EMPLOYEE

COMPENSATION
KIT ECA-3
Accident Resulting in Death of
An Employee at the Workplace

Compensation Mechanism under The Employee

Compensation Act (ECA), 1923
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STEPS INSTRUCTIONS FORMAT

1 Prepare the fatal incident report in the format of Form EE.

Form EE and submit it with the commissioner See Page 3
within seven days from the date of accident.

2 File the fatal incident report in the notice book Keep in notice book folder.
under the ECA.

3 Conduct inquiry or investigation and prepare Guidelines for report.

a report on the cause and circumstances of the See Page 4
accident.

4 Calculate the compensation amount payable Schedule for calculation of

to the dependant of the deceased employee. the compensation as under
Advance may be made to the dependant within ECA.
limits set under ECA. See Page 5

5 File the compensation amount calculated with Filing in Form A.

the commissioner, within thirty (30) days of the See Page 6
accident, and obtain a receipt.

6 Where the employee is hired through a Consult legal practitioner

contractor and the compensation is paid for or for indemnity proceedings.
deposited by the Principal Employer, commence
indemnity process against the contractor by set
off against any payment or filing of claim with
the commissioner.

Note: In case of a notice received from local authority for proceedings initiated by employee
claiming misrepresentation of record, the appearances and pleadings have to be made before the
commissioner. It is recommended that any appearances made before the Commissioner be through
an Advocate or a Legal Practitioner.
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COMPENSATION
KIT ECA-3
GUIDELINES FOR THE FATAL ACCIDENT REPORT
The report of fatal accident shall be filed with the commissioner within 7 days from the date
of the accident, in the format of Form EE. The details required in the form are preliminary in
nature and do not prejudice the employer. Subsequent inquiry report or memorandum may
visit the incident in greater detail.
The details required in the report of fatal accident are:
1. The name of employee and address of his residence.
2. The date of accident and details of the workplace premises.
3. The time of the accident and place where it occurred.
4. The manner in which the deceased employee was employed at the time – that is whether
contractual or full time, etc.
5. Cause of the accident.
6. Other relevant details concerning the accident at the time.
The report may be copied to the contractor who may be the immediate employer of the
deceased employee.

COMPENSATION KIT ECA-3

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Workmen’s Compensation Rules

FORM EE
See Rule 11
Report of Fatal Accidents

To
................................................

Sir,

1. I have the honour to submit the following report of an accident which occurred
on....................... (dated), at..................................................................................................
(here enter details of premises) ............................................................................................
..........................................................................................................................................
and which resulted in the death of the workman/workmen of whose particulars are given
in the statement annexed.

2. The circumstances attending the death of the workman/workmen were as under:

(a) Time of the accident.......................................................................................................
(b) Place where the accident occurred.................................................................................
(c) Manner in which deceased was/were employed at the time..........................................
(d) Cause of the accident......................................................................................................
(e) Any other relevant particulars........................................................................................
I have etc.

Signature and designation of person making the report

STATEMENT

Name Sex Age Nature of Full postal address

employment
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REPORT OR INTERNAL MEMORANDUM OF THE

ACCIDENT
The internal report may be prepared by anyone in the employer organization who has the
knowledge of the events or is capable of carrying out a satisfactory investigation in the matter.
Note: where a notice is served under Section 10A ECA by the commissioner asking for details with
respect to the fatal accident, the same memorandum may be submitted within 30 days of the notice.
The points which may be covered under the memorandum are:
1. Name of the deceased employee, her/his age and her/his residential address.
2. The details of the wages paid to the employee along with attendance and other records
maintained on the employee, including the immediate employer.
3. The date of report of fatal accident submitted to the commissioner, if applicable.
4. The description of the location of the accident along with an approximate site map
showing key features.
5. Date and place of occurrence of the accident.
6. Brief narration of the circumstances and cause of the accident.
7. Photograph of the conditions at the site of accident along with key features of the
accident.
8. The compensation amount calculated on the basis of the wage of the employee.
9. List of witness along with testimonial where possible as to the circumstances of the
accident.
10. Documentation or records pertaining to the machinery, if any, involved in the accident.
11. Site safety certificates or notes issued by the site safety in charge prior to the accident.
12. List of known dependants of the deceased employee, if present.
Note: where the report or memorandum is sought to be filed with the commissioner, any one from
the employer organization in the position to know the above facts may do so along with an affidavit
and requisite fee. The affidavit prepared shall be required to attest to the facts being presented under
the report to be true.

