WC – Workman Compensation Policy

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What is WC – Workman Compensation Policy

WC – Workman Compensation Policy: Buy/Renew WC – Workman Compensation Policy Online Instantly

The Workman Compensation Policy, also known as the Employer’s Liability Insurance, is designed to provide financial protection to employers against liabilities arising from workplace injuries, occupational diseases, or death of their employees. Coverage for medical expenses, disability benefits, and legal costs is offered, ensuring that employees receive timely compensation and support in case of work-related accidents or illnesses. The policy is considered essential for businesses to comply with legal requirements and to demonstrate their commitment to the well-being of their workforce.

⛦ Example Scenario: An accident took place on the project Site –
Imagine Ankur Gupta, a civil contractor, who runs a construction company with several workers involved in various projects. While working on one of the construction sites, unfortunately, one of his employees, Rajesh, sustains a serious injury due to an accident. In such a scenario, the Workman Compensation Policy comes to Ankur’s aid.

1. Medical Expenses Coverage: The policy would cover Rajesh’s medical expenses, including hospitalization, surgeries, medications, and rehabilitation. It ensures that Ankur doesn’t have to bear the financial burden of Rajesh’s medical treatment.

2. Disability Benefits: In case Rajesh suffers a permanent disability due to an accident, the policy would provide disability benefits to him. These benefits offer financial support and compensation for the loss of income and future earning capacity.

3. Death Benefits: In the unfortunate event of Rajesh’s death due to the accident, the policy would provide compensation to his family. This includes financial assistance for funeral expenses and a lump-sum payment to support his dependents.

4. Legal Protection: If Rajesh or his family decides to pursue legal action against Ankur’s company, the policy will cover the legal costs and expenses associated with the claim.

By having the Workman Compensation Policy in place, Ankur Gupta ensures that his workers are protected and compensated adequately in case of any work-related injuries or accidents. It provides a sense of security to the employees and builds trust in the employer, fostering a safer work environment.

Coverages of WC – Workman Compensation Policy

Workplace Injuries

Workplace Injuries

Coverage for medical expenses, hospitalization, and treatment in case of injuries sustained by employees while on the job.

Occupational Diseases

Occupational Diseases

Protection against occupational diseases or illnesses contracted by employees due to their work environment or job duties.

Disability Benefits

Disability Benefits

Compensation for partial or total disability caused by work-related accidents, providing financial support to affected employees.

Workplace Injuries

Death Benefits

Financial assistance to the family or dependents of an employee who suffers a fatal accident or dies due to a work-related cause.

Legal Costs

Legal Costs

Coverage for legal expenses in case of lawsuits filed by employees against the employer for work-related injuries or illnesses.

Temporary or Permanent Disability

Temporary or Permanent Disability

Compensation for temporary or permanent disability, ensuring employees receive income support during recovery or long-term disability.

Rehabilitation Support

Rehabilitation Support

Assistance for rehabilitation and vocational training for employees who need to transition to different job roles after an injury or illness.

Compliance with Regulations

Compliance with Regulations

Ensuring the employer complies with legal requirements related to workers’ compensation and employee welfare.

Additional Add-ons OF WC – Workman Compensation Policy

Workplace Injuries

Accidental Death and Dismemberment (AD&D) Cover

Provides additional compensation in the event of accidental death, dismemberment, or loss of sight, speech, or hearing due to work-related accidents.

Medical Evacuation and Repatriation

Medical Evacuation and Repatriation

Offers coverage for the cost of emergency medical evacuation or repatriation of employees to their home country for treatment if needed.

Disability Benefits

Extended Disability Benefits

Extends the duration of disability benefits beyond the standard coverage period, providing extended financial support to employees during their recovery.

Travel Insurance

Travel Insurance

Covers employees during business travel for medical emergencies or accidents occurring while they are away from their regular workplace.

Daily Cash Allowance

Daily Cash Allowance

Provides a daily cash benefit to employees during the period of hospitalization or temporary disability, helping them meet daily expenses.

Critical Illness Cover

Critical Illness Cover

Offers financial assistance in case an employee is diagnosed with critical illnesses specified in the policy.

Group Personal Accident Insurance

Group Personal Accident Insurance

Extends coverage to include all employees under a single policy, simplifying the administration of the insurance program.

Factors Determining the Premium of WC – Workman Compensation Policy

Nature of Business

Nature of Business

The type of industry or business and the associated level of risk influence the premium. High-risk industries may have higher premiums.

