Workmen Compensation Insurance Glossary

Workmen Compensation Insurance is a crucial aspect in India when it comes to workplace safety and employee welfare. It protects employers against legal liabilities, and provides prompt assistance to injured workers or their dependents. Workmen Compensation Insurance is a complex and daunting subject, particularly to small business owners, HR professionals, or any person who is faced with a workplace injury claim in India. The policy documents may be full of jargon which may seem like a legal maze. To simplify, we have developed an A to Z list of glossary terms to de-mystify the main concepts and terminologies of the Workmen Compensation Insurance in India. Whether you are a policyholder, employer, or a curious reader, this glossary can be a useful guide you should turn to.

A 

1. Accident – An unforeseen event causing injury or death during employment.
2. Accidental Injury – Physical harm sustained due to a workplace accident.
3. Act Liability – Statutory obligation under the Workmen’s Compensation Act, 1923.
4. Age Factor – Multiplier used to calculate WC insurance compensation based on age (from Schedule IV).
5. Arising Out of Employment – The injury or death must be directly related to the worker’s job.
6. Annual Premium – The yearly payment made by the employer for insurance coverage.
7. Assessment of Disability – Medical evaluation to determine the level of disablement.
8. Artificial Limbs Cover – Insurance coverage for prosthetics in the event of limb loss.

B 

1. Benefits – Compensation or services provided as per the terms and conditions of the insurance policy.
2. Bodily Injury – Physical harm to an employee or worker , caused by an accident at work place.
3. Burden of Proof – Responsibility to prove injury or death occurred during employment.
4. Beneficiary –The individual who is entitled to compensation.
5. Bonus Exclusion – Bonus amounts not included in calculation of wages.
6. Basic Wage –The fixed wage of the employee taken into account in Workmen Compensation Insurance claims.
7. Broken Bone Clause – Particular provision that provides benefits to the employee in case of a fracture..
8. Boarding Allowance –Not to be included in wages unless stipulated on the insurance contract.

C 

1. Compensation – Financial settlement against injury or disability or death.
2. Contract Labour – The workers are hired by the contractors but the employers may still be liable.
3. Commissioner –Government appointed officer who decides WC claims.
4. Claim Settlement –The settlement and payment of a compensation claim.
5. Casual Worker – Non- permanent workers, may or may not be covered by the insurance policy.
6. Cause of Action – Lawful justification of a compensation claim.
7. Coverage Extension –Extra protection beyond the statutory requirements.
8. Cumulative Injury – Recurrent strain injuries over a period of time (e.g. RSI).

D 

1. Death Benefit – Lump sum payment to dependents after a fatal accident.
2. Disability Compensation – Financial aid based on degree of disability.
3. Dependent – Family member(s) eligible to receive benefits.
4. Diagnosis Report – Doctor’s report explaining nature of injury.
5. Doctor’s Certificate – Certifies medical condition and fitness.
6. Disablement – Loss of working capacity due to injury.
7. Deductibles – Part of WC insurance claim borne by insured before insurer pays.
8. Documentation – Wage slips, accident reports, and proof of employment.

E 

1. Employer’s Liability –  the legal responsibility to compensate the workers.
2. Earnings – Regular income that is used to determine the compensation amount.
3. Employee Classification – Classifying workers in terms of risk level.
4. Evidence of Injury –Evidence that the accident took place.
5. Extended Coverage – Optional add-ons to the basic insurance policy.
6. Earning Capacity – Capacity to earn after the injury.
7. Employment Certificate – Confirms the fact that the injured was employed with the insured employer.
8. Exclusion Clause – Circumstances under which the Workmen Compensation Insurance policy is not applicable (e.g. intoxication).

F 

1. Fatal Accident – An accident that causes death.
2. Funeral Expenses –Funeral expenses are covered by some of the Workmen Compensation Insurance policies. They compensate for the expenses incurred by the family for the funeral of the deceased worker. 
3. First Aid Costs – initial treatment costs.
4. Field Worker – Covered in case of an accident during work outside the premises.
5. Factory Act – Laws governing the safety provisions in industrial premises.
6. Fixed Compensation – Amount fixed for compensation for certain injuries.
7. Fraudulent Claim – False or exaggerated Workmen Compensation Insurance claims.
8. Final Settlement – Finalisation of a compensation claim.

