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Employee’s Compensation Insurance


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What is Employee’s Compensation Insurance?

Every company must ensure a safe workplace, but accidents can still happen. Injuries or, in severe cases, death during employment require compensation under laws like the Employee’s Compensation Act 1923 (previously called as the Workmen’s Compensation Act, 1923).

Not compensating can lead to legal issues, affecting employee confidence and the business's reputation. Employee’s compensation insurance (commonly known as WC policy or WC insurance) helps financially, covering compensation and legal costs. It also protects against lawsuits, as employees usually give up the right to sue for workplace negligence when accepting benefits. Previously known as Workmen Compensation Insurance, it ensures both businesses and employees are financially protected.

ICICI Lombard’s Employee’s Compensation Insurance helps you financially safeguard your employees and their families against unfortunate workplace accidents and mishaps. Most importantly, it presents you as a thoughtful and caring employer who values his workforce, an asset for any organization.

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What is the Employee’s Compensation Act?

The Employee’s Compensation Act, 1923 prescribes about financial compensation to employees if they encounter an accident during the course of employment while doing/discharging their duties. Under this law, all full-time, part-time or casual employees are liable to receive financial protection. The Act's provisions kick in when employees suffer injuries that render them incapable to perform their duties or they succumb to their injury

The compensation workers are eligible to receive under this Act are:

Scenarios Compensation
Death resulting from an injury Amount equal to 50% of the monthly wages of the deceased employee multiplied by the relevant factor.

OR

An amount of Rs 1.2 lakhs, whichever is more
Permanent total disablement from injury An amount equal to 60% of the monthly wages of the injured employee multiplied by the relevant factor.

OR

An amount of Rs 1.4 lakhs, whichever is more
Permanent partial disablement result from the injury In the case of an injury specified in Part II of Schedule I, Percentage of the loss of earning capacity caused by that injury (I)

in the case of an injury not specified in Schedule I, Proportionate to the loss of earning capacity as assessed by the qualified medical practitioner permanently caused by the injury ()
Temporary disablement whether total or partial results from the injury A half monthly payment of the sum equivalent to 25% of monthly wages of the employee to be paid in accordance with the provisions of sub-section (2) section 4 of Employee’s Compensation Act, 1923.

Why do you need an Employee’s Compensation Insurance Policy?

Having Employee’s Compensation Policy (previously known as

Workmen Compensation Policy) is crucial for these reasons:

  • It supports employees financially for work-related injuries, covering medical expenses
  • Prioritizing employee safety enhances your brand image, positively impacting customer and investor perceptions.
  • Compliance with contracts requiring employee’s (workmen's) compensation ensures legal obligations, preventing disputes.
  • Mitigating financial risks, it acts as a safety net, fostering a win-win situation for productivity and revenues.
  • It provides peace of mind, fulfilling legal duties for employers and offering financial security for employees in case of job-related injuries.
workmens compensation insurance price
Employee's Compensation insurance price

What is Covered under Employee’s Compensation Insurance?

The policy covers legal liability of an employer under:

  • 1. Workmen Compensation Act, 1923 [as amended through Employee’s Compensation (Amendment) Act, 2017], and subsequent amendments of the said Act prior to the date of issue of the policy.
  • 2. Common law, only up to the limit of indemnity agreed under the respective policy
  • 3. Fatal Accident Act 1955

Employee’s Compensation Policy provides coverage for:

  • Accidental death, Permanent total or Partial Disability and Temporary total disability suffered at the workplace during working hours

Additionally, add-on covers provided under Employee’s Compensation Insurance (previously: Workmen Compensation Policy) covers:

  • Occupational diseases specified under Schedule III of the Employee’s Compensation Act, such as diseases caused by the use of toxic compounds.
  • Contractor and subcontractors and their employees
  • Expenses incurred on medical surgeries in case of hospitalization for more than 24 hours

Coverage under Employee’s Compensation Insurance (formerly known as Workmen Compensation Insurance) is provided if, at the time of the accident, the worker is engaged in the employer’s business and not doing something for personal benefit. Employee and employer relationship is one of the prerequisites for the policy’s benefits to kick in.

