Dear Senior, Can any one describe the benefit employee will get under mediclaim and WC policy...? Like In WC can employee will get the benefit for injury..? Regards, Sunil Prajapati
From India, Mumbai
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4From India, Mumbai
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Employee's Compensation Act and Mediclaim Insurance
The Workmen's Compensation Act, 1923 (now known as the Employee's Compensation Act), provides insurance for legal liability coverage for compensation to employees for bodily injury or death caused due to accidents or occupational diseases arising out of and in the course of employment. This applies where employees are not eligible to be covered under the ESI Act.
Mediclaim Insurance
Mediclaim Insurance is a hospitalization benefit policy offered by both public and private sector general insurance companies. The policy covers medical expenses incurred for hospitalization or domiciliary treatment of the insured in case of sudden illness. The Mediclaim Policy stipulates that a claim is admissible when the insured is admitted to a hospital or nursing home for a minimum period of 24 hours for treatment.
The coverage of accidental injuries can be included by paying an extra premium, or a separate workmen's compensation policy can be obtained for accidental injuries caused in and out of employment.
Regards,
BS Kalsi
From India, Mumbai
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The Workmen's Compensation Act, 1923 (now known as the Employee's Compensation Act), provides insurance for legal liability coverage for compensation to employees for bodily injury or death caused due to accidents or occupational diseases arising out of and in the course of employment. This applies where employees are not eligible to be covered under the ESI Act.
Mediclaim Insurance
Mediclaim Insurance is a hospitalization benefit policy offered by both public and private sector general insurance companies. The policy covers medical expenses incurred for hospitalization or domiciliary treatment of the insured in case of sudden illness. The Mediclaim Policy stipulates that a claim is admissible when the insured is admitted to a hospital or nursing home for a minimum period of 24 hours for treatment.
The coverage of accidental injuries can be included by paying an extra premium, or a separate workmen's compensation policy can be obtained for accidental injuries caused in and out of employment.
Regards,
BS Kalsi
From India, Mumbai
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Dear Sir,
Thank you for your reply. In the workers' compensation (WC) policy, if an employee is in the course of employment, such as traveling on the staff bus or being on duty away from company premises for company work, will they be eligible for medical reimbursement?
Secondly, can an employee claim minor injury compensation for incidents like finger cutting that occur during work under WC? Or do we need to have a separate medical policy for such claims? Can we combine Employees' State Insurance Corporation (ESIC) with the WC policy if the employer suggests it?
Please provide your suggestions.
Regards, Sunil Prajapati
From India, Mumbai
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Thank you for your reply. In the workers' compensation (WC) policy, if an employee is in the course of employment, such as traveling on the staff bus or being on duty away from company premises for company work, will they be eligible for medical reimbursement?
Secondly, can an employee claim minor injury compensation for incidents like finger cutting that occur during work under WC? Or do we need to have a separate medical policy for such claims? Can we combine Employees' State Insurance Corporation (ESIC) with the WC policy if the employer suggests it?
Please provide your suggestions.
Regards, Sunil Prajapati
From India, Mumbai
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I have already mentioned to you that the Employee's Compensation Act, 1923 is applicable where employees are not eligible to be covered under the ESI Act. Coverage of employees under the ESI Act is the BEST OPTION if the establishment meets the criteria and falls within the implemented area.
Benefits of the ESI Act
The ESI Act provides the following benefits:
1. Medical Benefit
2. Sickness Benefit (SB)
i) Temporary Sickness Benefit
ii) Extended Sickness Benefit (ESB)
iii) Enhanced Sickness Benefit
3. Maternity Benefit
4. Disablement Benefit
i. Temporary Disablement Benefit (TDB)
ii. Permanent Disablement Benefit (PDB)
5. Dependants' Benefit (DB)
6. Funeral Expenses
Others:
(a) Rehabilitation Allowance
(b) Vocational Rehabilitation
(c) Medical Benefit to Retired Persons
Regards,
BS Kalsi
From India, Mumbai
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Benefits of the ESI Act
The ESI Act provides the following benefits:
1. Medical Benefit
2. Sickness Benefit (SB)
i) Temporary Sickness Benefit
ii) Extended Sickness Benefit (ESB)
iii) Enhanced Sickness Benefit
3. Maternity Benefit
4. Disablement Benefit
i. Temporary Disablement Benefit (TDB)
ii. Permanent Disablement Benefit (PDB)
5. Dependants' Benefit (DB)
6. Funeral Expenses
Others:
(a) Rehabilitation Allowance
(b) Vocational Rehabilitation
(c) Medical Benefit to Retired Persons
Regards,
BS Kalsi
From India, Mumbai
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Dear sir,
One of our employees has been working in a steel plant for 12 years. Due to sound pollution, he has experienced a loss of hearing in both ears (up to 50 dB). Is he eligible to receive benefits from the Mediclaim policy? He is covered under the Mediclaim policy, but since he will not be admitted to a nursing home for 24 hours due to the ear loss, he will only receive treatment on an outpatient basis. He now requires hearing aids. Will the insurance company reimburse the cost of the hearing aids under the Mediclaim policy?
Thank you.
From India, undefined
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One of our employees has been working in a steel plant for 12 years. Due to sound pollution, he has experienced a loss of hearing in both ears (up to 50 dB). Is he eligible to receive benefits from the Mediclaim policy? He is covered under the Mediclaim policy, but since he will not be admitted to a nursing home for 24 hours due to the ear loss, he will only receive treatment on an outpatient basis. He now requires hearing aids. Will the insurance company reimburse the cost of the hearing aids under the Mediclaim policy?
Thank you.
From India, undefined
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Jahangir Hospet,
Please meet the commissioner for employee compensation having jurisdiction over the factory or ESI regional office with all reports and data. The factory inspector/ESI inspector may ask for his earlier medical records from the factory. On the face of it, it looks like a valid case for entitlement of compensation.
From India, Mumbai
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Please meet the commissioner for employee compensation having jurisdiction over the factory or ESI regional office with all reports and data. The factory inspector/ESI inspector may ask for his earlier medical records from the factory. On the face of it, it looks like a valid case for entitlement of compensation.
From India, Mumbai
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Employee Benefits.doc