G 

1. Grievance Redressal – Mechanism to solve disputes or delays in claim processing.
2. Gross Salary –This is not always applicable in Workmen Compensation Insurance claim computation; basic wage is preferable.
3. Government Notification – Amendments issued by the Government authorities in relation to wage limits, diseases etc..
4. General Exclusions – List of standard events that are not covered by the insurance policy.
5. Good Faith Disclosure – Duty to disclose accurate information  by both the insurer and the insured.
6. Group Policy – insurance providing coverage to more than one employee.
7. Guidewire Injury – Workplace injury or death caused by operating heavy tools.
8. Guidelines – Official claim and conduct procedures.

H 

1. Hospitalisation Expenses – Medical costs during treatment, if covered.
2. Hazardous Work – High-risk tasks requiring additional insurance coverage.
3. Hearing Loss – Occupational condition in noisy workplaces.
4. Health Certificate – Pre-employment document proving medical fitness.
5. Hourly Wage Worker – Compensation based on average hourly income.
6. Hearing with Commissioner – Legal hearing for disputed Workmen Compensation Insurance claims.
7. Hidden Conditions – Pre-existing conditions not disclosed.
8. High Court Appeal – Legal route if dissatisfied with Commissioner’s order.

I 

1. Injury – Physical damage or trauma from a work accident.
2. Incapacity to Work – Medically proven inability to continue working.
3. Inpatient Treatment – Hospitalisation beyond 24 hours.
4. Insurance Certificate – Proof of active WC insurance coverage.
5. Insurable Interest – Employer’s legal interest in protecting employees.
6. Intimation Period – Time limit for reporting the injury or death.
7. Indemnity – Compensation to restore the worker’s financial status.
8. Insurer’s Liability – Financial responsibility accepted by the insurance provider.

J 

1. Jurisdiction – Area where legal action can be started.
2. Joint Employer Liability –Shared liability between more than one employer
3. Job Description – Assists in determining whether the injury or death was work related.
4. Judgement Copy – Copy of order passed by the court or WC Commissioner.
5. Justifiable Claim – A claim that fulfills all the legal requirements.
6. Job Risk Level – Determines Workmen Compensation Insurance premium and policy terms.
7. Judicial Review – Review of judicial decisions in superior courts.
8. Job Role Clarification – Avoids conflicts over the scope of duty.

K 

1. Keyman Cover – cover of high value employees (not common in WC insurance but optional).
2. Knowledge of Incident – When the employer knows about the injury or death caused to an employee.
3. Key Documents – Medical, wage and employment related documents.
4. Knee Injury – A typical injury in the workplace in jobs where physical labour is involved.
5. Known Condition Disclosure – Disclosure of pre-existing illnesses.
6. KYC Compliance –Identity verification of employers by the insurer.
7. Kilocalorie Loss (Fatigue) – Applied in hazardous industry reports.
8. Keep-In-View Cases – Workmen Compensation Insurance claims pending further investigation.

L 

1. Legal Liability – Employer’s responsibility under law.
2. Loss of Earning Capacity – Reduction in ability to earn wages.
3. Leave of Absence – Time off due to injury.
4. Labour Welfare Fund – State funds aiding injured workers.
5. Long-Term Disability – Disability lasting beyond a year.
6. Late Intimation – Delay in reporting can affect claims.
7. Lump Sum Settlement – One-time payment instead of periodic compensation.
8. Loss of Limbs – Major injury leading to permanent disability.

M 

1. Medical Report – A critical document detailing the nature and extent of the injury.
2. Medical Expenses Extension – Optional coverage for hospital bills and treatment costs.
3. Malingering – When an employee exaggerates symptoms to claim compensation fraudulently.
4. Maximum Liability – The highest amount an insurer is liable to pay under the Workmen Compensation Insurance policy.
5. Monthly Wage Calculation – Used in determining compensation as per statutory formula.
6. Manual Labour – Workers involved in physical work; generally higher risk category.
7. Mental Trauma – Psychological injury due to workplace incidents (rarely compensated unless severe).
8. Minor Injury – Injuries that require minimal treatment and time off work.

