WIBA (Work Injury Benefits Act) is a policy that covers the employees of the insured whilst on duty. Especially, those engaged in the execution of the Insured’s business and any project undertaken by the insured. Including, insurance cover against accidental bodily injury, disablement or even death.
In general, this is a combination of the workmen injury benefit act (WIBA) and Group Personal Accident (GPA) covers. That intends to give an employer a one-stop solution for employee insurance. It addresses workplace risk as well as off-duty risks.
For an injured employee to receive benefits, the worker needs to follow the correct workers’ compensation claims process, including filing a claim before the state deadline. Since the payout under the WIBA section is standard as per the Act. Hence, benefits under the GPA cover help to suit individual needs – say multiplier on 3, 5 or 8 years.
What is WIBA in Kenya?
In Kenya, for instance, WIBA is an Act of Parliament In Kenya to provide compensation to employees for work-related injuries and diseases. In that case, contracted in the course of their employment and for connected purposes.
Basically, an accident in WIBA means an accident arising out of and in the course and scope of an employee’s employment and resulting in personal injury. Whereby, every employer must obtain and maintain an insurance policy. With an insurer approved by the Minister in respect of any liability that the employer may incur under this Act to any of its employees.
The Minister may exempt from the provisions of subsection (1) an employer who provides and maintains in force security. In particular, that complies with the requirements of subsection (3). An employer who carries on business in Kenya must within the prescribed period and in a prescribed manner – register with the Director.
How does the WIBA Compensation claim Work?
If a worker is injured on the job, there is a limited amount of time to submit paperwork in order to receive workers’ compensation benefits.
Both the worker and the employer must act promptly when an injury occurs. Otherwise, the claim could be denied.
When an injury occurs, the employer must:
- Give the employee the appropriate paperwork and guidance
- File the claim with the insurer
- Comply with state law for reporting work injuries
The employee must:
- Notify the employer of the injury (date, time, type of injury, and how it occurred)
- File a formal workers’ comp claim
The workers’ compensation process can vary depending on where the employee is located since workers’ compensation is regulated by the state.
Why is WIBA important?
Many of you have jobs in stressful work environments. Your employer and supervisors demand that you complete your work tasks quicker and produce more.
If you’re hurt while working for a demanding employer, you may be concerned that you will lose your job if you’re injured and have to miss time from work. You may have some concerns about reporting your work accident to your employer. And you may try to work through the pain from your injury until you can’t do it anymore. Just to save your job.
This is understandable. But, as an example, the Virginia Workers Compensation Act does not recognize these concerns. You must give notice of the workplace accident to your employer immediately. If it’s not possible to give immediate notice of the accident, then you must give notice as soon as practicable.
What types of Accident Notices do You have to Give?
The Workers Compensation Act requires you to give to the employer written notice of the accident.
To satisfy this requirement, I recommend finding a pen and paper and writing the following:
- Your name
- Your address
- The time and place of the accident
- How the accident occurred
- The type of injury you suffered
- All the places where you are having pain, numbness, tingling, or swelling
Turn this report into your employer. But, do not leave until you have received a time-stamped copy of the report for your records.
For one thing, having a record of giving notice of the accident to the employer can prevent many potential problems with your workers’ compensation claim. You can also e-mail or text the information described above to your employer. But, make sure that you keep a copy of what you send.
If you’re not sure of what to write down, you can use the sample letter reporting your work injury as a template. In order to keep records;
An employer must;
Keep a register or other record of the earnings and other prescribed particulars of all employees. And so to say, at all reasonable times produce the register or record on demand to the Director for inspection; retain the register, record or reproduction referred to in subsection (1)(a). Or rather, a period of at least six years after the date of the last entry in that register or record.
An employee involved in an accident resulting in the employee’s disablement or death is subject to the provisions of this Act, entitled to the benefits provided for under this Act. An employer is liable to pay compensation in accordance with the provisions of this Act to an employee injured while at work.
When should an Employee File a WIBA claim?
An employee should file a workers’ compensation claim if injuries were sustained on the job or within the scope of employment.
This includes occupational accidents, diseases, trauma injuries, or illness caused by exposure to work activities or chemicals.
In order to file a claim, all of the following must be true;
- an employer has a workers’ compensation policy.
- the injured worker is an employee of the business, not a contractor.
- an employee became injured while at work.
Workers’ compensation typically won’t cover:
- stress or other psychiatric injuries
- self-inflicted injuries
- injuries caused by fighting or horseplay
- the injuries that happen while commuting to or from work
- an injury incurred while committing a crime, while under the influence of drugs or alcohol, or while violating company policies
Which are the Rights of WIBA Compensation?
An employee is not entitled to compensation if an accident, not resulting in serious disablement or death, is caused by the deliberate and willful misconduct of the employee.
The “no-fault clause” for the purposes of this Act, an occupational accident or disease resulting in serious disablement or death of an employee is deemed to have arisen out of and in the course of employment. Also, if the accident was due to an act done by the employee for the purpose of, or in the interests of or in connection with, the business of the employer.
