Employee Benefits Product Guide

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Preston Fisher
8 years ago
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1 Employee Benefits Product Guide

2 Resolution Insurance entered the Kenyan market in 2002 (as Resolution Health East Africa), the first company to be registered as a Medical Insurance Provider (MIP). We were recognized as Medical Insurance Provider of the Year in 2012 in the Think Business Insurance Awards. We were licensed as a General Insurer by the Insurance Regulatory Authority (IRA) in We are licensed to provide Personal Accident, Workmen s Compensation, Liability, Medical and Miscellaneous classes of General Insurance Business. With 10 years experience, Medical Insurance is our core product. We have managed the medical needs of over 60,000 members comprising of corporate, social groups, families and individuals through innovative solutions. We have developed a strong network of over 750 medical service providers (hospitals, clinics and doctors ) across East Africa that our members can access. Resolution Insurance has partnered with a multi-national travel insurance expert Linkham Services to offer Resolution Travel to cater for persons travelling for leisure, business or studies. Resolution Travel Plans are delivered on a fully automated web platform. We offer seven plans that have local, regional, schengen countries and worldwide cover options. As we grow our product offering our aim is to be a one-stop shop for Employee Benefits. The Work Injury Benefit Act came into force on June 2, 2008 replacing the Workmen s Compensation Act. The Act makes it compulsory for every employer to provide cover for all their employees against bodily injury, disease or death sustained and arising out of and in the course of their employment. It is for this reason that over the last year we have introduced products targeted at corporate organizations namely Work Injury Benefits Act (WIBA), WIBA Plus and Group Personal Accident Cover (GPA). We also offer Personal Accident Covers to Individuals & Families. If you would like to consider these plans for companies and groups we have Business Consultants, and have partnered with Brokers & Agents who are available to develop a proposal based on your needs. 2

3 WIBA & WIBA Plus - BENEFITs WIBA (OCCuPATIONAl COVER) Death COVERAGE Permanent Total Disablement Temporary Total / Partial Disablement Medical Expenses Funeral Expenses COMPENsATION PER EMPlOYEE 96 months earnings 96 Months earnings 52 weeks earnings subject to percentages as set out in the First Schedule of Work Injury Benefits Act, 2007 Actual expenses incurred but limited to Kshs 100,000 per employee Kshs 30,000 per employee Life s Assistance Kshs 1,000,000 Occupational Illness Kshs 4,000,000 per person (Max.) WIBA Plus (24HRs) BENEFITs Death COVERAGE Permanent Total Disablement Temporary Total / Partial Disablement Medical Expenses Funeral Expenses Occupational Illness COMPENsATION PER EMPlOYEE 96 months earnings 96 Months earnings 104 weeks earnings subject to percentages as set out in the First Schedule of Work Injury Benefits Act, 2007 Actual expenses incurred but limited to Kshs 200,000 per employee Kshs 50,000 per employee Life s Assistance Kshs 1,000,000 Artificial Appliances Kshs 50,000 limits of liability - WIBA Per Person Kshs 20,000,000 Kshs 4,000,000 per person (Max.) Per Event Kshs 100,000,000 In Aggregate Kshs 500,000,000 WIBA RATING GuIDE WIBA Table of Rates Geographical area: Kenya only Policy Excess: The first Kshs 5,000 on each and every claim excluding claims for funeral expenses TTD EXCEss: 3 days deferment period My Health, My Life, My Resolution 3

4 EMPlOYER s liability Basis Rate The Work Injury Benefits Act (WIBA) Insurance rates shall form the basis of rating Employer s Liability Insurance and the rates shall be considered as minimum rates net of all discounts. Multipliers OPTIONs Option A Option B Option C Option D EL Multipliers (percentage of WIBA rates) 25% 30% 35% 40% limits of liability Options. The options of liability are as follows: EVENTs Option A Option B Option C Option D Any one Person 2M 4M 6M 8M Any one Occurrence 10M 15M 20M 25M Any One year 20M 30M 40M 50M Deductible/Excess A deductible/excess of Kshs 25,000 for each and every claim shall apply 2

5 GROuP PERsONAl ACCIDENT Death COVERAGE COMPENsATION PER EMPlOYEE Standard cover 5 years earnings Permanent Total Disablement Temporary Total / Partial Disablement Medical Expenses Funeral Expenses Standard cover 5 years earnings Weekly earnings up to a max of 104 weeks Actual expenses incurred but limited to Kshs 500,000 per employee Kshs 50,000 per employee ADDITIONAl BENEFITs Artificial Appliances Kshs 50,000 Repatriation/Body transfer Kenya Kshs 100,000 International Kshs 200,000 Emergency Transportation/Rescue Up to Kshs 100,000 Life Assistance Up to Kshs 1,000,000 Geographical Area: Worldwide Accumulation limit: Kshs 100 Million Requirements for Quotation Name and nature of business List of occupations and respective gross salaries Preferred sum assured My Health, My Life, My Resolution 5