N 

1. Notice of Accident –This is a mandatory report of injury by the employee to the employer within the specified timelines.
2. Non-Compliance Penalty – Legal penalties that are attracted on failure to comply with the provisions of the WC Act.
3. Nominee –The person to whom the employee wants compensation to be paid in the event of his/her death.
4. Non-Fatal Injury –Injury that does not cause death but may result in temporary or permanent disability
5. Non-Scheduled Injury –Injuries that are not on the compensation schedule and are assessed on a case-by-case basis..
6. Notification of Insurer – Timely reporting of an incident to the insurance company..
7. Notice Period –The stipulated time in which claims are filed or accidents are notified.
8. Non-Renewal Consequences –The risk of being uninsured after the expiry of the Workmen Compensation Insurance policy, which results in employer liability.

O 

1. Occupational Disease – diseases contracted as a result of the nature of employment (e.g., silicosis, asbestosis).
2. Outpatient Treatment – Treatment without the need for hospitalisation.
3. Overexertion –Bodily injury as a result of strain or stress during work.
4. On-Duty Accident –An injury that is suffered during work and under the scope of official duties.
5. Off-Site Work Injury – An injury that occurs during work outside the main premises (e.g. during delivery at client site or during travel).
6. Ongoing Claim –A claim which is under examination or partially settled.
7. Occupational Hazard – Risk associated with the type of job (e.g. construction, mining)..
8. Out-of-Court Settlement – It is a private agreement between the parties to settle claims without going to court.

P 

1. Policy Schedule – The detailed outline of coverage, premium, and terms of the insurance plans
2. Permanent Partial Disablement (PPD) – Permanent but not total loss of earning capacity.
3. Permanent Total Disablement (PTD) – Permanent and complete inability to work.
4. Premium Rate – Cost of the insurance plans, influenced by risk type and number of employees.
5. Proof of Employment – Documents verifying the worker’s engagement with the employer.
6. Policy Period – Duration of insurance coverage, usually one year.
7. Pre-Existing Condition – Health issues prior to employment or policy inception.
8. Proximate Cause – The direct cause of injury that determines liability.

Q 

1. Quantum of Compensation – The calculated amount of compensation as per the Act.
2. Qualified Injury – An injury eligible under WC provisions.
3. Quick Claim Settlement – Fast-track process adopted by some insurers.
4. Quarterly Earnings Data – Used for wage averaging in compensation cases.
5. Qualified Medical Opinion – Specialist report that can impact claim acceptance or rejection.
6. Query from Insurer – Request for additional documents or clarifications during processing.
7. Quality Assurance Report – Internal audits of workplace safety practices.
8. Quasi-Judicial Body – Refers to the WC Commissioner’s authority to pass binding orders.

R 

1. Risk Assessment – Evaluation of the hazards present at the workplace.
2. Return to Work Policy – Guidelines for reintegrating injured workers post-recovery.
3. Rehabilitation Benefit – Insurance coverage for physiotherapy or vocational retraining (optional).
4. Retroactive Cover – Insurance coverage for incidents occurring before policy purchase (rare in WC).
5. Renewal Notice – Reminder issued by insurer before Workmen Compensation Insurance policy expiry.
6. Repetitive Stress Injury – Damage caused by continuous movements (e.g., typing).
7. Resumption Certificate – Declaration by a doctor allowing a worker to return to work.
8. Reimbursement – Repayment for medical costs or funeral expenses.

S 

1. Schedule IV – Wage and age table used for calculating compensation.
2. Schedule of Injuries – List of predefined injuries and corresponding compensation rates.
3. Sum Insured – Maximum amount payable under the Workmen Compensation Insurance policy.
4. Salary Slip – Proof of wages, important for determining compensation.
5. Statutory Coverage – Mandatory insurance coverage defined by law.
6. Safety Measures – Steps taken to prevent workplace injuries.
7. Subrogation – Insurer’s right to recover claim costs from third parties at fault.
8. Sanction Letter – Communication from the insurer approving compensation.

T 

1. Temporary Total Disability (TTD) – Total incapacity to work for a short time.
2. Temporary Partial Disability (TPD) – Partial work ability after injury, expected to improve.
3. Third-Party Administrator (TPA) – Manages claims on behalf of the Workmen Compensation Insurance provider.
4. Treatment Record – Medical documents tracking the recovery process.
5. Timely Intimation – Crucial for claim acceptance; delays can cause rejection.
6. Transport Cost Reimbursement – Optional cover for ambulance or hospital transport.
7. Tribunal Hearing – Legal review in case of employer-insurer-worker disputes.
8. Third-Party Recovery – Recovery of claim amount from third party responsible for injury.