Advantages of ICICI Lombard’s Employee’s Compensation Policy

Comprehensive and Flexible Coverage

Our Employee’s Compensation Policy (previously known as Workmen Compensation Policy and WC policy) offers extensive coverage, encompassing medical expenses for workplace injuries or illnesses. Beyond benefiting employees, it also shields employers from legal liabilities.

Hassle-free Claims Settlement Process

Our dedicated team promptly handles and reviews claims, working collaboratively with you for swift processing, minimal disruption, and transparent communication.

Coverage Suited for Unique Business Needs

At ICICI Lombard, we understand that every business is unique and faces different risks. Therefore, we have designed our Employee’s Compensation Policy (previously referred to as Workmen Compensation Insurance) in a manner that suits the unique needs of every business.

Convenient Buying Journey

Buy our Employee’s Compensation Policy in just a few clicks, making the process seamless and efficient, allowing you to protect your business and employees smartly from anywhere, be it home or office.

Employee's Compensation insurance price

Who Can Buy an Employee’s Compensation Policy Online?

  • Any employer, whether as a principal or contractor, engaging “employees” as defined in the Employee’s Compensation Act, 1923.
  • Any employer of such employees who do not qualify as an employee as per the said act but, virtue of the nature of engagement with an employer, share a like employee-employer relationship

Why You Should Buy ICICI Lombard’s Employee’s Compensation Insurance Policy?

Our policy (popularly known as WC policy and WC insurance) provides you and your workers comprehensive coverage and helps you fulfil your legal obligations.

  • The buying process is quick and convenient
  • We provide customizable options
  • The claims are settled on time - effortlessly.
workmens compensation insurance price

How to Buy Employee’s Compensation Insurance Policy from ICICI Lombard?

Here’s how you can buy Employee’s Compensation Insurance online:

  • Visit our website www.sme.icicilombard.com
  • Choose Employee’s Compensation Insurance from the Employee Benefit Dropdown on the top left corner
  • Fill in the details on the right-hand side of the webpage that appears, including industry category, policy period, and number of skilled and unskilled workers (including their salaries)
  • Provide other details like your mobile number, email ID, your company’s name and pincode
  • Check on the Terms & Conditions and Receive updates on WhatsApp boxes
  • Next, click on ‘Proceed to Buy’
  • Follow the instructions on the page that opens once you click proceed to purchase your policy.

You can also take the help of our responsive and intelligent assistant, RIA, to buy the policy. You can also fill out our ‘Request a callback’ form, whereby our executives will call you at your chosen time slot to help you with policy queries and buying.

You can also write to us at businessinsurance@icicilombard.com to learn more about the policy and buying process.

What are the benefits of renewing your Employee's Compensation insurance online?
workmens compensation insurance price

What is the Claim Process for
Employee’s Compensation Insurance?

Follow these steps to make a claim from the Employee’s Compensation Insurance (previously known as Workmen Compensation Insurance):

  • Send the insurance company a written notice and intimate about the accident and the disablement or death of a worker immediately
  • The investigating officer from the insurance company will verify the claim's authenticity
  • Collect all information and documentary evidence
  • Submit these along with the claim form and provide the policy number, name of the insured, name of the injured, date of accident, nature of claim along with a brief description of the accident, FIR (wherever applicable) and all the relevant and necessary documents

Documents Required for Buying Employee Compensation Policy

Have these documents ready to buy an Employee’s Compensation Insurance (previously: Workmen's Compensation Insurance):(Have full checklist from claims team)

  • A completely filled proposal form from the company's authorised signatory specifying its line of work
  • Employee records stating the number of workers and their job profile
  • Salary/wages of workers
  • Other documents, as required by the insurance company
workmens compensation insurance price

Frequently Asked Questions – Employee’s Compensation Policy

  • General
  • Cover
  • Policy
  • Claims

What types of injuries or illnesses are typically excluded from coverage under Employee’s (Workmen’s) Compensation Insurance?

For complete list of exclusions, read the policy wordings here.

How does the nature of employment or work-related tasks impact the exclusions under Employee’s (Worker’s) compensation insurance?