Number of Employees

Number of Employees

The total number of employees covered under the policy affects the premium. More employees generally result in a higher premium.

Annual Payroll

Annual Payroll

The total annual payroll of the employees is a crucial factor in determining the premium. A higher payroll may lead to a higher premium.

Claim History

Claim History

The claim history of the employer is considered. Frequent claims or high claim amounts may result in a higher premium.

Occupational Hazards

Occupational Hazards

The nature of work and potential hazards involved in the job can impact the premium. Riskier occupations may have higher premiums.

Experience Modification Factor

Experience Modification Factor

This factor reflects the employer’s past claims experience and safety records. It can influence the premium positively or negatively.

Safety Measures

Safety Measures

The implementation of safety measures and risk management practices in the workplace can impact the premium positively.

Compliance with Safety Regulations

Compliance with Safety Regulations

Employers complying with safety regulations and legal requirements may be eligible for lower premiums.

Major Differences Between Workman Compensation Policy and Group Personal Accident Policy

Aspect Workman Compensation Policy Group Personal Accident Policy
Coverage
Provides coverage for work-related injuries and illnesses of employees.
Provides coverage for accidental injuries or death of insured members within the group.
Scope
Mandatory for employers under labor laws to cover employees.
Voluntary and can be opted by employers for specific groups of individuals.
Purpose
Protects employers from financial liabilities arising from employee injuries.
provides financial support to the insured or their beneficiaries in case of accidents.
Insured
Employees or workers engaged in the course of employment.
Group members or individuals specified in the policy.
Premium Calculation
Based on the nature of the business, employee wages, and risk factors.
Calculated based on the sum insured and age group of members.
Coverage Duration
Continuous coverage throughout the policy period.
Coverage is for a specified term, usually one year.
Benefits
Covers medical expenses, disability benefits, and death benefits for employees.
Provides compensation for accidental death, permanent or partial disability, and other benefits as per the policy.
Type of Injuries Covered
Work-related injuries and occupational diseases.
Accidental injuries and death, regardless of the cause.
Commute Coverage
Usually does not cover injuries during daily commutes.
May or may not include coverage for daily commutes.
Legal Requirement
Mandatory for certain businesses under labour laws.
Not mandatory but may be required by certain organizations.
Extent of Coverage
Comprehensive coverage for work-related incidents.
Limited to accidents and injuries specified in the policy.
Purpose of Coverage
Primarily aimed at compensating employees and protecting employers.
Focuses on providing financial assistance to the insured or their beneficiaries.

How to Settle WC – Workman Compensation Policy Claims ?

Notification

Report the Incident

In case of a work-related injury or illness, the affected employee or the employer must report the incident to the insurance company immediately. Prompt reporting ensures a smooth claims process.

Document Collection

Document Collection

The employee must inform the employer about the incident and the resulting injury or illness. The employer will initiate the claim process with the insurance company.

Medical Treatment

Medical Treatment

The injured employee should seek medical attention and treatment as necessary. The medical records and reports will be essential for claim verification.

Claim Form

Claim Form Submission

The employer should obtain the appropriate claim form from the insurance company and fill it accurately. The employee’s details, incident description, and medical treatment information must be provided.

Document Submission

Document Submission

Along with the claim form, relevant documents like medical reports, hospital bills, medical certificates, and any other supporting evidence should be submitted to the insurer.

Investigation and Verification

Investigation and Verification

The insurance company will conduct an investigation to verify the claim’s authenticity. They may seek additional information or conduct inquiries, if required.

Claims Settlement

Claims Settlement

Once the claim is verified and approved, the insurance company will process the settlement. The compensation amount, as per the policy terms and the extent of injury or illness, will be determined.

Payment to the Employee

Payment to the Employee

The insurance company will disburse the compensation amount to the injured employee or their nominated beneficiary, as applicable.

Dispute Resolution

Dispute Resolution

In case of any dispute or disagreement regarding the claim settlement, the insured or the employee can approach the appropriate authorities or insurance regulatory bodies for resolution.

Regular Updates

Regular Updates

Throughout the claims settlement process, the insurance company should keep both the employer and the employee informed about the progress and status of the claim.

Exclusions of WC – Workman Compensation Policy

Self-Inflicted Injuries

Self-Inflicted Injuries

Injuries intentionally caused by the employee to themselves are not covered.

Injuries Outside of Work

Injuries Outside of Work

Injuries occurring outside the workplace or unrelated to job duties are excluded.

