Workers Compensation Insurance offers insurance coverage for
injuries or occupational diseases suffered at workplace and
compensates for lost wages. It does not matter who was at fault.
Workmans Comp Insurance has been made compulsory in every
state. However, in Texas, there is no such compulsion. The policy
varies from one state to another in terms of the following:
Handling of claims
Death benefits
Disputes settlement
Evaluation of impairment
Cost control strategies
The state law may also provide for special exemptions in case of officers/owners, small companies, domestic workers, farm hands, and independent contractors.
Employers should ascertain that the insurance policy is in accordance with
the state regulations for Workmans
Comp Insurance. If an employer fails to carry the insurance
policy or otherwise meet a states regulations in this regard,
it can leave him to pay these benefits out of his own pocket,
as well as pay penalties imposed by the state.
The Workmans Comp Insurance plays a major role
in influencing business decisions to relocate or to expand in
a state, and thereby, generating millions of jobs.
Workers Compensation Insurance provides indemnity
in the following areas:
1. Loss of limbs.
2. Injury inflicted at work.
3. Medical treatment.
4. Wages (up to two-thirds of the employee's salary).
5. Death.
6. Lawsuits filed by injured employees.
Employees payable under the Workers Compensation
Insurance are:
1. Permanent full-time staff
2. Part-time staff
3. Temporary staff
Self-Insurance
Employers have an option to self-insure their employees instead of purchasing the Workers Compensation Insurance policy. This would enable the employers to cover the costs flowing from on-the-job injuries themselves. An employer should always consider the financial status of his company while opting for self-insurance business. The state gives permission to the employers to self-insure. In other words, the rules in relation to who is eligible to self-insure differ from state to state. The Department of Insurance of the State decides if a particular business is required to purchase Workers Compensation Insurance.
Worker's compensation insurance in California
Workers compensation insurance is a very old indemnity policy
in California. It does not matter who was at fault. The employees
should receive compensation for injuries sustained in the workplace.
This is an exclusive remedy for injured employees, when the
employer neglectfully causes the injury. This insurance policy
has also helped in eliminating the existing proceedings Workmans
Comp over whether employers were negligent in causing injuries
to workers.
California law prescribes three basic parts to the
workers compensation system:
The benefit structure
This structure describes what and how much injured workforce are entitled to receive when they suffer an injury arising out of and in the course of their employment and resulting in death or disablement. The structure define six basic types of workers compensation benefits available, depending upon the nature, date and sternness of the worker's injury such as medical care, vocational rehabilitation services, temporary disability benefits, supplemental job displacement benefits, permanent disability benefits, and death benefits.
The benefit delivery system
In California, private insurance companies are authorized to provide workers compensation. These companies administer the Workers Compensation Insurance.
Once the employer becomes aware of any injury to a worker at the workplace, he should provide him with the minimal benefits to which the latter is entitled. The employer is liable to pay these benefits. In the benefit delivery system, the State supervises the proviso of workers compensation benefits. It also provides information and assists the employees and employers involved in the system, in resolving disputes if any.
The benefit financing system
In this system, the employers provide benefits to
their employees with the help of adoption of any of the following
three methods:
1. Self-Insurance
2. Private Insurance
3. State Insurance
Special funds
I. Uninsured Employers Fund
If an employee gets injured at his workplace, and his employer is uninsured,
the employee is entitled
to be reimbursed for the same. However, an attempt can be
made to recuperate the amount paid from the uninsured employer.
II. Subsequent Injuries Fund
If an employee suffers from permanent disability and sustains an injury at the workplace, the employer will be only liable for the injury sustained at the workplace.
Workers compensation insurance in India
It is the responsibility of the employer to purchase the Workers Compensation Insurance in accordance with the regulations prevailing in the state. Social security in India commenced with the advent of Workmens Compensation Act in 1923
The sole aim of the Act is to provide for the payment of compensation to workers and their families in case of industrial accidents and / or certain occupational diseases arising out of and in the course of employment and resulting in death or disablement.
The employers are liable to pay compensation to workers if the injury has been caused in the workplace. The compensation is not paid in lieu of negligence shown on the part of the employer. It is paid as per the norms given in the insurance policy.
The term workman includes persons employed through sub-contractors by a person fulfilling a contract with the railway. The worker loses the right of compensation if the accident is caused by a worker, who, at the time of accident, was either drunk or was taking drugs, or if it is caused by his noncompliance of rules or orders or his disrespect for safety measures.
The term wages include overtime pay and the value of concessions or benefits in the form of clothing, food, accommodation, etc. The amounts of compensation payable to a worker or his dependents are based on the nature and extent of disablement and his average monthly wages.
In order to protect the interest of dependents in case of fatal accidents, all such cases should be brought to the notice of Commissioner of Labor. The employer has to deposit the amount of reimbursement with the Commissioner within 30 days. If the employer denies his liability, the Commissioner must decide whether there is a ground for claim. The Commissioner may inform the dependents if there is a ground for claim.
In India, it applies to seamen and shipmasters of power driven ships or of non-power driven ships of 50 tons or more. Generally, it applies to organized industries and hazardous occupations including building and loading or unloading operations.
The insurance policy does not cover the following:
1. Persons working in administrative or clerical jobs.
2. Persons employed in casual work.
3. Persons employed in the Armed Forces.
4. Persons who earn more than $140000 per month.
The Employees State Insurance Act, 1948 is a legislation, which aims at bringing
about social and economic justice to the labor class of the
country. It offers compensation benefits to the employees incase
of sickness, maternity, disablement, medical expenses, and funeral
expenses to the workers injured at workplace.
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