6 Awesome Benefits of WIBA Insurance Cover in Kenya

September 8, 2022 BUSINESS INSURANCE

Work injury benefit act insurance (WIBA insurance in Kenya) provides insurance coverage to employees who have suffered an injury or illness during the course of their employment. The scheme is mandatory for all employers in Kenya. This has been made possible by the WIBA Act of 2007.

WIBA insurance is provided for insurance companies in Kenya that have been approved by IRA and these insurance companies need to be approved by the Ministry of Fiance. The expenses cover expenses incurred by the employee due to injury or occupational illness such as:

1. Temporal accidental bodily injury disablement
2. Permanent bodily injury disablement or death
3. Medical expenses
4. Funeral expenses
5. Occupational illness

The Work Injury Benefit Act (WIBA) provides coverage for employees who have suffered an injury or illness during the course of their employment.

Work injury compensation benefits and claim process in Kenya

In this section, we shall be looking at the WIBA Insurance Kenya benefit summary and also the WIBA claim procedure.

Work injury benefits act summary

The summary of the WIBA insurance cover includes 5 major coverages:

1. Death benefit covers death that might arise following an accident or occupational illness as specified by the WIBA Act. This employee needs to be on duty and engaged at the time of death or contraction of the illness.
2. Permanent Total disability which the WIBA Act has a well-indicated schedule of what is considered a permanent and total disability. This disability means it affects your ability to work for the rest of your life.
3. Partial/Temporal disability has a continental scale of what is temporal disability and it dictates the amount payable as well. This disability could affect your working ability for more than 3 days as indicated in the act but with retraining and a physiotherapist helping you, you can resume normal working ability.
4. Medical Expenses also form part of the benefits the Act requires an employer to provide in the event of an accident. These expenses need to be reasonable and go hand in hand with first aid.
5. Funeral expense the WIBA Act also dictates that the employer provides a reasonable funeral expense allowance in the event of death as dictated by the policy.

The WIBA Insurance summary of benefits is shown below and also shows how are WIBA Claims compensation is calculated.

WIBA ACT BENEFIT	COMPENSATION LEVEL
Death	96 months salary maximum is determined by the Minister of Labour
Permanent total disability	Percentages as set out in the First Schedule of Work Injury Benefits Act, 2007 subject to the maximum of amounts set out under the Limits of Liability above.
Temporary total or partial disablement.	Up to 52 weeks and the employee is/will be absent from work for more than 3 days
Medical Expenses	As from Ksh. 30,000. The WIBA Act states reasonable expense. Insurance companies are free to set minimum limits.
Funeral Expenses	As from Ksh. 30,000. The WIBA Act states reasonable expense The insurance companies are free to set a minimum limit.
Occupational Illness

WIBA insurance application form

The WIBA application form is an intensive form that will require the below information provided:

1. Name and address of the business
2. Nature of business/industry it operates
3. if there is any law/regulation governing the conduct or maintenance of premises apply to your premises
4. if there is any machinery operated on the business premise
5. Any chemicals, acids, or explosives handled by the business
6. Previous WIBA policies
7. Claim history
8. Schedule of number of employees, position held, nature of the job held, and annual incomes of each employee

WIBA insurance policy

Upon successful application and acceptance of the application form, a WIBA certificate is issued and it includes:

1. Name and address of the business
2. Insurance period
3. Premiums paid/payable
4. Estimated overall annual salaries/ earnings
5. Benefits/ insurance coverage
6. Limits of compensation per employee
7. A list of insurance warranties, clauses, and conditions applicable to the policy.

WIBA claim procedure

WIBA Claim documentation includes:

1. Duly filled claim form
2. Filled Dosh forms 1 and 2
3. Signed original medical bills
4. Signed original medical reports from authorized medical personnel
5. Death certificate, burial permit copy in the event of a death claim
6. Sick-off sheet signed by the employer
7. Copy of national identity card of the person claiming
8. Appointment letter of the claimant by the employer.
9. Report by the insured from the health and safety committee of the employer.

Steps to filling a WIBA Insurance claim include:

1. Fatal work-related accidents need to be reported to the director of OSHA within 24 hours either in writing or in person
2. Non-fatal accidents can be reported within 7 days
3. The employer and attending doctor fill in the Dosh 1 and Dosh 2 forms respectively.
4. Then the employer together with the labor office will fill in the claim form
5. The employer will need to get a written statement from the injured employee, a supervisor, and an eyewitness
6. All these are to be submitted to the insurance company.
7. If everything checks out and all documents submitted are satisfactory, the WIBA Act dictates that the claim be settled within 90 days.

Give your employees and yourself peace of mind by discussing with us your WIBA insurance and ensure that you are comprehensively covered and you are compliant.