Intoxication or Substance Abuse

Intoxication or Substance Abuse

Injuries resulting from the influence of alcohol, drugs, or any other intoxicating substances are not covered.

Pre-existing Conditions

Pre-existing Conditions

Medical conditions or injuries that existed before the commencement of the policy are excluded.

Injuries During Commute

Injuries During Commute

Injuries sustained during the employee’s commute to and from the workplace are generally not covered.

War or Civil Commotion

War or Civil Commotion

Injuries arising from war, acts of terrorism, or civil commotion are excluded.

Injuries in Violation of Law

Injuries in Violation of Law

Injuries caused while violating laws or regulations are not covered.

Injuries Not Reported Timely

Injuries Not Reported Timely

Claims not reported within the policy’s specified time limit may be excluded.

Injuries of Contractual Workers

Employees who are not covered under the policy due to contractual terms are excluded.

Employees Above Age Limit

Employees Above Age Limit

Employees above the specified age limit set by the policy may be excluded from coverage.

Documents Required for Claim Settlement under
WC – Workman Compensation Policy

To initiate the claim settlement process under the Workman Compensation (WC) Policy
**In Case of an Accident**

Claim Form

Claim Form

 The claim form is the primary document that needs to be filled out accurately and submitted to the insurance company. It contains essential details about the accident, the injured employee, and the nature of the injury.

Medical Records

Medical Records

The injured employee should provide all relevant medical records related to the accident. This includes doctor’s reports, medical certificates, treatment details, and hospital bills.

Accident Report

Accident Report

An accident report detailing the incident, including the date, time, location, and circumstances leading to the injury, should be prepared and submitted to the insurer.

Witness Statements

Witness Statements

If there were any witnesses to the accident, their statements should be collected and included in the claim documentation.

Photographic Evidence

Photographic Evidence

Photographs of the accident scene, injuries, and any relevant evidence can be included to support the claim.

Police Report

Police Report

In case of accidents involving law enforcement, a copy of the police report should be submitted.

Medical Certificates

Medical Certificates

The employee’s medical certificates confirming the nature and extent of the injury should be provided.

Employment Records

Employment Records

Relevant employment records, including the employee’s job role, designation, and salary details, may be required for claim verification.

Aadhaar Card

ID Proof

The injured employee’s identification proof, such as an Aadhar card or passport, should be submitted.

Bank Details

Bank Details

Details of the employee’s bank account, including account number and IFSC code, for processing the claim settlement.

Injured Employee Statement

Injured Employee Statement

A statement provided by the injured employee detailing the incident, the nature of the injury, and the circumstances surrounding the accident.

Injured Employee Attendance in the Attendance Register

Injured Employee Attendance in the Attendance Register

The attendance register, where the presence of the injured employee is recorded, helps verify their work schedule and presence at the workplace on the day of the accident.

Wage Register of the Insured

Wage Register of the Insured

The wage register maintained by the insured employer, documenting the wages and salary details of the injured employee, is crucial for calculating the compensation amount.

Documents Required for Claim Settlement under
WC – Workman Compensation Policy

To initiate the claim settlement process under the Workman Compensation (WC) Policy
**In case of a fatal death**

Death Certificate

Death Certificate

A copy of the official death certificate issued by the relevant authorities.

Post-mortem Report

Post-mortem Report

If applicable, the post-mortem report detailing the cause of death.

Claim Form

Claim Form

The completed and signed claim form, provided by the insurance company.

Employer's Report

Employer's Report

A report from the employer, describing the incident and confirming the employee’s death occurred during the course of employment..

Employee's Details

Employee's Details

Relevant details of the deceased employee, such as name, age, occupation, and employment details.

Aadhaar Card

Identity Proof

A copy of the deceased employee’s identity proof, such as an Aadhaar card, passport, or voter ID.

Construction Contract

Employment Contract

If available, the employment contract or agreement between the employer and the deceased employee.

Nominee/Beneficiary Details

Nominee/Beneficiary Details

Information about the nominee or beneficiary, including their name, relationship with the deceased, and contact details.

Bank Account Details

Bank Account Details

The bank account details of the nominee or beneficiary for the settlement of the claim amount.

Police FIR (if applicable):

Police FIR (if applicable):

In cases where the death occurred due to an accident or criminal activity, a copy of the First Information Report (FIR) is filed with the police.

Wage Register of the Insured

Injured Employee Statement

A record of employee wages, hours worked, deductions, and total pay for a specific period.

