Non-compliance leads to compensation non-payment: COID ACT

Compensation non-payment is possible and employers should be ready to face the rejection of some of their claims. However, employers must be informed that there are certain reasons that constitute to a rejection of a claim, the major one being non-compliance to procedures and the Act. Learn more about it below.

Certain terms and conditions govern the processing and payment of claims. Employers must be well aware of such terms.

Compensation non-payment is possible for the following claims and stated below are other conditions that may lead to employers ending up paying the claims, to the employees, out of their own pockets.

• In terms of the COID Act, claims for compensation for pain or suffering will not be approved or paid out.
• The Compensation Authority will definitely conduct an investigation for every incident that a claim is submitted for. If it is found that the employer was non-compliant or was negligent; the Compensation Authority will not pay out for such a claim. Employers will be faced with footing medical, legal and funeral bills out of their own pockets. If a company does not meet the health and safety compliance standards stated in the OHS Act and such non-compliance contributes to an accident, they can get themselves ready to foot the bills for the injured employee. It is for this reason that we have always emphasised the importance of being fully compliant with the OHS Act.

   

• Employers are encouraged to submit the relevant and required documents to the Compensation Authority or they will risk a possibility of the rejection of their claims. The Compensation Authority does not process and pay out claims unless all relevant documentations and the correct forms are used and submitted.
• Funeral costs incurred as a result of the accident are compensated to a determined maximum.
• Compensation non-payment is possible if an employee is found to have been negligent in his duties and caused or contributed to the incident. No compensation will be made unless in the case where the employee has died. In that case, compensation will be paid to the surviving spouse(s) and children up to the age of eighteen (18) years by means of a monthly pension. If a dependent’s child is physically or mentally disabled and unable to earn a living, the pension will be paid until death.
• An injured employee may apply for increased compensation if he/she feels the employer was grossly negligent. Employer may be faced with a civil case if such a scenario occurs.
• Compensation non-payment is possible for a claim where an employer carries out his business chiefly outside the country and his employee is injured whilst temporarily working in South Africa.
• Compensation non-payment is definite if an employee refuses to undergo medical examination or refuses to submit a medical examination report. Also, compensation will not be paid if an employee submits false information. Employers should ensure only the correct information is submitted.
• Compensation may not form part of the estate of a deceased employee. It may not be ceded, pledged, set off against debt or taxed.
• If an employee was involved in an accident and is absent from work for days not exceeding three, no compensation payment will be made for such an employee.

   

  

Claiming does not automatically guarantee that a claim will be paid out. There are many steps and procedures that must be followed. A further investigation will be conducted by the Compensation Authority. If an employer or an employee is found to be at fault and has caused or contributed to the incident, this will result in Compensation non-payment. Registering with the relevant authorities is not a guarantee for compensation as well. Employers should also ensure that they are compliant with all health and safety standards.

Contact MAKROSAFE for assistance with registering with the correct Compensation Authority. We can also effectively handle all the paperwork and procedures for claiming, to help you avoid facing the worst in the worst situation, Compensation non-payment. We boast of a good success rate for almost all the claims we have handled and we ensure claims are paid out immediately when the financial assistance is much needed. Call our Consultants today and let us help you.