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1. To the Reader . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 2. The Finnish Workers Compensation Insurance System . . . . . . . . . . . . . . . . . . . . . . . . . 2 3. Employment Accident Insurance . . . . . . . . . . . . 2 4. Supplementary Insurances . . . . . . . . . . . . . . . . . 4
5. Voluntary Insurance in Accordance With the Employment Accidents Insurance Act . . . . 5 6. Employment Accident Compensations . . . . . . . 6 7. Other Obligations of the Employer. . . . . . . . . . 8
1. To the Reader
The purpose of this guide is to provide the reader with basic information on the Finnish workers compensation insurance system, on annual measures relating to the statutory workers compensation insurance, and on premiums and accident compensations. In addition to these, this guide presents insurance which supplement the employment accident insurance: employers and employees unemployment insurance, and employees group life insurance. The handling of If P&C Insurance Company Ltds employment accident insurance and claims settlement for entrepreneurs, small and mid-size companies and general government takes place in Turku. Postal address: 20025 IF Telephone within Finland is 010 19 15 15, and from abroad +358 10 19 15 15. Telefax within Finland is 010 514 1678 or 010 514 2454, and from abroad + 358 10 514 1678 or +358 10 514 2454. Our visiting address is Kalevantie 3, Turku. The handling of If P&C Insurance Company Ltds employment accident insurance and claims settlement for large and international companies takes place in Helsinki. Postal address; 00025 IF Telephone within Finland 010 19 15 15, and from abroad +358 10 19 15 15. Telefax within Finland 010 514 5780, and from abroad + 358 10 514 5780. Our visiting address is Niittyportti 4, Espoo.
The following persons are within the scope of the workers compensation insurance:
persons in employment relationship, and civil servants an employee who is in a leading position in a limited company and who, alone or together with family members living in the same household, owns no more than half of the companys share capital a partner in a leading position in a general or limited partnership who, alone or together with family members, has no more than half of the authority over the general or limited partnership company certain students, participating in practical training in accordance with the syllabus patients in certain care institutions and homes, who participate in practical work in accordance with the treatment programme.
The following persons are not within the scope of the accident insurance:
private entrepreneurs family members living in the same household with the private entrepreneur an employee who is in a leading position in a limited company and who, alone or together with family members living in the same household owns more than half of the companys share capital a partner in a leading position in a general or limited partnership who, alone or together with family members, has more than half of the authority over the general or limited partner-ship company person doing voluntary or other unpaid work.
termination must be made at the latest three months before the intended date of termination. The insurance can only be terminated in purpose of transfer on the last day of March, June, September and December. Thus, for example, if the employer leaves the notice of termination on December 15th, the insurance will be terminated on March 31st and will come into force in another company on April 1st. This does not apply to the rst insurance period. The insurance can not be transferred during the rst insurance period. The cancellation is valid only if it is proved that the insurance has been taken out from another insurance company and that the insurance enters into force at the beginning of the following calendar year. The insurance expires if the policyholder is found to be indigent at distraint of premiums or if the where-abouts of the policyholder are unknown.
before tax, including fringe benets, overtime payments, annual holiday compensations, holiday pays, holiday salaries, gifts and other extraordinary rewards, piece rates, and sick pays. If the policyholder neglects to submit to the insurance company the information needed for calculating the premium, or gives false information, the insurance company is entitled to make an estimate and charge the premium at the most fourfold, for that part of information which the negligence concerns.
notication of changes
During the insurance period, some changes may take place in the company which the insurance company must be notied of. The insurance company must be informed, for instance, of changes in the company name, address, owner-ship, or company form. The insurance company must also be informed of changes in the eld of activity, in the distribution of various tasks, or in the number of employees, or of changes in the amount of salaries and wages paid. On the basis of these changes the advance premium is adjusted if necessary.
3.6 premiums
The bases of the statutory workers compensation insurance premiums are conrmed in each insurance company annually.
company discount
The company discount granted by If Insurance Company is depending on how long the customership has lasted.