Injured Employee Attendance in the Attendance Register

Employee Attendance Records

Track employees’ presence and absence during working hours to monitor attendance patterns and ensure compliance.

Contact Information for Claim Settlement: related to WC– Workman Compensation Policy

If Policy Obtained through Agent/Broker

Claims are the reason we get a car insurance in the first place! Therefore, ensure the claim process of your desired car insurance is smooth and doesn’t take too long. When you’re in trouble, the last thing you want is, to spend all your time and energy in just filing a claim!

If Policy Obtained Directly from Insurance Company

Claim Settlements are basically getting your compensations done right. Claims being such an important part of a car insurance, check for your desired insurer’s claim settlement ratio so that you’re assured that no matter what, your claims will be settled!

Claim Contact Information for Policy from Beemawala.com

If you have taken the policy from Beemawala.com, please use the following contact details to register your claim.

Frequently Asked Questions: WC– Workman Compensation Policy

The Workman Compensation Policy provides coverage to employers for financial liabilities arising from work-related injuries or illnesses suffered by their employees during the course of employment.
The policy covers a wide range of work-related injuries, including accidents, occupational diseases, and disabilities.
Yes, the policy covers medical expenses incurred for the treatment of employees’ work-related injuries or illnesses.
Yes, the policy provides compensation for lost wages during the period of temporary disability caused by work-related injuries or illnesses.
In case of a fatal accident, the policy provides compensation to the deceased employee’s family as per the policy terms.
Usually, injuries sustained during the daily commute to and from work are not covered under the policy.
Pre-existing medical conditions are generally excluded from coverage under the policy.
Yes, the policy covers employees involved in hazardous work, subject to policy terms and conditions.
To make a claim, the employer should promptly inform the insurance company about the incident and submit the necessary documentation.
Yes, the policy usually extends coverage to temporary or contract workers engaged by the employer.
The compensation limit varies based on the policy’s sum insured and terms and conditions.
Yes, additional extensions for legal liabilities towards third parties can be included in the policy.
Yes, the policy typically provides coverage for employees during off-site work assignments.
Yes, the policy can be tailored to meet the specific requirements of the employer’s business.
The policy usually has a waiting period before coverage begins, as specified in the policy terms.
The policy can be renewed before its expiry date by paying the premium and updating any changes in employee details.
Yes, employers can choose higher coverage limits based on their needs, subject to insurer approval.
Yes, the policy may cover legal representation expenses incurred by employees during claim disputes.
Coverage for employees working abroad may be subject to additional endorsements or riders in the policy.
The insurance company assesses the validity of the claim, conducts investigations, and settles the claim amount based on policy terms and the extent of the injury or illness.
Add-ons are additional coverages that enhance the basic policy. They provide extra protection, such as coverage for legal liabilities or extended benefits, making the policy more comprehensive and tailored to your business needs.
Yes, you can opt for Terrorism Coverage as an Add-on to protect against work-related injuries or fatalities caused by acts of terrorism.
Yes, you can add coverage for Employees’ Repatriation Expenses, which compensates for the cost of sending an injured employee back to their home country for medical treatment.
Yes, Loss of Personal Effects can be added to compensate employees for personal belongings damaged or lost during a work-related incident.
Yes, you can opt for Family Transportation Expenses coverage to reimburse the cost of transporting the family members of a deceased employee to their home location.
Yes, you can choose an Add-on to increase the compensation limit beyond the standard coverage, providing higher benefits to employees in case of severe injuries or disabilities.
Yes, you can include Commute Coverage Add-on to extend protection to employees during their daily travel to and from work.
Yes, you can opt for Coverage for Occupational Diseases, providing financial support to employees suffering from work-related illnesses.
Yes, you can add Critical Illness Coverage to provide financial assistance to employees diagnosed with critical illnesses due to work-related factors.
Yes, you can extend coverage to temporary or contract workers by including an Add-on in the policy.
Yes, you have the flexibility to customize the Add-ons to align with your specific business needs and the nature of your workforce.
Yes, you can include Travel Accident Coverage Add-ons to protect employees during official business trips.
Yes, you can opt for Legal Defense Costs Add-on to cover legal expenses incurred during claim disputes or lawsuits.
Yes, you can choose an Add-on to cover Rehabilitation Expenses, helping employees recover and return to work after an injury.
Yes, you can include a Group Life Insurance Add-on to provide life insurance benefits to employees as part of the policy.

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