of income lost due to hospitalization. If you were paid a salary during your absence from work, you can exclude that element but request only for costs incurred. If they do not agree, you can escalate it as a dispute to the appropriate authority. Initially, approach the Labor Officer for conciliation.

In my considered opinion, according to Section 51C of the ESI Act, accidents arising to employees while they travel by transport provided by the company are considered as accidents arising in the course of employment. I feel that accidents arising while traveling to and from employment otherwise will not attract the Theory of Notional Extension.

However, as per Section 51E of the ESI Act, if the nexus between the circumstances, time, and place in which the accident occurred and the employment is established, it may be considered as an accident arising in the course of employment. For example, sales representatives, service technicians, etc.

Moreover, describing an accident that happened on the road is generally not reported by the employer in the specified accident report. It will be an accident for which treatment can be rendered by ESI.

On a humanitarian ground, the employer may extend financial support, but it cannot be placed as a demand.

The treatment rendered by ESI and sick leave provided by ESI will be the only compensation that will be payable to the employee injured in a road accident while traveling to and from work.

Regards,

MVK

Employment Injury and Notional Extension

If an accident occurs in a company-provided vehicle, irrespective of the location and time, it is considered an employment injury as per the EC Act and ESI Act. To establish it as occurring during the course of and in connection with employment, there is no need to apply the doctrine of notional extension. It is well settled that when a workman is on a public road or on public transport, he is there as any other member of the public and is not there in the course of his employment unless the very nature of his employment makes it necessary for him to be there. The verdict from the Supreme Court in 1958 in Saurashtra Salt Manufacturing Co. v. Valu Raja, AIR 1958 SC 881, (1958) IILLJ 249 SC was similar to this. However, most of the later directions accepted the doctrine of notional extension.

Examples of Notional Extension

For example, Sadgunaben Amrutlal and Ors. v. The Employee's State Insurance [(1981) 22 GLR 773], Superintending Engineer, T.N.S.E.B v. Sankupathy (T. M. T.), 2004 (pertains to Employees' Compensation).

I personally have had three or four instances wherein the injured have been awarded compensation by the ESI Corporation. Of these, one is a death case, and the dependent parents are receiving a pension every month. Therefore, I strongly believe that notional extension applies to accidents that happen in public places and public transport as well.