Despite the fact that the employee was at the time of the accident acting in contravention of any law or to any instructions by or on behalf of his employer. Or was acting without any instructions from his employer.
For the purposes of this Act, the conveyance of an employee to or from the employee’s place of employment for the purpose of the employee’s employment. By means of a vehicle provided by the employer for the purpose of conveying employees is deemed to be in the course of the employee’s employment.
Thereinafter, for the purposes of this section, an injury shall only be deemed to result in serious disablement. If for instance, the employee suffers a degree of permanent disablement of forty percent or more.
Accidents outside Kenya
If an employer carries on business chiefly in Kenya and an employee ordinarily employed in Kenya is injured in an accident while temporarily deployed outside Kenya, the employee is, subject to paragraph (c), entitled to compensation as if the accident had happened in Kenya.
This does not apply to an employee who has been deployed outside Kenya-for a continuous period of twelve months or longer, or for a shorter period if the employment outside Kenya is expected to last for more than twelve months.
Substitution of Compensation
No action shall lie by an employee or any dependant of an employee for the recovery of damages.
In respect of any occupational accident or disease resulting in the disablement or death of such employee against such employee’s employer. And no liability for compensation on the part of such employer shall arise. Particularly, saved under the provisions of this Act in respect of such disablement or death.
Accidents or Occupational Disease reporting
Notice of Accident by Employee to Employer Written or verbal notice of any occupational disease or accident must be given. By or on behalf of the employee concerned to the employer after such disease or accident happens.
Furthermore, many people know that there are time limits for filing a legal claim. You give up your right to the benefits and damages sought if you fail to file a claim before the applicable time limits. Also called statutes of limitations, run out.
Notice of injury or accident by the employer to Director
Subject to the provisions of this section an employer must report an accident to the Director in the prescribed manner. Notably, within seven days after having received notice of an accident or having learned in some other way.
For the purposes of this section, an accident includes any injury reported by an employee to his employer. On the contrary, if the employee when reporting the injury alleges that it arose out of and in the course of his employment. And also, irrespective of the fact that the employer is of the opinion that the alleged accident did not so arise out of and in the course of employment.
An employer must at the request of an employee or the dependant of an employee furnish the employee or dependants with a copy of the notice of the accident. Furnished by the employer to the Director in respect of a claim for compensation by such employee or dependant.
Notice of Accident by Employee to Employer
Written or verbal notice of any occupational disease or accident must be given by or on behalf of the employee concerned to the employer after such disease or accident happens.
An employer must at the request of an employee or the dependent of an employee furnish the employee or dependants with a copy of the notice of the accident. Furnished by the employer to the director in respect of a claim for compensation by such employee or dependent.
How does the Employer conduct the Inquiry?
Generally speaking, there are various claim procedures for the work injury Benefit Act (WIBA).
The employer is required to report the details of an accident in respect of an employee to the Director of Occupational Safety and Health Services in the prescribed manner within two days for fatal & seven(7) days for others.
After having received notice of an occupational accident or disease or having learned in some other way that an employee has been injured in an accident. Or eventually, contracted an occupational disease. Therefore, the Director shall make such inquiries as are necessary to decide upon any claim or liability in terms of this Act.
Employee to submit to a medical examination
An employee who claims compensation or to whom compensation has been paid or is for that matter payable must when required by the Director or the employer as the case may be.
And after reasonable notice, submit himself at the time and place mentioned in the notice to an examination. By the medical practitioner designated by the Director or the employer with the approval of the Director.
If in the opinion of any medical practitioner, an employee is not capable of calling upon the designated medical practitioner, the employee shall inform the party requiring the examination.
How do I Claim for WIBA Compensation?
A claim for compensation in terms of this Act shall be lodged by or on behalf of the claimant in the prescribed manner within 12 months after the date of the accident or, in the case of death, within 12 months after the date of death.
If a claim for compensation is not lodged in terms of paragraph (1)(a), the claim for compensation may not be considered in terms of this Act. Except where the accident concerned has been reported in terms of section 21.
If an employer fails to report an accident or disease or to provide the information requested by the Director as specified in the request, the Director may-Conduct an investigation. Recovering the costs of the investigation from the employer. As a debt due from the employer, levy a penalty on the employer,
Compensation for Temporary Total or Partial Disablement
An employee is not entitled to receive a periodical payment during any period in which the employee is receiving full pay, whether in terms of the Employment Act, any other law or contract of service.
The periodical payment of an employee who is receiving a part payment of remuneration must be reduced so that the employee does not receive more than the employee would otherwise have earned.
Expiry of Compensation for Temporary Total or Partial Disablement
The right to compensation for temporary total or partial disablement expires upon the termination of the disablement.
Or if the employee resumes the work upon which the employee was employed at the time of the accident or occupational disease. As well as, if the employee resumes any other work at the same or greater earnings.
Compensation for Permanent Disablement
Compensation for permanent disablement must be calculated on the basis of 96 months’ earnings. Subject to the minimum and maximum amounts determined by the Minister. Of course, after consulting the Board, from time to time set out in Schedule 3.
If an employee has sustained an injury set out in Schedule 1, the employee must for the purposes of this Act be deemed to be permanently disabled. To the degree set out in the second column of the said Schedule.