U 

1. Underwriter – Insurance expert who assesses the risk before issuing a Workmen Compensation Insurance policy.
2. Unfit for Duty – Certified medical opinion stating the worker is unable to resume job.
3. Uninsured Employer – Employer without active WC cover, legally liable.
4. Urgent Claim – Priority claim processed quickly due to medical emergency.
5. Upfront Payment Clause – Provision for advance payment in severe injury cases.
6. Unpaid Leave – Leave granted post-injury, often without salary.
7. Unreported Incident – Accidents not disclosed by employee or employer within time limits.
8. Usage of PPE – Relevance of personal protective equipment in WC insurance claims approval.

V 

1. Voluntary Compensation – Payments made even when not legally required.
2. Vocational Training Benefit – Insurance coverage for skill development post-injury.
3. Verification Process – Checks conducted by the insurer before disbursing claims.
4. Valid Claim – Meets all conditions of insurance coverage and timelines.
5. Visiting Employee – Temporary worker from another location—may be covered.
6. Verification Certificate – Validates the employment and accident details.
7. Vehicle Accident During Duty – Covered if the employee was working at the time.
8. Validity Period – Duration for which the Workmen Compensation Insurance policy remains effective.

W 

1. Wages – Includes salary and fixed allowances used for compensation calculation.
2. Work Injury – Any injury sustained while performing work duties.
3. Wage Register – Official document recording employee pay history.
4. Workplace Safety Compliance – Legal responsibility of employer to maintain safety.
5. Waiting Period – Minimum time after injury before claim can be made.
6. Writ Petition – Filed in High Court to challenge lower authority decisions.
7. Weekly Benefit – Periodic compensation paid weekly (if applicable).
8. Witness Testimony – Eyewitness accounts used during legal hearings.

X 

1. X-Ray Report – Diagnostic document often submitted as injury proof.
2. X-Gratia Payment – Voluntary payment by employer out of goodwill.
3. X-Factor Risk – Unpredictable risk element considered during underwriting.
4. X-Employee Claim – Claim from former employee (in case of delayed symptoms).
5. X-Section Injuries – Injuries affecting cross-sectional areas like spine or ribs.
6. X-Policy – Term used in internal insurer code for special-class WC insurance policies.
7. X-Filed Report – Archived case file retrievable on demand.
8. X-Category Job – High-risk job classifications (e.g., scaffolding, blasting).

Y 

1. Yearly Renewal – Annual extension required to maintain insurance coverage.
2. Year of Service – Duration of employment, sometimes considered in benefit calculation.
3. Yielding to Risk – Employer acceptance of known workplace hazards.
4. Youth Worker – Employees under the age of 18; special provisions may apply.
5. Yellow Tag Incident – Minor incidents requiring observation but no compensation.
6. Yoga-Related Injury – Rare but relevant in wellness-centric workplaces.
7. Year-End Statement – Financial summary from insurer for audit/reporting.
8. Your Responsibilities – Policyholder’s obligations like accurate disclosure and timely claims.

Z 

1. Zero Error Filing – Flawless submission of claim forms and documents.
2. Zonal Office – Regional branch of insurer handling claims and policy issues.
3. Z-Category Worker – Top-level or executive category, not always under WC.
4. Zone-Wise Risk Rating – Risk classification based on geographical zone.
5. Zero-Day Claim Processing – Ultra-fast approval for critical cases.
6. Z-Form Certificate – Rare document required in certain legacy policies.
7. Zero Depreciation Clause – Not common in WC but applies in allied insurance plans.
8. Zigzag Work Pattern – Erratic job roles affecting compensation evaluation.

Final Thoughts

It is no longer a burden to understand the fine print of Workmen Compensation Insurance. Now you have this A-Z glossary and have a complete reference tool at your disposal. Every key term is now demystified, including the difference between an accident and Zone-Wise Risk Rating. This glossary is the go-to resource you need when you are an employer who wants to ensure compliance, an HR professional with claims to manage, or an ordinary person who wants to understand the subject matter.

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