Q.What are the qualifying conditions?
A. An insured person should have contributed at least six months since registering in the programme. In addition:
- The claimant should have contributed for at least two months in the last four months, immediately prior to the month of sickness.
- Claimant must have been in insurable employment at the time of illness.
- Claimant must not be receiving full wages from employer during illness.
Q. What is the maximum sickness period?
A. Sickness benefit is payable for a maximum of 26 weeks.
Q.What happens if an illness continues for a period longer than 26 weeks?
A. The insured person may be entitled to an invalidity benefit on condition that all other requirements are satisfied.
Q. At what rate is Sickness Benefit paid?
A. The rate of Sickness Benefit is 65% of the average insurable earnings, in the last four months immediately prior to the month of sick leave.
Q. If I am given seven (7) days sick leave would NIC pay 65% for seven (7) days?
A. NIC does not pay for the first three days of sick leave. The first three days are considered to be waiting days. Waiting days are checked from the first day of absence from work. A working week is also considered as six days. Therefore, the claim would be paid for three (3) days. However, any other claim for sickness benefit made within eight weeks from the last day of previous sick leave would be considered a continuation and no waiting days would be deducted. All claims for sickness benefit must be supported by a medical certificate issued by a registered Doctor with a valid practicing certificate.
Q. If as an employee, I work on Sundays, would I be losing on my benefits?
A. You would not be losing since persons who work on Sundays would normally be off on a day during the week. NIC pays for six days and most persons work for six days or less in a week.
Q. Are there any cases where the NIC can refuse to pay a sickness benefit claim?
A. Yes, there are a few cases.
- Should the claimant fall sick through his/her own misconduct.
- If the claimant is in paid employment during the period of illness.
- If the claimant is engaging in behaviour which would retard the recovery process.
- If the claimant refuses to submit to a medical examination if asked to do so by the National Insurance Corporation.
- If the medical certificate is issued by someone who is not a registered medical practitioner with a valid practicing certificate.