The premiums are determined according to either of the following two basic systems:
General tariffs, which are based on extensive national statistics. These rates are applied to small and medium-sized insurances. Special tariffs, in the calculation of which the own loss statistics of the insurance are applied. These special tariffs apply to large insurances whose annual premiums meet the minimum quantity levels which are annually conrmed for the so-called obligatory special tarifng.
4. Supplementary Insurances
Unemployment insurance and employees group life insurance are insurances which are administered as supplementary insurances to the employment accident insurance. However, accident insurance companies are not involved in the claims settlement of these.
Employees Group Life Assurance Pool has been established for the implementation of this system. The insured interest is the death of the insured, regardless of the cause of death. The beneciaries are primarily the employees spouse and children under the age of 18. The sum insured consists of a basic sum as well as of child and accident increases. In order to receive the sum insured an application for compensation must be lled in. Claims settlement matters relating to employees group life insurance are handled by a pool at Retro Life Assurance Company Ltd (Mikonkatu 15 A, 00100 Helsinki, tel. +358 20 7631 690 and fax +358 20 7631 689).
sports insurance
The sports insurance can be taken out as a group insurance to cover the companys entire personnel. The sports insurance covers accidents occurring in company sports activities. The compensations are determined as in the leisure time group insurance where applicable.
property damage
Workers compensation insurance covers spectacles, hearing aids, dentures, orthopaedic dressings, back braces as well as articial limbs and organs which were used by the injured and broken or lost in connection with an employment accident. Other property damage is normally not compensated.
other compensations
In some cases, the following compensations can be paid: compensation for increased household management expenses, additional handicap indemnity for exceptional handicap, clothing allowance in case the use of an articial limb or other aid causes exceptional wearing of clothes, and guide dog allowance if the injured needs to acquire a guide dog due to an employment accident.
daily allowance
Daily allowance is granted when the injured has been completely or partly unable for work for at least three successive days excluding the day of the accident. The daily allowance is paid for a maximum period of one year as from the day of the accident. If the disability continues after this period, compensation for lost earnings will be paid in theform of employment accident pension. The amount of the daily allowance and the employment accident pension is based on the injureds income. The daily allowance is taxable income.
6.2 compensations
compensation for expenses
Workers compensation insurance compensates the employee for expenses arising from medical treatment in case of employment accident. These medical expenses include medical care and medication. Medical expenses are compensated without time or monetary limits. For accidents that have occurred before Jan 1st 2005, hospital treatment is compensated primarily in accordance with the general tariffs of general hospitals. If the accident has occurred after Jan 1st 2005, it is compensated according to Full Compensation Act. According to the Act, insurance companies pay full compensation directly to the producers of medical care due to medical treatment of accidents. Insurance companies are now able to channel patients with a commitment to pay to such treating institution (private or public sector) that will treat the patient as soon as possible. The essential objective of the reform is to accelerate the treatment and rehabilitation of patients injured in accidents at work. Urgent treatment due to an accident, however, will still mainly be given by the public sector. It has now become even more critical, that the employer informs the insurance company immediately of the accident (accident report, described on the next page). Without accident report the insurance company is unable to channel patients to the best available medical care institution. Travel costs resulting directly from medical care are also compensated.
handicap indemnity
Handicap indemnity is paid for permanent general handicap caused by injury or disease. The amount of the handicap indemnity is determined on medical grounds in accordance with the decision on handicap classication given by the Ministry of Social Affairs and Health.
rehabilitation
The aim of rehabilitation is to rehabilitate an employee who has become incapable for his former work. The means used are, for instance, medical rehabilitation, training, and preparation for work. Rehabilitation matters are handled centrally through the Insurance Rehabilitation Agency.
survivors pension
If the employee dies as a result of an employment accident or occupational disease, his beneciaries are entitled to survivors pension. The survivors pension is granted as a spouses pension and/or childrens pension. As a general rule, a wedded spouse is entitled to a spouses pension, but also a common-law spouse may be entitled to the spouses pension. The childrens pension is paid to children under the age of 18, and to children who are full-time students until the age of 25. The maximum amount of survivors pension is 70 % of the employees annual income. The survivors pension is taxable income. The amount of the survivors pension is revised annually in accordance with the TyEL (Employees Pensions Act) wages index.
