Applications for indemnification for compulsory insurance for construction site personnel in Vietnam

Applications for indemnification for compulsory insurance for construction site personnel in Vietnam (Internet image)

Regarding this issue, LawNet would like to answer as follows:

1. Applications for indemnification for compulsory insurance for construction site personnel in Vietnam

The insurer shall cooperate with the policyholder, the insured and relevant agencies, organizations and individuals in collecting adequate documents to make an application for insurance claims. The application for claim for compulsory insurance for construction site personnel:

- A claim form completed by the policyholder.

- Documents concerning the insured including:

= Insurance policy, insurance certificate, employment contract signed between the insured and the employee involved in a labor accident or occupational disease, timesheet.

= Claims form concerning the employee’s labor accident or occupational disease (if any).

- Documents proving that the employee is injured or dead due to a labor accident (Certified true copy from the original or copy verified by the insurer after being compared with the original):

= A record of labor accident investigation made by a competent agency in accordance with law (if any). In case the employee is involved in a traffic accident which is determined to be a labor accident, there must be a traffic accident record or a scene investigation record and a diagram of the scene of the traffic accident prepared by competent agencies in accordance with law.

= Depending on the extent of damage to life, one or more of the following documents may be included: Written proof of injury; hospital discharge paper; Certificate of surgery; Medical record; Extract of death certificate or death notice or written certification of a police agency or examination results of a forensic examination agency.

= A minute of assessment of the level of working capacity impairment made by the Medical Assessment Council in case the employee has a working capacity impairment of 5% or more (if any).

= Valid invoices and vouchers of healthcare facilities proving the employee's treatment of injury caused by a labor accident.

- Documents proving that the employee is injured or dead due to an occupational disease:

= A record of measurement of environmental hazards within the prescribed time limit made by a competent agency, in case the record is used for more than one person, the application of each employee must contain an extract (if any).

= A hospital discharge certificate (in case of non-treatment at the hospital, an occupational medical examination certificate is required) or an occupational disease consultation slip; Medical record; Extract of death certificate or death notice (in case the employee is dead).

= A minute of assessment of the level of working capacity impairment made by the Medical Assessment Council in case the employee has a working capacity impairment of 5% or more (if any).

= Valid invoices and vouchers of healthcare facilities proving the employee's treatment of injury caused by an occupational disease.

- Documents proving indemnities that the construction contractor has provided to the employee for their covered injury or death due to occupational accidents and occupational diseases.

- Other relevant documents (if any).

(Article 53 of Decree 67/2023/ND-CP)

2. Principles of indemnification for compulsory insurance for construction site personnel in Vietnam

An insurer shall consider and settle an insurance claim according to regulations of law on insurance business and the following principles:

- When a labor accident or occupational disease occurs for construction site personnel, the policyholder shall cooperate with the insurer in settling the insurance claim as follows:

= Immediately notifying the insurer via contract information means, then submit a written notification to the insurer within 14 days from the date on which such accident or disease happens to the construction site personnel.

= Implementing all measures within their capacity to minimize damages.

= Implementing and allowing the insurer to implement necessary actions and measures or agreeing to the request of the insurer in order to protect entitlements of the insurer after providing indemnity for covered losses according to regulations herein.

- When a labor accident or occupational disease occurs for construction site personnel, the insurer shall guide the policyholder and cooperate with the policyholder and relevant agencies, organizations and individuals in collecting sufficient documents to make an application for insurance claims; determine the cause and extent of damage.

- When an employee is dead or injured due to a covered labor accident or occupational disease arising from construction on the construction site, the insurer shall pay amounts agreed upon between the construction contractor and the employee or the employee's legal representative (in case the employee is dead), including the following payments:

= The allowance for leaving work during the treatment period prescribed by the treating doctor which is calculated based on the employee’s salary according to the employment contract but not exceeding 6 months' salary in each insured event.

= Actual medical expenses including emergency expenses, necessary and reasonable inpatient and outpatient treatment expenses.

= In case the employee has a working capacity impairment of less than 81%, the specific coverage rate for each type of injury or damage to life shall be determined according to the Schedule of compulsory insurance indemnities for construction site personnel according to Annex VII enclosed with Decree 67/2023/ND-CP.

= In case the employee is dead or has a working capacity impairment of 81% or more, the insurer shall pay VND 100 million to one employee in one case.

The total insurance indemnity as prescribed at Points a, b, c and dd, Clause 3, Article 52 of Decree 67/2023/ND-CP shall not exceed VND 100 million per employee per case in case the maximum coverage is VND 100 million.

- In case a labor accident or occupational disease arising causes injury to the employee and this injury is aggravated by previous injuries or diseases, the insurer is not responsible for providing indemnity for such aggravated part.

(Article 52 of Decree 67/2023/ND-CP)

Ho Quoc Tuan

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