COMPENSATION KIT ECA-3

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CALCULATION OF COMPENSATION
The compensation shall be calculable factoring the monthly wages and the extent of liability
employer is admitting.
Monthly wages will be determined as per any of the following methods:
a. Where service has been rendered continuously for more than 12 months preceding
the accident, the monthly wage shall be 1/12 of the total amount paid as wages in the
preceding 12 months.
b. Where service has been rendered for less than a month preceding the date of accident,
the monthly wages will be either that paid by the employer to another employee doing
the same work or that which is paid to a person for performing the work in that location,
in that order.
c. In other circumstances, the monthly wage will be equal to

Total wage paid in preceding continuous time period

x 30 days
No. of days wages paid

Note: Continuous time period implies any time period without any interruption/absence from work
exceeding 14 days.
The calculation of compensation shall be an amount equal to 50 per cent of the monthly
wages of the deceased employee multiplied by the relevant factor in the schedule under ECA
or an amount of Rs. 1,20,000, whichever is more in amount.
Interim compensation may be paid by the employer to a known dependant. The maximum
refund allowed from compensation amount eventually deposited with the commissioner is
upto 3 months of wages within the actual entitlement of the dependant being paid to the
compensation.
Note: Payments made towards the funeral expenses of the deceased employee, whether directly or as
reimbursements, shall not be adjusted or counted as the amount of compensation paid.
The Schedule IV of the ECA titled ‘Factors for working out lump sum equivalent of compensation
amount in case of permanent disablement and death’ is relevant for the calculation of
compensation amount.
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DEPOSIT OF COMPENSATION WITH THE

COMMISSIONER
Within 30 days from the date of accident, the compensation amount due by the employer shall
be deposited with the commissioner.
The compensation amount must be filed in Form A with the commissioner.
The following details are to be provided:
1. Details of the employee – name, father’s name, spouse’s name, age, caste, local address
and permanent address.
2. The monthly wage ascertained along with the date and amounts of previous payments
of wages made.
3. Particulars of any advance made to a dependant of the deceased employee along with
details of the dependant.
4. Whether there is a desire to be included as party in the subsequent proceedings initiated
by dependants for distribution of the compensation.
5. The total compensation amount due under the ECA.
After submitting the compensation amount in the above format, the employer will be issued a
receipt by the commissioner’s office. This receipt shall be treated as proof of the compensation
amount having been paid to the employee. The date of receipt shall be regarded as the date
of payment. The disbursement of the compensation amount to the employee will be done by
the commissioner.
Note: There is a possibility of the dependants challenging the compensation amount deposited
with the commissioner, in which case proceedings for further claim may be initiated. It is strongly
recommended that upon receipt of any notice regarding proceedings from the commissioner, services
of a legal professional or an advocate be engaged.

COMPENSATION KIT ECA-3

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Workmen’s Compensation Rules

FORM A
See Rule 6(1)
Deposit of Compensation for fatal accident
Section 8(1) of the Workmen’s Compensation Act, 1923

1. Compensation amounting to Rs. ........................................is hereby presented for deposit

in respect of injuries resulting in the death of the workman, Whose particulars are given
below, which occurred on...................................

Name..........................................................................................................................................
Father’s Name............................................................................................................................
(Husband’s name in case of married woman and window).
Caste..................................................................................................................................................
Local address..............................................................................................................................
....................................................................................................................................................
Permanent address......................................................................................................................

His/Her monthly wages are estimated at Rs ..................................................................He/She

was over/under the age of 15 years at the time of his/her death.

2. The said workman had, prior to the date of his/her death received the following payments,
namely:
Rs. ................................... on....................... Rs. .................................... on.........................
Rs. ................................... on....................... Rs. .................................... on.........................
Rs. ................................... on....................... Rs. .................................... on.........................

3. An advance of Rs ............................................ has been made on account of compensation

to................................................ being his/her dependent.

4. *I do not desire to be made a party to the proceedings for distribution of the aforesaid
compensation.

Dated.............................. 20................

*An employer desiring to be made a party to the proceeding should strike out the words “do not”.
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Schedule IV
Factors for working put lump sum equivalent of compensation amount
in case of permanent disablement and death

Completed years of age on the last Factors

birthday of the workman immediately
preceding the date on which the
compensation fell due
(1) (2)
Not more than 16 228.54
17 227.49
18 226.38
19 225.22
20 224.00
21 222.71
22 221.37
23 219.95
24 218.47
25 216.91
26 215.28
27 213.57
28 211.79
29 209.92
30 207.98
31 205.95
32 203.85
33 201.66
34 199.40
35 197.06
36 194.64
37 192.14
38 189.56
39 186.90
40 184.17
41 181.37
42 178.49
43 175.54
COMPENSATION KIT ECA-3

44 172.52
45 169.44
46 166.29
47 163.07
48 159.80
49 156.47
50 153.09
51 149.67
52 146.20
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Completed years of age on the last Factors

birthday of the workman immediately
preceding the date on which the
compensation fell due
53 142.68
54 139.13
55 135.56
56 131.95
57 128.33
58 124.70
59 121.05
60 117.41
61 113.77
62 110.14
63 106.52
64 102.93
65 or more 99.37
Notes