Jobs involving high-risk activities such as construction, firefighting and mining may have different exclusions compared to office-based roles as in the former, as chances of injuries are higher.

Are there any pre-existing health conditions that may be excluded from coverage under Employee’s (Workmen’s) Compensation insurance?

Pre-existing health conditions not directly caused by work activities can be excluded from coverage. One needs to consult with the respective insurer to learn more about it.

In what situations might an Employee’s (Workmen’s) compensation insurance claim be denied based on policy exclusions?

Claims for non-fatal injuries and those that don't cause partial disablement for more than 3 days can be denied. Also, claims for self-inflicted injuries or that caused under the influence of drugs or alcohol are excluded.

What are the basic coverage provided under Employee (Workmen's) Compensation policy?

The policy provides coverage for accidental death, permanent total disability, permanent partial disability and temporary total disability

What addon covers are provided in Employee's (Workmen's) Compensation policy?

  • Occupational Disease
  • Contractor /Sub Contractor Coverage
  • Medical Expenses

What is Permanent Total Disablement?

"Permanent total disablement" means such disablement of a permanent nature as incapacitates an employee for all work which he was capable of performing at the time of the accident resulting in such disablement. List of disablements is specified in the Employee's compensation Act.

What is Permanent Partial Disablement?

Permanent partial disablement" means, where the disablement is of a permanent nature, such disablement as reduces the earning capacity of an employee in every employment which he was capable of undertaking at the time of the accident resulting in the disablement. List of disablements is specified in the Employee's compensation Act.

What is Temporary Disablement?

Temporary disablement" means a condition resulting from an employment injury which requires medical treatment and renders an employee, as a result of such injury, temporarily incapable of doing the work which he was doing prior to or at the time of the injury.

What is Employee's compensation insurance?

The Employee's Compensation Insurance provides for payment of compensation to Employer on behalf of its employees in case of accidental injury to at workplace arising out of and in the course of employment and resulting in death or disablement

  • Employee's compensation claims are for accidents within work premises and during working hours
  • It also covers direct travel of employees from office to home and vice-versa
  • At the time of injury, workman must have been engaged in the business of the employer and must not be doing something for his personal benefit
  • Employer and employee relationship is an important prerequisite for issuance of Employee's compensation (EC) policy

What legal liabilities are covered in Employee's compensation policy?

  • Employee's Compensation Act, 1923 [As Amended through Employee Compensation (Amendment) Act, 2017], and subsequent amendments of the said Act prior to the date of issue of the policy.
  • Fatal Accidents as per Fatal Accident Act, 1855
  • Common Laws

How is Employee's Compensation policy different from ESIC (Employee State Insurance)?

  • Construction site workers are excluded from ESIC coverage as per ESI Act but can be covered in WC policy
  • Employees with wages above 21000 not covered in ESIC but there is no limit of wages under WC/ EC Act
  • Seasonal Factories (Includes factories engaged Less than 7 Months) are not covered in ESIC, but can be covered in a Employee's compensation policy
  • Organization with up to 10 workers (20 in case of Maharashtra and Chandigarh) does not require to have ESIC registration however there is no restriction as to no. of workers in WC /EC policy
  • Lower and flexible rates as compared to fixed ESIC Rates

What is occupational disease cover?

Occupational Diseases covers those diseases that are specified under Schedule III of Employee or Employee's Compensation Act. It covers those disease which arise due to nature of occupation Ex. disease caused by use of toxic compounds

What is Compressed Air Disease cover?

Compressed air disease is one of the occupational illnesses covered under Employee's compensation policy. It is a sickness attributed to the working environments where air pressure may be higher or lower than the normal surface air pressure. Ex. Underground or underwater works.

What does Medical Extension add on cover?

Medical extension covers reasonable medical surgical and hospital expenses incurred by the Insured in connection with any case of injury of employee, if hospitalisation is for more than 24 hours

What is covered under Contractor /Sub Contractor Coverage?

Contractor / Sub-contractor and their employees can be covered under this coverage.

What is PAN India Location Coverage?

