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Wednesday, March 10, 2010

INCIDENT OF HEART ATTACK AND LIABILITY OF INSURER UNDR WC ACT

Dear (s) - WC Act is all about compensation for accident at work place which is stressful.



Human heart provides continuous blood circulation and is one of the most vital organs of the body. One of the high causes of death is heart attack. To an Insurer, claims arising out of heart attack are very common and quite frequently the question crops up as to whether a heart attack would lead to a WC claim. There have been common instances where the driver or cleaner or coolie of a truck suddenly develops chest pain whilst on the truck, taken to hospital unfortunately dies. A claim would be preferred before the WC Commissioner for compensation for death.


Heart attack is a commoners term – in medical parlance it is known as Myocardial infarction (MI) – interruption of blood supply to part of the heart, causing some heart cells to die. This is mostly block of coronary artery causing ischemia (restriction in blood supply) and oxygen shortage, which left untreated can cause death. The heart muscle is living and needs food and oxygen to survive. There are arteries within the heart muscle which supply the food and oxygen to the heart muscle. These arteries are known as coronary arteries. When one or more of these arteries in the heart get narrowed, or partially blocked, then it leads to coronary artery disease. When one or more of these arteries get blocked then some part of the heart muscle does not get food and oxygen. This condition is called a heart attack. This is no attempt on a medicinal piece but on WC (Employers Liability for Compensation)

myocardial infarction


Sec 3 of the WC Act 1923 reads “ If personal injury is caused to a workman by accident arising out of and in the course of his employment, his employer shall be liable to pay compensation in accordance with provision of this Chapter”. The section talks of : personal injury, accident, employment and compensation. The word accident is not clearly defined legally. In common parlance, it means any unintended and unexpected occurrence which produces hurt or loss. The word accident is also often used to denote both the cause and the effect, no attempt being made to discriminate between them. The great majority of what are called accidents are occasioned by carelessness. Again commonly it connotes something occurring externally. A rupture, failure of muscular action of heart, exertion, shock are internal and generally not classified as accidents. Whether external or internal, there should be some happening at a definite point of time resulting in some incapacity.


Recently, the Apex Court reiterated its exalted opinion on the need for a causal connection between heart attack and the death for claiming compensation under Workmen Compensation Act. This judgment came in Civil Appeal No. 1638 of 2010 – the appellant being Rashida Haroon Kupurade and one of the respondents being Oriental Insurance Co Ltd. Once a policy is taken the vehicle owner seldom cares to know of the claim was once again demonstrated at none of the respondents chose to oppose the appeal save the Insurer. The appeal was against order of Karnataka High Court (MA 3340/2004) under WC Act 1923 for setting aside the order passed in an appeal filed by the Insurer. The court upon finding that since the deceased workman had died of natural cause (namely a heart attack) exonerated the Insurers finding no nexus between the death of workman and the accident but stated that since the employment was not in dispute fastened the liability on the Employer. The court granted leave for recovering compensation from the owner of the vehicle.


The appellant / owner of the vehicle submitted that the provisions of Sec 3 of WC Act {as quoted earlier} had been wrongly interpreted and that there had to be some link between the accident and the death of the employee in order to attract the proviso of the Act. The Insurers contended that the High Court had correctly held the liability of the Insurer and had exonerated them.


The Apex Court held that when there was no connection of death with the accident, the High court had erred in holding the owner of vehicle as liable. The Court held that it is clear from the wording of the section that compensation would become payable only if the injury is caused to workman by accident arising out of and in the course of employment. There has to be an accident in order to attract the provisions of Section 3 and such accident must have occurred in the course of the workman's employment. When there is no nexus, the order of the High Court is set aside and appeal succeeded. The Judge further held that this order will not prevent the heirs of the deceased Workman from taking recourse to any other legal remedy, if available to them.


In sum and substance, another reiteration of the stand that has uprightly held by Courts in similar circumstances.


With regards - S Sampathkumar.

8 comments:

  1. very well written and intriguing post. thanks author. i would like to say something on injury compensation, The challenge is to come up with an estimated settlement amount that is equally ambitious and reasonable. Personal injury compensation settlement amounts vary strongly from case to case. The defendant's insurance lawyers will certainly try to come up with and $ amount that is as low as possible. So make sure you do your math right. It is recommendable to let a good settlement lawsuit attorney help you with this exercise. They know what you will be likely awarded with, based on your injury, the expenses that already occurred and will occur in the future.

    Here is what the lawyer's of the defendant will do - and this is exactly what you supposed to do, too. Ask yourself these questions: did my work induced injury or disease affect my earnings? Could I have earned more if the incident hadn't occurred? Did my physical appearance get affected and if yes, how severely do I suffer from that emotionally? Basically, all questions that are directly linked to your quality of life before and after the incident are valid and important to be asked.

    ReplyDelete
  2. Dear John, It certainly portrays your insight on the subject at your place. In India, Work men compensation statute has fixed tabulated liability and the computation is based on a) death / injury b) age of the deceased / injured c) salary earned (which again is restricted to Rs.4000/- pm for the purposes of computation. Thus the amount is fixed and does not pay for any medical expenditure. This judgment is more about whether this is an accident and would fall within the purview of the WC legislation.
    Thanks

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