Notification of Claim & Payment

2.10 Notification of a Claim

(a) Sickness Benefit
At the start of his incapacity the Operative should request from his doctor, at the same time as he is given the medical certificate for National Insurance purposes, an ordinary medical certificate which should be forwarded, within one month, to his employer.  The employer will complete an SJIB Claim Form and send it on to the SJIB together with a copy of the medical certificate.  If the first medical certificate does not show the date on which the Operative is fit to resume work, further certificates must be obtained and submitted.

(b) Other Benefits
If an Operative dies or suffers dismemberment whilst insured under the appropriate schemes, the employer shall immediately notify the SJIB where guidance in respect of the claim will be given.

Note: - Any person who knowingly makes any false statement or representation for the purpose of obtaining benefit renders himself liable to prosecution.

2.11 Payment

When the claim for sickness benefit and the medical certificate have been received, the SJIB will assess the claimant’s entitlement to benefit.

A remittance will be passed to his employer who will make the necessary payment to the Operative.
If the incapacity continues for an unusually long period or if the SJIB is not satisfied with the circumstances surrounding any claim, the claimant may be asked to present himself for examination by a medical referee to determine his entitlement to benefit.

If an Operative should sustain an accidental bodily injury which results in more than one loss (see 2.6 above), payment shall be made only for one loss.