Additionally, if an employee has sustained an injury not mentioned in schedule 1 which leads to permanent disablement, the employee must be paid such percentage of disablement. So to say, in respect thereof as in the opinion of a medical doctor. And which will not lead to a result contrary to the guidelines of Schedule 1.
What is a WIBA payout?
For the purposes of the Act, the government considers someone an employee if they have any contractual obligations with another party. In such a way that their relationship includes a consideration for work done. The act considers any agreement, verbal or otherwise, to be contractual, with the only exception being casual laborers.
For this reason, WIBA applies to all persons working for a specific employer. It is almost impossible for an employer to distance themselves from taking responsibility for the safety of those working for them under a written, verbal or implied contract. Hence, the employer remains aware of all persons doing anything on his behalf for the purposes of the act.
One of the easiest ways of getting great quotes from insurance companies is to speak to insurance agents. Insurance agents spend lots of time comparing quotes from different carriers and over time, they have expert knowledge on where to get the best quotes.
The downside of relying on insurance agents or brokers is that they make more money when they sell products that are more expensive. You, therefore, need to be very shrewd when dealing with them. Their information is however very reliable.
How do I receive WIBA Compensation?
On one hand, in case an employee suffers temporary total disablement. Due to an accident that incapacitates the employee for three days or longer is entitled to receive a periodical payment. Equivalent to their earnings. Also, subject to the minimum and maximum amounts fixed by the Minister from time to time. In that case, after consulting with the Council.
Important to realize, an employee is not entitled to receive a periodical payment during any period in which the employee is receiving full pay. Whether in terms of the Employment Act, any other law or contract of service.
The periodical payment of an employee who is receiving a part payment of remuneration must be reduced. So that the employee does not receive more than the employee would otherwise have earned.
- the value of any rations or quarters or both. Supplied by the employer to the date of the accident or report of disease;
- allowances paid regularly and any overtime payment or other special remuneration of a regular nature or for work ordinarily performed. But, excluding- payment for intermittent overtime;
- payment for non-recurrent occasional services; amounts paid by an employer to an employee to cover any special expenses;
- ex-gratia payments whether by the employer or any other person.
What employees should know
As can be seen, this is a combination of the workmen injury compensation act (WICA) and Group Personal Accident (GPA) covers. Whereby, it addresses workplace risk as well as off-duty risks.
While payout under the WIBA section is standard as per the Act, benefits under the GPA cover can be tailored. To suit individual needs – say multiplier on 3, 5 or 8 years.
Work Injury Benefit as set out by an Act of Parliament, payment is for Death, Disability, and Medical expenses and funeral costs.
Read Also: How long do you have to report a Work Accident and Injury in Virginia?
An Act of Parliament sets the Work Injury Benefit. Every employer has to compensate employees for any death/injury while on duty. Payment is for Death, Disability, and Medical expenses and funeral costs.
Usually, WIBA comes into force when the injury or illness directly attributes to the working conditions. The act considers the employer to provide a means of transport to fit within the general areas where WIBA applies.
If one faces an accident while riding on a company bus, such a person will be eligible for compensation. This act provides a compensatory framework for employees involved in an accident during the course of their duties. As it stands, the injury must be accidental. And must be as a cause by factors beyond the grasp of the company or the employee.
What is the WIBA Risk?
This refers to the liability that a company may face if its employees lodge a demand. Especially, for compensation after falling ill.
It also applies after an employee is in an accident within a place where the law holds the employer responsible. Particularly, for the safety of the employee.
In monetary terms
A legal WIBA payout can go as high as 96 months’ worth of pay. This type of risk is the one that employers liability insurance takes care of to shield companies from possible bankruptcy. Or making huge financial losses in the event of claims that lodge against it.
In the past, companies could get away without compensating employees. Currently, the government makes the employer responsible for employee safety, hence WIBA.
In conclusion, every company needs the services of a lawyer to assess their legal exposure. Based on this advice the company has to get WIBA insurance to transfer this risk.
In fact, the act expects every employer to ensure their employees have a WIBA insurance cover. This is so if they injure themselves while at work.
According to the First Assurance, this policy covers the employees of the insured. For Accidental bodily injury or disease arising out of and in the course of their employment. Additionally, the benefits as stipulated by the WIBA Act 2007 are as below: –
- Death- 8 Years Earnings
- PTD – 8 Years Earnings
- TTD – Actual weekly Earning up to 104 weeks
- Medical 100,000/-
- Last Expenses 30,000/-
- And Much More!
I hope the above-revised guide on the benefits of using WIBA was useful. But, if you’ll have additional questions, recommendations or even suggestions, please Contact Us. Or even, feel free to share your insights in the comments box below this post.
Finally, there are more Adequate and Credible Sources that are for general public information and reference purposes only. Including, the Independent, InsureAfrika, Resolution Insurance, Capital News, jmexclusives (general health & fitness research blog), etc.
More related and useful topic links:
- What is a Health Insurance Cover?
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- Types of Health Plans: How They Compare
- Physical Fitness on Beginners Weight Training