payment of compensation
The daily allowance is paid monthly in arrears. The employment accident pension, continuously paid handicap indemnity, and survivors pension are paid monthly in advance.
sick pay
The employers obligation to pay the employees for the period they are unable to work is determined on the basis of the Contracts of Employment Act and collective labour agreements. Daily allowance or employment accident pension granted under the workers compensation insurance is paid to the employer insofar as the employer has paid the injured salaries or wages during the sickness period. During a period of four weeks as from the day of the accident, the daily allowance equals the sick pay paid by the employer. The gross amount of sick pay is compensated the employer, covering also the tax withheld. If the employer has not paid sick pay, the compensation is paid to the injured.
funeral grant
Funeral grant is paid to the decedents estate or to the person who took care of the funeral arrangements. The amount of the funeral grant is a xed sum irrespective of the amount of the actual funeral expenses. In 2009 the funeral grant is EUR 4 340.
taxability
The daily allowance, the compensation for lost earnings due to physical therapy, the employment accident pension and the survivors pension paid in accordance with the statutory workers compensation insurance are entirely taxable income insofar as they are compensations for lost earnings. Compensations for expenses, funeral grant, handicap indemnity and additional handicap indemnity are tax-free compensations.
accident report
An accident report is needed for the handling of the claim whenever the incapacity for work has lasted for three successive days excluding the day of the accident. The accident report has to be made also in cases of occupational disease, or death, and when the employment accident is a road accident. The report has to be made without delay by use of a form approved by the Ministry of Social Affairs and Health, which can be obtained from any insurance company. As a general rule, accident compensation has to be claimed within a year from the date of the accident.
withholding tax
The insurance company withholds tax insofar as the compensation for lost earnings is paid to the injured or the survivors pension to the family. Tax is not withheld from compensation which is paid to the employer, the Social Insurance Institution or other pension institution, because tax has already been withheld from their equivalent payment. The employer withholds tax of the sick pay. At the same time, the employer pays also the social security contribution, which later can be amended for the part of the daily allowance payable due to accident. If the employers insurance has a deductible for each accident (EUR 200 in 2009), tax must be withheld for this part of the daily allowance payable. Social security contributions, on the other hand, need not be paid.
medical certicate
A medical certicate is always needed when an injury causes compensable incapacity for work. In obvious cases, the A certicate which is meant for applying for daily allowance from health insurance is sufcient. The employer can submit the A certicate together with the accident report to the insurance company. The handling of the case, however, often requires the E medical certicate which is used in employment accident matters. The insurance company asks for the E certicate directly form the medical care institution where necessary.
increased compensation
When the payment of the accident compensation is delayed, an increase is paid for each day of the delay period. The increase in compensation is 9,5 % during January 1st June 30th 2009. The period of delay starts when three months have passed from the end of the month in which the insurance company was notied of the grounds and amount of the claim. An increase which is less than the minimum amount is not paid.
appeal
The insurance company can reconsider its decision and change its former decision if it is found to be incorrect. The parties always have a right to appeal against decisions concerning employment accidents. The appeal is free of charge. The rst appeal instance is the Employment Accidents Board. The petition of appeal must be submitted within 30 days from receipt of the decision to the insurance company which made the decision. If the company approves of all the claims entered in the appeal, it alters its decision. If the appeal is not approved of, the company sends the appeal to the Employment Accidents Board. The handling of the appeal in the Employment Accidents Board takes on the average four months. It is possible to appeal against the decision of the Employment Accidents Board to the Insurance Court. The appeal addressed to the Insurance Court is submitted to the insurance company, which forwards the appeal. The period for appeal is thirty days. The proceedings in the Insurance Court take on the average 10 months. It is possible to appeal to the Supreme Court against the decisions of the Insurance Court only in certain, separately prescribed situations. The time period for the petition for leave to appeal and for submitting the appeal is 60 days from receipt of the decision of the Insurance Court.
If P & C Insurance Company Ltd. Registered domicile Helsinki P.O. Box 4, FI-00025 IF, FINLAND Business ID 1614120-3
58684i 4/2009