- Author: Raymond
- Category: Insurance in Kenya
Understanding Work Injury Benefits Act {Wiba} 2007
Work Injury Benefits Act allows employees to claim for medical expenses and lumpsum compensation for permanent incapacity, if any, or death.
All employers in Kenya should compensate employees for injuries or death, or diseases that arise out of and in the course of employment. This applies to either any local or foreign employee who is under a contract of service or contract of apprenticeship, regardless of salary, age or nationality, failure to provide adequate insurance is an offence www.imana.co.ke
WIBA benefits are calculated based on the employee’s earnings and nature of the work-related injuries and diseases.
An employee is not entitled to compensation if an accident, not resulting in serious disablement or death, is caused by the deliberate and wilful misconduct of the employee.
For the purposes of the WIBA 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 if the accident was due to an act done by the employee for the purpose of, 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 any instructions by or on behalf of his employer; or without any instructions from his employer.
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.
To address workplace risks as well as off-duty risks, employers ought to consider combining WIBA and Group Personal Accident hence WIBAPlus. This way, employees are covered 24 hours worldwide
When eligible for compensation;
· Been injured as a result of an accident that arose in the period/course of employment
· The accident happened while you were on an overseas/local assignment
· The accident happened while on a flexi-work arrangement that you agreed with your employer
· Dependents of an employee who died because of a workplace accident can also make a claim on behalf of the employee
· Contracted occupational diseases as well if incase of biological and chemicals emitted while at work
Tip: Employers should potentially reduce on insurance premiums and maximize on profits by avoiding duplicate coverage. Imana Insurance www.imana.co.ke specializes in employee benefits advisory.
How to report a claim;
Notification is done by employer in writing to the agent, broker or directly to insurance company if WIBA policy is in place or Director of Occupational, Safety & Health where WIBA policy is not in place by the Employer and must meet specific requirements.
Types of claims;
1. Temporary Total Disability Claim
2. Permanent Total Disability Claim
3. Death
4. Funeral Expenses
5. Medical Expenses
A claim is confirmed when;
1. A WIBA policy is in force
2. The persons are covered under the policy
3. Injured person and employment status, location of the accident confirmed
4. Nature and extent of disability
5. There is any Initial treatment given
Types of Compensation Benefits;
Benefits/compensation payable are fixed by the Act and are as stated below:
· Death: this applies for 96 months actual earnings without any limit.
· Temporary Total disability: The period of temporary total disability is that period following the injury where the workman is certified unfit to work as a result of the accident by a registered medical practitioner. Kindly note that to qualify for compensation the period of absence shall be at least 3 consecutive days.
· Permanent Total disability; The period of temporary partial is that period subsequent to temporary total disability but preceding final assessment of disability during which the employee is only able to do part but not whole of his duties.
· Medical Expenses: Employers are obligated to defray any reasonable expenses incurred by an employee in an accident and covers, dental, hospital treatment, surgical dressing, drugs, skilled nursing care (including at home), traveling to and from place of treatment is included.
· Funeral Expenses: Employer will be liable to pay reasonable funeral expenses subject to a maximum to be determined by the Minister if WIBA policy is not in place.
Documents Required In Processing WIBA Claims
1. Original Dosh 1 forms from ministry of Labour offices
2. Original medical bills from the attending hospital
3. Medical report signed by the doctor
4. Sick off sheets from the employer
5. Appointment letter of the claimant by the employer
6. Copy of I/D of the claimant
7. A report from the insured’s Health and safety committee
Raymond Momanyi – Imana Insurance Consulting Kenya Ltd