6 4 PERsONAl ACCIDENT Benefit Child Guard student / Intern Cover Option 1 Option 2 Option 3 Option 4 Option 5 Option 6 Option 7 Option 8 Death 100, , , ,000 1,000,000 2,000,000 3,000,000 5,000,000 7,000,000 10,000,000 Permanent Total Disablement Temporary Total Disablement (Per Week Max 104Weeks) 100, , , ,000 1,000,000 2,000,000 3,000,000 5,000,000 7,000,000 10,000, ,000 2,000 2,500 3,500 4,000 5,000 6,000 7,000 Critical illness , , , , , , ,000 Accidental Medical Expenses 20,000 25,000 35,000 35,000 50, , , , , ,000 Funeral Expenses 20,000 25,000 30,000 30,000 30,000 50,000 50,000 50,000 50, ,000 Hospital Cash 1,500 1,500 2,000 2,500 3,000 5,000 6,500 8,000 Artificial Appliances 15,000 15,000 15,000 15,000 15,000 20,000 25,000 30,000 40,000 50,000 Tuition during incapacitation(per Week Max 5 weeks) 10, Entry Age ,167 1,667 2,310 2,610 4,260 7,440 9,660 14,100 19,140 26,880 Entry Age ,567 2,900 4,733 8,267 10,733 15,667 21,267 29,867 Rates do not include 0.45% tax & Kshs 40 stamp duty For groups of more than 5 individuals, we are able to provide group rates at a more affordable rate. Simply request for a quote within your preferred limits through your agent.

7 GROuP PERsONAl ACCIDENT

9 DEFINITIONs Definition of Employee (1) In the WIBA Act, employee means a person who has been employed for wages or a salary under a contract of service and includes an apprentice or indentured learner. (2) Sub-section (1) applies irrespective of whether the contract is expressed or implied, is oral or in writing, and whether the remuneration is calculated by time or by work done and whether by the day, week, month or any longer period and whether the payment is in cash or recognized legal tender. (3) The following persons shall not be regarded as employees for purposes of this Act: (a) (b) (c) (d) A person whose employment is of a casual nature and who is employed otherwise than for the purposes of the employer s trade or business; Any person employed outside Kenya save as provided in section 11 of this Act; A member of the employer s family dwelling in the employer s house or cartilage thereof and not for the purpose of employment; or A member of the Armed Forces as defined in the Armed Forces Act. Obligations of Employers Every employer shall obtain and maintain an insurance policy, with an insurer approved by the Minister in respect of any liability that the employer may incur under this Act to any of his employees. life Assistance as defined in the WIBA ACT If an injury in respect of which compensation is payable causes disablement of such a nature that the employee is unable to perform the essential functions of life without the constant assistance of another person, the Director shall grant an allowance in addition to any other benefit provided for under this Act, towards the cost of such help as may be required for a specified period, which allowance shall be reviewed from time to time. Death - Meaning loss of life as a result of an accident or occupational disease. Permanent Total Disability - Means inability to engage in any occupation for which the employee is reasonably qualified by education, training or experience as a result of an accident. Temporary Total/Partial Disablement - Means temporary inability to engage in ones occupation. (Excluding the first seven days) Accidental Medical Expense - Any medical expense incurred as a result of an accident. Funeral expenses - pays an immediate lump sum upon the death, to cater for funeral expenses. Hospital Cash - Amount paid to one while admitted but subject to 3 night s window period. Usually paid in lump-sum after discharge Artificial Appliances - Includes but not limited to walking crutches, wheel chairs, arm strings, neck support, back bands and similar items required by injured employee to support life functions. Tuition - Tuition costs while incapacitated. REQuIREMENTs FOR QuOTATION Name and nature of business List of occupations and respective gross salaries My Health, My Life, My Resolution 5

10 June 2014 Our Business Consultants, Brokers and Agents are available to meet with you at your convenience to take you through our products. REsOluTION INsuRANCE COMPANY limited HEAD OFFICE: Parkfield Place, Muthangari Drive, Off Waiyaki Way, Westlands, P.O. Box , Nairobi, Kenya Tel No: , , Mobile: , , Fax: Nation Centre: 13th Floor, Kimathi Street, Nairobi CBD Tel: MOMBAsA BRANCH: 1st Floor Harbour House, North Wing, P.O. Box , Mombasa Tel: , , Mobile: KIsuMu AGENCY: Ground Floor Mega City, P.O. Box Kisumu, Tel: , Mobile: MERu AGENCY: Upper Ground Floor, Hart Towers, Njuri Ncheke Street, P. O. Box Meru Tel: Resolution Insurance -Kenya ResolutionKE info@resolution.co.ke WEBsITE: RI/EB/Pl/09 Rev.0 AGENT CONTACT DETAIls

WORK INJURY BENEFIT CLAIM FORM

WORK INJURY BENEFIT CLAIM FORM Important information please read carefully i. This report is to be completed by the employer in case of injury to or death of a workman and returned back along with the