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Dokumen Polisi Pampasan Pekerja

WORKMEN’S COMPENSATION POLICY

FOR NON - CONSUMER INSURANCE CONTRACTS (INSURANCE FOR PURPOSE RELATED TO THE INSURED'S TRADE, BUSINESS OR PROFESSION)

This Policy is issued in consideration of the payment of premium as specified in the Policy Schedule and pursuant to the answers given in the Insured’s Proposal Form (or when the Insured applied for this insurance) and any other disclosures made by the Insured between the time of submission of the Insured’s Proposal Form (or when the Insured applied for this insurance) and the time this contract is entered into. The answers and any other disclosures given by the Insured shall form part of this contract of insurance between the Insured and Pacific & Orient Insurance Co. Berhad (hereinafter called “the Company”). In the event of any pre-contractual misrepresentation made in relation to the Insured’s answers or in any disclosures made by the Insured, it may result in avoidance of the Insured’s contract of insurance, refusal or reduction of the Insured’s claim(s), change of terms or termination of the Insured’s contract of insurance.

This Policy reflects the terms and conditions of the contract of insurance as agreed between the Insured and the Company.

WHEREAS THE Insured carrying on the Business described in the Schedule and no other for the purpose of this insurance by a proposal and declaration  which  shall  be  the  basis   of   this   contract   and   is   deemed   to   be   incorporated   herein   has   applied   to   the   PACIFIC & ORIENT INSURANCE CO. BERHAD thereinafter called “the Company” ) for the insurance hereinafter contained and has paid or agreed to pay the premium as consideration for such insurance.

NOW THIS POLICY WITNESSETH that if at any time during the Period of Insurance any employee in the Insured’s immediate service shall sustain personal injury by accident or disease arising out of and in the course of his employment by the Insured in the Business and if the Insured shall be liable to pay compensation for such injury either under the Law(s) set out in the Schedule or at Common Law then subject to the terms exceptions and conditions contained herein or endorsed hereon the Company will indemnify the Insured against all sums for which the Insured shall be so liable and will in addition be responsible for all costs and expenses incurred with its consent in defending any claim for such compensation.

PROVIDED ALWAYS that in the event of any change in the Law(s) or the substitution of other legislation therefore this Policy shall remain in force but the liability of the Company shall be limited to such sum as the Company would have been liable to pay of the Law(s) had remained unaltered.

EXCEPTIONS


The Company shall not be liable under this Policy in respect of:

  • Any injury by accident or disease directly attributable to war invasion act of foreign enemy hostilities (whether war be declared or  not) civil war mutiny insurrection rebellion revolution or military or usurped power.
  • The Insured’s liability to employees of contractors to the Insured.
  • Any employee who is not a “workman” within the meaning of the Law(s).
  • Any liability of the Insured which attaches by virtue of an agreement but which would not have attached in the absence of such agreement. 
  • Any sum which the Insured would  have been entitled to recover from any party but for and agreement between the Insured and  such party.
  • Any liability of whatsoever nature directly or indirectly caused by or contributed to by or arising from (i) nuclear weapons material (ii) ionising radiations or contamination by radioactivity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel and for the purposes of this exception combustion shall include any self-sustaining process of nuclear fission.

CONDITIONS

1.This Policy and the Schedule shall be read together as one contract and any word for expression to which a specific meaning has been attached in any part of this Policy or of the Schedule shall bear such specific meaning wherever it may appear.

2. Every notice or communication to be given or made under this Policy shall be delivered in writing to the Company.

3. The Insured shall take reasonable precautions to prevent accident and disease and shall comply with all statutory obligations.

4. In the event of any occurrence which may give rise to a claim under this Policy the Insured shall as soon as possible within 14 days give notices thereof to the Company with full particulars. Every letter claim writ summons and process shall be notified or forwarded to the Company immediately on  receipt. Notice shall also be given to the Company immediately the Insured shall have knowledge of any impending prosecution inquest or fatal enquiry in connection with any such occurrence as aforesaid.

5. No admission offer promise or payment shall be made or on behalf of the Insured without the consent of the Company which shall be entitled if it so desires to take over and conduct in his name the defence or settlement of any claim or to prosecute in his name for its own benefit any claim for indemnity or damages or otherwise and shall have full discretion in the conduct of any proceedings and in the settlement of any claim and the Insured shall give all such information and assistance as the Company may require.

