The successful management of each business requires a comprehensive assessment of the risks and taking all necessary measures to prevent them. An accident at work poses a risk to both the employee and / or the employer, since upon its occurrence the latter owes compensation for the tangible and intangible damage suffered by the injured employee. The amount of the compensations, awarded in case of work-related accidents, is often too high, which causes serious financial difficulties for the company and, in some cases, bankruptcy.
Definition for work-related accident
Pursuant to Art. 55, par. 1 of the Social Insurance Code (SIC), “a work-related accident is any sudden health impairment which has occurred during and in connection with or with regards to the performance of the work, as well as any work performed in the interest of the employer, where the said impairment has caused temporary incapacity for work, permanent disability or death.”
However, these are not the only hypotheses of a work-related accident. Pursuant Art. 55, par. 2 of the SIC, Employment injury shall furthermore be any injury of a person, which has occurred during the usual commuting to or from the working place to: the principal place of residence or to another additional place of residence of a permanent nature; the place where the secured person customarily takes his or her meals during the working day; the place where a remuneration is received.”
The accident is work-related even if it was caused negligently by the employee. The only case in which the Code provides that the accident is not work-related, is when the injured employee intentionally harmed his health.
In case of work-related accident, the employer is responsible for the occurred damages, which has caused temporary disability, permanent disability of 50 and more than 50 percent or death of the employee. It is irrelevant to the occurrence of this liability whether his/her body or any other employee is guilty for the accident.
The employer`s liability for damages can`t be exempted even if the work-related accident, which has occurred during or with regards to the performance of work assigned by the employer or work performed in the interest of the employer, is caused by force majeure.
The employer is responsible for the damage caused to the employee even if the work accident has occurred during a rest, spent in the enterprise.
The employer`s liability covers all tangible and intangible damaged, caused to the employee.
- Tangible damages are the losses suffered (for instance money paid for medical treatment) and the loss of profits (for instance the difference between the gross remuneration and the social security benefits received).
- Intangible damages are the pain and the suffering, which the employee or his/her relatives has suffered. If the injured employee has contributed to the work-related accident, by committing gross negligence, the liability of the employer should be reduced accordingly. According to the well-established court practice, there is gross negligence, when the employee is aware that the harmful effects may occur, he foresaw the abstract possibility of causing the damage, but considered himself capable of preventing them.
Compensations and/or pension by the social insurance due in case of work-related accident
All the employees are mandatory secured against work-related accident, regardless of the nature of the work, the mode of pay, and the source of funding.
The compensation due may vary depending on the consequences of the work-related accident, namely:
- In case of temporary disability, the employee is entitled to compensation under the short-term insurance, which amounts to 90% of the gross remuneration or the average daily insurance income on which basis the insurance contributions have been paid.
- In case of permanent disability of 50 and more than 50 percent, the injured employee is entitled to disbursements under the long-term insurance, namely disability pension due to work-related accident.
In case of death, SIC envisages right of one-off aid and a survivor pension in favor of the spouse, children, and parents of the injured employee.
Compulsory Insurance for the risk ‘work-related accident’
The Insurance for the risk ‘work-related accident’ is compulsory to be concluded as to those employees, who perform work that endangers their lives and health.
The covered insurance risks are:
- death of the insured person;
- permanent disability due to a work-related accident;
- temporary disability due to a work-related accident.
The Ordinance on the compulsory insurance of employees for the risk “work-related accident” (the Ordinance) envisages limits of the insurer`s liability (sums insured), which should be determined on the basis of the monthly gross remuneration of the employees at the moment of the insurance.
It is explicitly provided that the sum insured may not be less than 7 times the annual gross remuneration of the employee concerned. It is important to point out that often in insurance contracts (the policy), insurers exclude their liability for work-related accident, resulting from gross negligence (see paragraph 2) of the employee.
Group Insurance – Life Insurance
According to the Insurance Code (IC), the employee can conclude group insurance. In this case, insured persons are the employees, and the subject-matter of the insurance are their lives, health, bodily integrity and working capacity. In such group insurances, beneficiaries are the employees or their heirs.
Upon the occurrence of the insurance event, the insurer shall pay the amount agreed in the contract to the employee or to his or her heirs.
Motor Third Party Liability Insurance
If the work-related accident results in a road traffic accident, the injured party could direct his/her claim for damages directly against the insurer under the Motor Third Party Liability Insurance, concluded by the person, who caused the damages.
Claim against the person, who caused the damages.
Finally, the injured employee can always claim compensation for his/her damages directly against the person, who caused the work-related accident, if any.
In most cases, the work-related accident is caused by act/omission of another employee.
Based on the above, we can conclude that in the event of personal injury resulting from a work-related accident, the injured employee may refer his/her claim for compensation to any of the above-mentioned persons. Thus, the question arises as to the correlation between the compensations due in the event of a work-related accident.
This issue is addressed in our article on the topic: Correlation between the compensations due in case of work-related accident