Workers Compensation Insurance for Injury Due to One’s Fault

Workers’ compensation is an insurance policy designed to provide financial and medical support to employees who are injured or become ill due to their jobs. It is a legal requirement in many countries, ensuring that employees receive necessary assistance without the need for lengthy legal battles.

So, payment of workers' compensation is based on fault? – Not necessarily, the purpose of workers’ compensation is twofold: to protect employees and to safeguard employers. For employees, it offers coverage for medical expenses, rehabilitation costs and a portion of lost wages while they recover. In the unfortunate event of a work-related fatality, it also provides financial support to the employee’s dependents.

For employers, workers’ compensation minimises the risk of lawsuits by providing a structured way to handle workplace injuries. It also helps businesses comply with legal regulations and maintain a positive work environment.

This no fault and worker’s compensation insurance applies regardless of who is at fault for the injury, ensuring that employees have access to timely care and support. By addressing the financial and medical needs of injured workers, workers’ compensation promotes workplace safety and productivity while protecting both employees and employers from unnecessary financial burdens.

Yes, you can claim workmen’s compensation even if the injury occurred due to your fault. Workers’ compensation insurance is designed to provide financial and medical support to employees for work-related injuries or illnesses, regardless of who is at fault. This no-fault workers' compensation principle ensures that employees receive necessary care without the need to prove negligence or liability.

However, there are exceptions:

Claims may be denied if the injury resulted from intentional misconduct, self-inflicted harm or actions taken under the influence of drugs or alcohol.

Injuries sustained while violating company policies or engaging in non-work-related activities may not be covered.

The primary goal of workmen’s compensation is to ensure that employees can recover without financial strain while protecting employers from potential lawsuits. If you are injured at work, it is important to report the incident promptly and follow the required procedures to file a claim.

Example

Consider a warehouse worker who accidentally trips over the equipment they misplaced and suffers a back injury. Even though the worker's own negligence caused the incident, they are still eligible to claim workmen’s compensation. The no-fault worker’s compensation insurance ensures the injured employee receives medical care, rehabilitation support and compensation for lost wages during recovery.

However, if the same worker was injured while engaging in alcohol consumption or violating a safety rule, such as operating machinery without authorisation, their claim might be denied. This highlights the importance of distinguishing between genuine accidents and situations involving misconduct.

**Also Read: **10 Questions About Workmen’s Compensation Answered

Also Read: Advantages of Workmen Compensation Policy

Before filing a claim, you need to understand whether worker's compensation is based on fault or not. Filing a workmen’s compensation claim with TATA AIG is a straightforward process. Follow these steps to ensure a smooth claim experience:**

-Notify TATA AIG: Inform TATA AIG about the accident as soon as possible. Provide a written notice detailing the incident and the worker’s resulting disablement or death.

-Claim Verification: TATA AIG will assign an investigating officer to verify the claim’s authenticity and gather necessary details about the accident.

-Collect Required Documents: Gather all essential documents, including evidence of the accident and injury. This may include medical reports, accident details and proof of employment.

-Submit the Claim Form: Fill out the claim form accurately and attach the required documents. Include details such as the policy number, insured person’s name, injured worker’s name, date of the accident, nature of the claim and a brief description of the incident.

-Also Read: Workmen Compensation Claim Settlement Process

The Employee Compensation Act, 1923, provides extensive coverage for work-related injuries and illnesses but excludes certain groups and has specific limitations:**

-Exempt Groups: The following groups are exempt from the Act as they are covered under other social security schemes or arrangements:**

• Members of the Armed Forces.

• Employees in managerial or administrative roles earning above a specified salary threshold.

-**Workers covered under other social security laws like the Employees' State Insurance Act (ESI).

-Compensation Limits: The Act sets specific limits on compensation amounts, which vary based on the type and severity of the injury or illness. These limits ensure uniformity in payouts.

-Eligible Employees: The Act covers full-time, part-time, temporary and permanent employees across various industries. Contract workers are also included, provided they meet the eligibility criteria defined under the Act.

-Also Read: Key Factors to Choose Workmen Compensation Policy

Workers’ compensation insurance is a vital safety net for employees and employers, ensuring financial and medical support in case of work-related injuries, even if the accident is due to the employee’s fault. For businesses, especially small and medium enterprises (SMEs), having a comprehensive SME insurance policy is crucial to safeguarding both their workforce and their operations.

TATA AIG offers tailored workmen compensation insurance plans designed to meet the needs of businesses across various industries. By a reliable workmen compensation cover, businesses can foster a safer workplace and build trust with their employees.

Am I still considered an active employee while on workers’ compensation?

No, during your recovery from a work-related injury or illness, you are placed on a leave of absence. Once your doctor clears you to resume work, your status will return to active.

Can I be fired for reporting a work-related injury?

No, it is illegal for an employer to terminate your employment for reporting a workplace injury. Employees are protected by law against retaliation for filing a workers’ compensation claim.

What happens if I miss work due to a work-related injury?

If you need to take time off because of a workplace injury, your supervisor will report the incident to the Workers’ Compensation Claims team. They will investigate the claim and manage the process to ensure you receive the necessary benefits.

Is payment of workers' compensation based on fault?

This policy is designed on a no-fault principle. It would be incorrect to say that the worker's compensation is based on fault. Employers can get coverage against statutory liabilities under this policy, and workers can get coverage in case of a workplace accident regardless of who is at fault.

What should I do if I am injured on the job?

Report the incident to your supervisor immediately. The supervisor will investigate the scene, ensure you receive prompt medical care, document the incident through the proper channels and address any safety issues that contributed to the injury.