Everything you need to know about occupational accident insurance
Suffering an accident at work is something nobody wants, but the truth is that it can happen at any time. Knowing how to act and what your rights are can make all the difference, whether you’re in an office, teleworking or even on the way to work. What is considered an accident at work? According to Law 98/2009 an accident at work is any event that occurs at the workplace and during working hours, causing bodily injury, functional disturbance or illness. These incidents can lead to a reduction in the worker’s working or earning capacity or, in more serious cases, result in death. The law also covers accidents that occur during work-related travel, such as the journey between home and the workplace. Occupational accident insurance exists to ensure that workers have access to the necessary medical care and that they receive adequate compensation in the event of temporary or permanent incapacity resulting from an accident at work or a condition associated with the exercise of their profession (occupational disease). And what is the “workplace”? Don’t be fooled if you think it’s just the office or the factory. The law includes all the places where workers must be in order to fulfill their contractual obligations, as long as they are under the employer’s control. And “working time” also covers more than you might think: it includes the moments of preparation before starting work, breaks such as lunchtime and the journey to and from work. Is occupational accident insurance compulsory? Yes, all companies are required by law to have occupational accident insurance for all employees. This insurance serves to ensure that the employee receives the necessary medical care and financial compensation in the event of temporary or permanent incapacity. If the company does not take out this insurance, it is committing a very serious offense. And, in the event of an accident, you will be responsible for covering all the costs with your own capital. How does occupational accident insurance work? Initial medical diagnosis: after the accident, the doctor assesses the worker’s condition and determines the need for time off work Communication to the insurer: the employer must communicate the accident and sick leave to the insurer Medical care: the worker will have the right to continuous medical care and necessary treatment until recovery Financial compensation: during sick leave, the work insurance ensures the payment of compensation, which varies according to the degree of incapacity (temporary, partial or absolute). And what does it cover? In practical terms, if you have an accident on site or during working hours, the insurance will cover you: Medical and hospital care: includes treatments, surgeries, consultations and examinations necessary for the worker’s recovery Medicines and pharmaceutical expenses: all costs related to the worker’s health resulting from the accident are borne by the insurer Transportation and accommodation expenses: if the worker needs to travel for treatment or stay outside their place of residence, these expenses are included Psychological support for the family: if necessary, psychotherapeutic support can be provided to the injured worker’s family. In addition to health care, the insurance also provides financial compensation that varies according to the degree of disability, which can be temporary or permanent, and includes daily indemnities or pensions for life. See below. How much do you get in employment insurance? The amount of compensation varies according to the type and degree of disability resulting from the accident. Temporary partial incapacity: daily compensation of 70% of the loss of earning capacity Absolute temporary incapacity: 70% of salary in the first 12 months and 75% in the following period Partial permanent disability: annual pension equivalent to 70% of the reduction in earning capacity Absolute permanent disability: lifetime pension of 80% of the salary, plus 10% per dependant (up to the limit of the salary). If the accident results in death, pensions are payable to the spouse, children and other family members, with amounts varying according to the degree of kinship. What if I’m teleworking? Am I entitled to insurance? Yes, even teleworking is protected by occupational accident insurance. However, it is necessary that the accident: Occur at the place indicated as your workplace (usually your home) It takes place during working hours and within the scope of the duties performed. It is recommended that teleworking arrangements be formalized and communicated to the insurance company, with information such as the place of work, working hours and duties performed. Accident insurance for self-employed workers? According to Decree-Law no. 159/99, of May 11, self-employed people are also obliged to take out occupational accident insurance. Those who work on green receipts are also obliged to take out this insurance. If you don’t have compulsory insurance, you could face fines of between 50 and 500 euros. Industrial accident leave: what it is This is the period of time off work given to a worker who has suffered an accident at work and is temporarily unable to perform their duties. To formalize this leave, a document is issued certifying the worker’s illness or inability to carry out their professional activity. Is sick leave for accidents at work the same as NHS sick leave? No. Although both schemes offer support in the event of temporary incapacity for work, there are important differences: SNS sick leave (also known as Temporary Incapacity Certificate – CIT) is issued by authorized entities (health centers, hospitals or permanent care services) and is applicable to illnesses or accidents outside the work context, being paid by Social Security The sick leave for accidents at work applies exclusively to accidents at work and is issued by the treating doctor appointed by the insurance company responsible for monitoring the clinical case. The whole process is managed and guaranteed by the insurance company contracted by the employer. What to do in the event of an accident at work? Prioritize your health and safety. Call the emergency medical services or go to the nearest hospital for first aid Inform the employer. Report the accident verbally or in writing within 48
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