Occupational accident insurance
If you are the victim of an accident at work or on the way to work, it is the work accident insurance that intervenes for the compensation.
What costs does work accident insurance cover?
to indemnities for your incapacity for work in compensation for the loss of salary suffered;
of reimbursement of your medical expenses following the accident (including the costs of surgical, pharmaceutical, and hospital care and prostheses);
What to do after an accident at work?
If someone witnessed your accident, you should ask them for their contact details so that you can call on them as a witness later. You will thus have additional proof of your accident at work.
Then, you must notify your employer as soon as possible, even if your accident does not prevent you from working. The employer must declare the accident within eight days of its occurrence.
Request a medical certificate from your attending physician.
Who should take out work accident insurance?
The insurance against accidents at work is compulsory insurance payable by the employer. He must take it out with an insurance company approved for this risk. It cannot have a retroactive effect.
Even an individual can be an employer. This is the case when he employs housekeepers. For all information on householders insurance.
Unlike the private sector, there is no compulsory work accident insurance in the public sector, where there is a free choice to take out insurance yes or not.
What is a work accident?
There must therefore be an “accident”, namely a sudden event;
which produces an injury (resulting in an incapacity for work or medical costs or the death of the worker).
And that this accident happened
during the performance of the employment contract
and by the fact of the execution of the employment contract
The sudden event is the determining criterion for the concept of a work accident. It distinguishes the work accident from the disease and in particular from the occupational disease.
The injury can be physical or mental.
The accident must occur during the performance of the employment contract. This is the case when the worker is at the time of the accident under the authority of his employer. At least under his ‘virtual’ authority: for example an accident during a company party.
The accident can occur at the place of work, or on the way between two different places of work.
What is an accident on the way to work?
Necessary and reasonably justifiable detours are part of the normal route.
The detour or interruption does not necessarily exclude the notion of a working path. It is according to the importance of the detour or the interruption and the reason for the detour or the interruption that the journey will keep its normal character or not.
There are also assimilations to the notion of the work path.
When finding workers’ compensation insurance is difficult
It happens that employers, confronted for example with an exceptionally high risk of accident at work, cannot find accident at work insurance.
The insurance sector has provided a solution: the Committee for Risks Difficult to Place in Workplace Accidents RDPAT Committee). All approved occupational accident insurers are part of it and together take on the financial risk of this Committee. They thus enable these employers to pursue their economic activity by their legal obligations and without incurring significant criminal penalties.
Work accident insurance and small statutes
Since January 1, 2020, work accident insurance has applied in the event of an accident under the minor statutes. The objective of the legislator was to protect the trainee.
By doing their internship, these young people or the unemployed are not in the performance of a real employment contract.
Since January 1, 2020, things have changed this insurance, unlike common law accident insurance, is a social security scheme subject to the control of the Federal Agency for Occupational Risks (Ferris). The control mission granted to this agency includes the control of the insurance obligation and the ratification of the indemnification agreements.
The law of December 21, 2018, on various social provisions extended the scope of the law of April 10, 1971, on accidents at work (private sector) and the law of July 3, 1967, on accidents at work in the public sector, to said young or unemployed persons whose internship is provided for within a legal framework.
Is my internship well covered by my employer’s accident insurance?
Training with the obligation to carry out practical internships in companies is generally organized in texts emanating from the Regions or the Communities of the country (six different sources of law).
You had to be a specialist in the field to be able to draw up a list for the whole kingdom.
The integration of small statutes into the accident at work insurance scheme resolved this difficulty.
The Federal Agency for Occupational Risks (Fedris) has been legally responsible for drawing up a list of the small statutes concerned and keeping it up to date.
Who must ensure the trainee?
The general principle stipulates that it is the employer (the company) which must take out insurance for the benefit of the trainee.
The person or organization considered as the employer must not only take out insurance against accidents at work but also declare the trainee to the ONSS (even if he is not subject to it) through the Dimona (immediate declaration). You will find the instructions of the NSSO on this subject via the following links.
Which compensation scheme?
Before the application of the work accident insurance, the content of the insurance provided for each of these courses was not always the same. This raised many questions and insecurity.
The integration of minor statutes into the work accident insurance scheme solved this lack of harmonization