6. The first premium and all renewal premiums that may be accepted are to be regulated by the amount of wages and salaries and other earnings paid by the Insured to employees during each Period of Insurance. The name of every employee together with the amount of wages salary and other earnings shall be properly recorded and the Insured shall at all times allow the Company to inspect such records and shall supply the Company with a correct account of all such wages, salaries and other earnings paid during any period of Insurance within one month from the expiry date of such Period of Insurance. If the amount so paid shall differ from the amount on which premium has been paid the difference in premium shall be met by a further proportionate payment to the Company as the case may be.

7. The Company may cancel this Policy by sending seven days notice by registered letter to the Insured at his last known address and in such event the premium shall be adjusted in accordance with Condition 6.

8. All differences arising out of this Policy shall be referred to the decision of an Arbitrator to be appointed in writing by the parties in difference or if they cannot agree upon a single Arbitrator to the decision of two Arbitrators one to be appointed in writing by each of the parties within one calendar month after having been required in writing so to do by either of the parties or in case the Arbitrators do not agree of an Umpire appointed in writing by the Arbitrators before entering upon the reference. The Umpire shall sit with the Arbitrators and preside at their meetings and the making of an Award shall be a condition precedent to any right of action against the company. If the Company shall disclaim liability to the Insured for any claim hereunder and such claim shall not within twelve calendar months from the date of such disclaimer have been referred to arbitration under the provisions herein contained then the claim shall for all purposes be deemed to have been abandoned and shall not thereafter be recoverable hereunder.

9. The due observance and fulfillment of the terms conditions and endorsements of this Policy so far as they relate to anything to be done or not to be done by the Insured and the truth of statements and answers in the Proposal shall be conditions precedent to any liability of the Company to make any payment under this Policy.

10. The Company shall not be liable in respect of any accident or disease occurring before the actual receipt of the premium by the Company or its authorized agents or in respect of any accident or disease occurring after the date of expiry and before the actual receipt of the premium for renewal.

PREMIUM WARRANTY

It is a fundamental and absolute special condition of this contract of insurance that the premium due must be paid and received by the insurer within sixty (60) days from the inception date of this Policy / Endorsement / Renewal Certificate.

If this condition is not complied with then this contract is automatically cancelled and the insurer shall be entitled to the pro rata premium for the period they have been on risk.

Where the premium payable pursuant to this warranty is received by an authorized agent of the insurer, the payment shall be deemed to be received by the insurer for the purposes of this warranty and the onus of proving that the premium payable was received by a person, including an Insurance Agent, who was not authorised to receive such premium shall lie on the insurer.

IMPORTANT NOTICE

Your attention is drawn to the 60 days premium warranty attached to the policy.

By this warranty, the insurance policy is automatically cancelled unless the full premium is paid to the insurer within 60 days from the commencement date of cover. Plese note that if this insurance is transacted through your insurance broker, the broker is acting on your behalf for the purpose of formation of this contract of insurance. It is important that you make full payment of the premium to your broker as soon as possible and in any case within the 60 days period of the premium warranty so as to enable your broker to remit the premiums early to your insurer. You are advised to request your broker to furnish you with the broker’s and insurer’s receipt on the premium that you paid.

WARRANTY 231 / WARANTI 231

Notwithstanding anything stated to the contrary in this policy, and subject to Condition 6 being deleted it is understood and agreed that if the wages herein stated are less than the actual wages (as defined in the Workmen’s Compensation Ordinance currently in force) paid for payable to the workmen hereby insured corresponding to the period of insurance, the liability of the Company in respect of any claim under this Policy shall be proportionately reduced and the insured shall be considered as his own insurer for the difference.

UNLESS OTHERWISE STATED HEREIN POLICY CONDITION 6 IS DEEMED TO BE DELETED.

WARRANTIES, EDNORSEMENTS AND CLAUSES

The following Warranties, Endorsements and Clauses are not applicable unless specified in the schedule.