If the insured has more than 1 risk locations (operating branches or factories) across the country, PAN India coverage enables employer to take a single insurance policy to cover its employees in all the branches.

What is the purpose of Employee’s Compensation Insurance (earlier known as WC insurance)?

The primary purpose of Employee’s (workmen) compensation insurance is to protect both employers and employees. For employers, it helps cover the costs associated with workplace injuries or illnesses for their employees,. For employees, it gives them the necessary financial cushion and support during injuries suffered at the workplace.

Who is responsible for obtaining and maintaining Employee’s Compensation Insurance (earlier known as Workmen Compensation Policy)?

Employers are responsible for obtaining and maintaining Employee’s Compensation Insurance. As an employer, you must ensure that the coverage meets the requirements set by law and remains active and up-to-date.

What types of injuries or illnesses are typically covered by WC insurance?

WC insurance typically covers a range of injuries and illnesses that can happen in the workplace as a result of work-related activities during the course of employment, including physical injuries, occupational diseases, and

How is the premium for Employee’s (Workmen’s) compensation insurance determined?

The premium of Employee’s (Workmen’s) compensation insurance is calculated depending on several factors, including the nature of work, the number of employees and their salaries, claims history, industry operation, and location, among others.

What steps should an employee take if they are injured at work?

When an employee is injured at work, he / she should immediately seek medication attention and report the injury to the employer as soon as possible. One should also provide complete details about how the injury happened and its nature to the employer so that claims can be filed from the Employee’s (Workmen’s) Compensation Insurance policy.

What basic information the Insurer needs to provide quotation?

  • Nature of work / Occupancy
  • No. of Employees
  • Monthly wages
  • Policy duration
  • Risk Location Address
  • Claim Experience of last 3 years with amount and count of claims

How Sum Insured is calculated in a Employee's compensation policy?

  • Sum Insured is the total earnings of the employees in the organisation.
  • The Sum Insured is calculated on the basis of monthly wages of employees.
  • Wages includes basic salary, allowance, perquisites or any benefits provided to the employees (Other than reimbursable expenses made by employees)

What is the process for filing a claim under Employee’s compensation insurance?

The first thing is to inform the employer about the injury or illness, post which the employer will ask to furnish details of the accident. After this, the employer will notify the insurance company about the accident, fill out the claim form, and provide the necessary documents related to the accident. Post this, the insurance company will verify the claim's authenticity, based on which the claim can be approved or denied. If you’ve purchased the Employee’s Compensation Insurance (previously known as Workmen Compensation Insurance and WC policy) from ICICI Lombard, you can intimate the claim, upload the documents, and track the claim status via this link - .

https://ilhc.icicilombard.com/Customer/ClaimIntimationOnlineTracking

What documentation is required when submitting Employee’s Compensation Insurance claim?

The documents required are:

  • Authorized Disability certificate from Govt hospital-Civil Surgeon
  • Cancelled Cheque with Printed Name of the claimant
  • Death certificate, in case of death
  • Duly filled in WCM Questionnaire
  • FIR/MLC/Police final report
  • Hospital Discharge Summary, Treatment papers, Investigation reports
  • Any other document asked/required by the insurer
  • KYC Documents

How long does it generally take for an Employee’s Compensation insurance claim to be processed?

On most occasions, the TAT for claim settlement of a WC policy or WC insurance is 14 days from the receipt of the last document. If the claim is sent to the surveyor/investigator, it would take another 15 days over and above the 14-day TAT.

Are there specific criteria that determine the approval or denial of Employee’s (Workmen’s) compensation insurance claim?

After investigation, if the insurance company is satisfied with the claim's authenticity and finds it aligns with the policy's terms and conditions, it will approve the claim. On the other hand, if it finds inconsistencies, it may reject the claim.

What support services are available to employees during the claims process under Employee’s (Workmen’s)Compensation Insurance?

Employees generally receive guidance and support on claims assistance, related paperwork, etc. They can also get support for medical care from their employers.

Product Product Code Retail UIN Commercial UIN
Employee's Compensation Insurance 4010 IRDAN115RP0010V02200607 IRDAN115CP0017V02201920