What is Occupational Accident Insurance?

The purpose of occupational injury (occupational accident OR workplace accident) insurance is to cover Employees against the risk of accidents occurring during, by reason of or in the course of work, even if the accident is the result of a force majeure event or if the work conditions have caused or aggravated the effects of such force majeure, unless the Employer or their (his/her) Insurer can prove, according to the general rules of law, that the victim's illness was the direct cause of the accident.

An accident at work shall also be deemed to be covered by this insurance if it occurs to the Employee during the journey to and from the workplace between:

  • The work place and their (his/her) or his/her main residence or a secondary residence of a permanent nature or any other place to which the Worker/Employee habitually goes;
  • The work place and the place where he/she usually eats and between the latter and his/her place of residence.

Accidents at work are governed in particular by Law No. 18-12 on compensation for accidents at work, which provides for the obligation to insure against accidents at work. Article 29 of the above-mentioned law n° 18-12 provides that:

  • "Employers subject to the provisions of the dahir bearing law no. 1.72.184 of 5 Jumada II 1392 (27 July 1972) relating to the Social Security System, as amended and supplemented, must take out a compulsory insurance contract with approved insurance companies to cover the costs and benefits provided for by this law.

Temporary, casual, daily and contractual local authority Employees and Employees of public establishments not covered by the civil service or the social security scheme referred to above shall benefit from the compulsory insurance provided for in the first paragraph above."

The insurance contract against occupational accidents and diseases is subject to the general conditions as set by the order of the Minister of Finance no. 2003-05 of 13 Ramadan 1426 (17 October 2005).

What is Covered by the Industrial Accident Insurance Contract?

This insurance covers the payment of compensation, pensions, medical and pharmaceutical expenses, hospitalization expenses, funeral expenses, legal expenses or other expenses for which the policyholder (the Employer) is liable as a result of accidents at work.

These include the following:

  • Guaranteed Costs:
  • The costs of diagnosis, medical, surgical and pharmaceutical care, hospitalisation, analyses and examinations, costs to be paid to doctors and medical auxiliaries, and in general all the costs required for the victim's treatment;
  • The cost of medical devices necessitated by the accident, including the cost of obtaining, repairing or renewing prosthetic or orthopaedic appliances;
  • The cost of transporting the victim to their (his/her) usual place of residence or to a public or private hospital or care facility closest to the place where the accident occurred;
  • In the event of death, funeral expenses and the cost of transporting the body to the place of burial.
  • Compensation in Case of Temporary or Permanent Disability or Death
  • Daily allowance during the period of temporary incapacity;
  • Compensation in the form of an annuity in the event of permanent disability;
  • Compensation in the form of an annuity for the victim's dependants in the event of death.

In addition, and subject to an additional premium and express stipulation in the insurance contract, the guarantee may be extended to cover occupational diseases.

Rights and Obligations of the policyholder?

We invite you to refer to the "Insurance Guide" and the "Step-By-Step Procedure : If you have been injured at work" published on the ACAPS portal.

What does the Authority do?

Within the framework of the powers vested in it by Law No. 64-12 establishing the Insurance and Social Security Supervisory Authority, the latter institution ensures that any and all insurance products offered to consumers are understandable, balanced, useful and that they comply with the regulations in force. It also shall monitor the reliability of the information provided to policyholders and ensure the fair treatment of policyholders by Insurers.

Legal/Judicial Remedies in Case of Dispute with Your Insurer?

In accordance with Article 7 of Law No. 64-12, the Insurance and Social Security Supervisory Authority has the power to investigate complaints from customers of insurance companies and the intermediaries (brokers) thereof. Nevertheless, it is recommended that you first contact the broker or Insurer against whom your complaint is directed. If the dispute persists after this step, you can contact ACAPS by one of the means at your disposal. The Authority shall then examine your complaint and take the most appropriate action, in accordance with the legal and regulatory provisions and within the scope of its powers, to settle the dispute.

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