3P11 VOLUNTARY WORKMEN’S COMPENSATION ENDORSEMENT 

It is hereby declared and agreed that the insurance under this policy shall extend to cover employees who are registered with and contributing to the employees social security act 1969 (SOCSO). In the event of any claim for employment injury, the company agrees to indemnify the insured employee for such amounts as the insured would have been obliged to pay by way of compensation under the workmen’s compensation ordinance 1952 (including its subsequent amendments), without the need for a labour assessment report from the government labour office. It is however agreed and noted that the insurance provided by this policy shall not be construed by the insured as an exemption to comply with any statutory obligation, including registration of employees with the social security scheme (SOCSO) where applicable.

3P20 LIMIT ON COMMON LAW LIABILITY (RM1,000,000.00) 

It is hereby declared and agreed that notwithstanding anything contained in this policy to the contrary, the limit of indemnity for the insured’s liability at Common Law shall be limited to Ringgit Malaysia One Million only (RM1,000,000.00) each and every accident and in all during the period of this insurance.

3P21 JURISDICTION CLAUSE 

Notwithstanding anything contained herein to the contrary it is agreed that the indemnity provided herein shall not apply to:-

i) Compensation for damages in respect of judgements delivered or obtained in the first instance otherwise then by a court of competent jurisdiction within Malaysia.

ii) Cost and expenses of litigation recovered by any claimant from the insured which are not incurred and recoverable in Malaysia.

3P23 WORKAWAY RISK CLAUSE 

The Policy is extended to include the Insured’s liability as within defined in respect of accidents to employees working abroad on temporary assignments, provided that any compensation or benefit arising therefrom must abide by the Malaysian or Singapore or Brunei Statutory Law and Jurisdiction.

WARRANTY 1 / WARANTI 1

ENDORSEMENT “A” & “B” – LIABILITY AGAINST GOVERNMENT OFFICERS (GOVERNMENT CONTRACTS)

Endorsement A 

It is hereby understood and agreed that in the event of any workmen employed by the within insured or by the insured’s Contractors as referred to in Endorsement “B” herein or any dependent of such workmen, bringing or making a claim under the Workmen’s Compensaton Ordinance in force in Malaysia against any officer of the Government of Malaysia or any state thereof for personal injury or disease or death sustained whilst at work on any Contract covered by the terms and conditions of the within Policy which the Insured may be carrying out for the said officer or Government, the company will indemnify the said officer against such claim, and any costs and charges and expenses in respect thereof. Provided always that the Company shall be entitled to have the sole conduct and control of all proceedings connected with claims covered by this endorsement, nothing in the endorsement shall be construed as affecting the Insured’s right to recover damages in any other way under this said Ordinance.

Endorsement B 

It is hereby understood and agreed that the indemnity herein granted is intended to cover legal liability of the Insured to workmen in the employment of Contractors performing work for the Insured while engaged in the business and occupation in respect of which the within policy is granted but only so far as regards Claim under the Workmen’s Compensation Ordinance in force in Malaysia.

WARANTY 60 – SUB-CONTRACTORS’ WORKMEN

It is hereby understood and agreed that subject otherwise to the terms, Exceptions and Conditions of the Policy the indemnity herein granted is extended to cover the legal liability of the Insured to workmen in the employment of sub-contractors performing work for the Insured while engaged in the business and occupation in respect of which the within policy is granted, but only so far as regards claim under including subsequent amendments to the said Ordinances and Enactmant passed prior to the date of this endorsement.

WARANTY 76 

ORDINANCE COVER FOR “NON-WORKMEN” 

In consideration of premium being paid on the total earnings of all employees not being workmen within the meaning of the workmen compensation ordinance it is hereby agreed that the Company will not in the event of any accident arising out of and in the course of employment to any such employee whilst engaged in the service of the Insured as set forth in the said Schedule raise the defence that such employee is not a workman within the meaning of the aforesaid Ordinance.

Subject otherwise to the terms and conditions of the within Policy.

WARANTY 77 

COMMON LAW EXTN. TO “NON-WORKMEN” 

In consideration of premium being paid on the total earnings of the employees described in the Schedule hereunder, not being workmen as defined in the workmen compensation ordinance it is hereby agreed that the within Policy is extended to indemnify the Insured in respect of his liability at Common Law for accidents to such employees arising out of and in the course of employment.

Subject otherwise to the terms and conditions of the within Policy.

Disputes can be referred to: Ombudsman for Financial Services (OFS) (Formerly known as Financial Mediation Bureau) Tel No : 03-2272 2811