State insurance scheme

Various types of benefits are available under the State insurance schemes for industrial injuries and are payable in respect of any person who has suffered personal injury caused by an accident arising out of and in the course of his employment or where such person suffers from what is termed a prescribed disease with reference to certain industrial occupations which may give rise to that particular disease. The phrases accident and arising... 

There are many cases involving the question whether an act of an employee arises out of and in the course of his employment especially under the State insurance scheme and while these are beyond the scope of this text they may be studied in detail elsewhere . For a comparatively recent decision on the topic illustrating some of the problem areas see R. v. National Insurance Commissioner ex parte Michael [1977] 2 All ER 420. 

The criteria by which arising out of and in the course of his employment is established are different in relation to Employer s Liability insurance and the State insurance scheme, the latter incorporating a broader definition. For... 

Section 22 of the Social Security Act 1989 made provision for the Department of Social Security to collect from those paying compensation for injury or ilkiess, the amount of benefit paid to persons as a result of such injury or illness. Effectively, this entitles the government to repayment of any state insurance scheme payments made to those injured or ill where those persons are entitled to compensation following pursuit of a common law claim. This Act was revis and superseded by the Social Security (Recovery of Benefits) Act 1997, the effect of which was to expand the circumstances in which benefit can be reclaimed and restrict the entitlement of compensators to offset the benefits against damages. This is dealt with in more detail in section 1.7.4 on the quantum of damages. 

The criteria by which arising out of and in the course of his employment is established are different in relation to Employer s Liability insurance and the State insurance scheme, the latter incorporating a broader definition. For an illustration of this aspect see Vandyke v. Fender [1970] 2 All ER 335 concerning the question of which insurer, motor or employer s liability, should deal with a claim where a company provides a car for its employees to go to or from work and an accident occurs on the road. 

Most countries operate with statutory state compensation schemes, which companies may need to supplement with other private-based insurances both usually include economic-based incentive systems to improve chemical safety40 [233]. Environmental and product liability generally establish when civil action can be successfully taken against a company or an individual [234]. If a company is in compliance with the law, it is possible that civil action becomes directed towards the regulator in the form of judicial review for... 

At about the same time, reforms were introduced to provide for compensation of injured workers in other industries. This system, known as Workers Compensation y had similar goals to the FELA but used a fundamentally different approach. It started as a scheme for federal employees in 1908, and expanded rapidly between 1911 and 1921 when it was adopted by all but six states as the primary method of compensating injured employees in both the private and government sectors. Workers compensation is based on the legal principle of strict liability. Employers have to compensate injured employees regardless of who was at fault. Therefore, unlike FELA, courts do not have to decide on the comparative negligence of employer and employee. In effect, workers compensation operates as social insurance scheme. To provide for settlements, employers can either self insure or pay premiums to private or state-run insurance companies. 

Generic substitution has however been implemented by a number of reimbursement authorities, both insurance based schemes as in the United States and nationally run health care schemes, for example, Sweden (introduced October 2002) and Finland (introduced 1st April 2003) both countries health care schemes claim very considerable savings of the order of 5% of national expenditure on medicines. Sweden is considering extending the scheme to lead to compulsory generic prescribing. 

Although Germany has a long-standing reputation as a passive welfare state with elaborate schemes of status-protecting income replacement through social insurance in case of unemployment and a full-blown system of active labour market policies, all benefit systems had formal elements of activation and work requirement - but they had not been enforced systematically. 

Hence, basic income is of growing relevance regarding the structure of benefits in the German welfare state. Compared to unemployment insurance benefits, means-tested basic income is now the more important welfare scheme. However, recent figures also show some moderate decline in UB II. 

Activation was introduced in Swiss social policy in the early 1990s, after a quick and impressive rise in the unemployment rate. Initially, this instrument was applied to unemployment insurance only, but the idea has since spread to other areas of the Swiss welfare state, most importantly social assistance and invalidity insurance. As will be shown below, these two schemes have seen their caseload increase dramatically over the last decade. The rise reflected what had happened with the unemployment rate, but with a 2-3 year time lag, suggesting that some fundamental transformation of the labour market has occurred (see Fig. 9 below). 

The introduction of the State scheme by the National Insurance (Industrial Injuries) Act 1946 can be considered as a compromise between the complete abolition of the common law system with its requirement of proof of fault on the part of the employer and the differing opinions of the type of accident insurance which would be most desirable. 

The aggregation of individual risks and their international transfer is typically facilitated by national private insurance markets. In cases where domestic insurers are unable to accomplish these tasks, state or governmental schemes can be an alternative or a complementary approach. Risk pools, catastrophe funds, or sovereign risk transfer are strategies that a country might adopt with the aim of aggregating and sometimes transfer individual risks. These systems are treated in the fourth and fifth sections of this work where the varied experiences of Turkey, New Zealand, Mexico, and the Caribbean are briefly described. 

In New South Wales, the State in which the Snowy Scheme was constructed, the level of premiums for accident insurance on construction operations is fixed every three years by the Government. Obviously under this system (known as the fixed loss ratio scheme ) there is no direct monetary incentive for a contractor to reduce his accident rate. 

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