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THE FEDERATED EMPLOYERS' MUTUAL ASSURANCE COMPANY |
| GUIDE IN RESPECT OF CLAIMS |
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Who is an employee?
Any person who has entered into a contract of service with an employer. The
service contract can be in writing, expressed or implied and applies to
temporary, permanent and under aged workers and is defined in section 1 of the
Act.
This Act is not applicable to
domestic employees employed as such in a private household.
Any person including the State, who employs an employee.
What is an Occupational Injury (ACCIDENT)
It
is an occurrence of which a date, time and place can be determined
Which Occupational Injuries (ACCIDENTS) must be reported?
All occupational injuries or alleged occupational injuries that entail medical
expenses and/or
The delay to report an accident or alleged accident is a criminal
Procedure when reporting an Occupational Injury (ACCIDENT)
Step 1: Complete EMPLOYER'S REPORT In full
Step 2: Sign and date form where indicated.
Step 3: Hand "Part B" to the injured employee before he goes for initial medical
treatment and instruct him to hand "Part
B"
to the medical practitioner or hospital concerned. In serious cases "Part B"
must be forwarded to the medical
practitioner or hospital without delay.
Step 4: Complete the rest of Part A, pages 1 and 2.
Step 5: Forward completed form together with a First Medical Report (if
available) to your
Regional office of the Federated Employers Mutual Assurance Company LTD (FEM)
With whom you have insured your
liability in terms of the compensation for occupational injuries and diseases
act, 1993.
See Reverse Part B Page 1 for addresses.
The employer is liable for the payment of compensation for the first three
months from the date of the occupational injury.
The compensation paid by the employer shall be reimbursed by the FEM.
Upon receipt of the
Employer's Report
of an Occupational injury and a
First Medical Report,
the claim will be considered
If
liability cannot at that stage be accepted an acknowledgement will be addressed
to the employer, providing the claim number allocated.
N.B. EMPLOYERS ARE REQUESTED TO QUOTE THIS NUMBER IN ALL CORRESPONDENCE WITH FEM
RELATING TO OCCUPATIONAL INJURY.
This will greatly facilitate the filing of correspondence and relevant documents
on
The basic information to identify a claim is as follows:
The registered trade name and registration number as registered with FEM.
The full names and surname of the injured employee (not nicknames).
The employee's identity number/personnel number and date of birth.
The date the occupational injury was sustained.
The above mentioned information is captured on the computer and any
discrepancies
It
is a disease arising out of and contracted in the course of an employee's
employment and which is listed in Schedule 3 to the Act.
An
employer must within 14 days after he gained knowledge of an alleged
occupational disease complete an
“Employer's
Report of an Occupational Disease form1 and
form2” and
forward it to your Regional office
of the Federated Employers Mutual Assurance Company LTD (FEM)
The commencement of the disease shall be the date on which the doctor first
diagnosed the illness.
Dispatch of further documents
Occupational Injuries (ACCIDENTS)
When the First Medical
Report was not posted together with the employer's report of an occupational
injury, it must be obtained without delay and submitted to FEM. In cases of
prolonged absence, a
Progress Medical
report must be obtained monthly from the practitioner and submitted. When
the employee resumes work, a
Resumption Report must
be completed and submitted to FEM together with the
Final Medical
Report.
The Employer's Report of an Occupational Injury must not be kept in abeyance
awaiting the medical report.
The medical reports must not be kept in abeyance until the employee's condition
has stabilized or when he has resumed work.
Fatal Occupational Injuries (ACCIDENTS)
If
the accident resulted in the employee's death, documentary proof indicating the
cause of death must be submitted without delay to your Regional office
of the Federated Employers Mutual Assurance Company LTD (FEM). |