In case of a work-related accident occurred, the injured employee may refer his/her claim for compensation of the damages caused, against the employer, the insurer under the compulsory insurance for the risk “Work-Related Accident” or the insurer under the “Motor Third Party Liability Insurance” (in event of road traffic accident) or against the person, who caused the damages.
However, the injured employee is entitled to disbursement only from one of the responsible parties, insofar as otherwise the principle of unjust enrichment will be infringed.
The damages that should be compensated are the same, even in case of more than one responsible person, either responsible for their own act/omission or for that of a third party. Therefore, the liability of each of them individually and collectively should not exceed the actual amount of the damage suffered by the act/omission.
The employer and the insurer are responsible for third party actions, wherefore their liability has a warranty character. Consequently, the scope of their liability is limited to the amount of compensation due by the person, who caused the damages.
However, in the case of the agreed sum insured (limitation of liability of the insurer), he/she is liable only within that sum.
If the insurer under the compulsory insurance has paid compensation to the injured party, based on an agreement in which the latter has stated that the damage was fully compensated, the injured party would not be entitled to disbursement from the person, who caused the damages. In this case, the injured party may receive payment only for the damages which weren`t compensated – those damages that are not covered by the agreement. These damages should be either new or of another type. If the amount agreed is limited to the sum insured under the insurance (limit of the liability of the insurer), the injured employee will also be able to claim compensation for the difference to the actual damages suffered.
Adhering to this basic principle, the legislator has provided that the compensation due in case of work-related accident amounts to the difference between the damages caused – intangible and tangible, including the loss of profit, and the compensation and/or the pension from the Social Insurance.
Also, this compensation should be reduced with the sums received under the concluded insurance agreements. This provision refers to the sums, received under the compulsory insurance for the risk “Work-Related Accident”, which was concluded by the employer, in favor of his employees. If the injured employee has received compensation by the insurer under the “Motor Third Party Liability Insurance”, which was concluded by the person, who caused the damages (in case of road traffic accident), the sums received should be also deducted from the compensation due.
If the claim against the employer concerns only intangible damages, the compensation received from the social insurance should not be deducted from the amount of the compensation (for intangible damages), due to the employer. This stems from the fact that the goal of these compensations is not to cover the same interest, as far as the compensation under the social insurance aims to cover the suffered tangible damages – loss of profit from remuneration, but not the intangible ones.
Due to the voluntary and personal nature of both “Life Insurance” and “Accident Insurance” (either concluded by the injured party or by the employer as group insurance), the insurer should pay the agreed sum to the injured employee no matter if he/she has already received compensation from the employer, the insurer under the compulsory insurance or the person, who caused the damages. Also, if the insured party has received payment under such insurance before receiving disbursement from any of the other responsible parties, the sum paid should not be deducted from the other compensations due. This is due to the fact, that both “Life” and “Accident” insurance do not have a direct compensatory effect, so far as in case of a work-related accident, the insurer owes only a pre-agreed sum, but not a compensation for the real damages caused.
The employer won`t cease to be liable if the injured employee has referred his claim against one of the other responsible parties – the insurer under compulsory insurance or the person, who caused the damages. He/she will be exempted from this liability only if the injured party has already received payment from one of the other parties. If the damages haven`t been compensated entirely by the insurer under the compulsory insurance due to the limitation of his liability, the injured party may claim the difference up to the whole amount of the damages suffered.
Employer`s rights in case of payment of the compensation
If the employer pays the compensation due, he/she shall be subrogated in the rights of the injured party or his/her heirs, against the person who caused the damages, if any.
In case that the injury was caused intentionally by the claimant, the employer is not responsible for the damages caused, but if the accident was caused by the gross negligence of the injured party, the employer`s liability should be reduced accordingly.
However, there are cases in which the work-related accident occurs as a result of the act/ omission of a third party, who is often another employee. There may also be a situation where there is no employment relationship between the person, who caused the damages and the employer.
In both cases, the employer has the right to sue the person, who caused the damages – be it under the terms of the Labor Code when it concerns another employee or under the general provisions of the Obligations and Contracts Act. Thus, if the employer pays the compensation, he/she can claim this amount from the person, who caused the damages.
According to the well-established court practice, the employer doesn`t have a claim against the insurer under the compulsory insurance for the risk “Work-Related Accident”. According to the Insurance Code and the Ordinance on the compulsory insurance of employees for the risk “Work-Related Accident”, the sum agreed in the policy should be paid to the injured employee (in which favor the insurance has been concluded) or to his/her heirs – in case of death.
That`s why the employer has the obligation to provide to the employees the whole information concerning the insurance and the way to exercise their insurance rights.
If the work-related accident is a road traffic accident and the employer pays the compensation due to the injured party, he/she can claim the amount paid from the insurer under the compulsory “Motor Third Party Liability Insurance”, who has refused to pay the due insurance compensation or hasn`t paid the whole amount.