Sickness Benefit is payable to an Insured Person who is rendered temporarily incapable of work, otherwise than as a result of an Employment Injury.
To qualify for the Benefit, the Insured Person must have:
- Been engaged in Insurable Employment immediately prior to the day on which incapacity commenced;
- Paid not less than fifty- (50) Contributions since his/her entry into insurance; and
- Been employed and paid Contributions during at least eight (8) Contribution Weeks in the period of thirteen (13) Contribution Weeks immediately preceding the week in which incapacity commenced
Rate of Benefit
The Daily Rate of Sickness Benefit is 70% of the Insured Person's Average Weekly Insurable Earnings, divided by six (6).
The Relevant Wage, for the purpose of Sickness Benefit, is the total earnings on which Contributions were paid and credits awarded, during each of the last eight (8) weeks in the period of thirteen (13) weeks immediately prior to the week in which the incapacity commenced.
To Calculate Benefit Rate:
- For Weekly Paid Employees:
- Sum the Weekly Insurable Earnings in the last eight (8) weeks worked before the week in which incapacity commenced.
- Divide item (a) by 8 = Average Weekly Insurable Earnings.
- Weekly Rate = 70% x item (b).
- Daily Rate = item (c)÷ 6
- For Monthly Paid Employees
- Sum the Monthly Insurable Earnings in last two (2) months worked before the month in which incapacity commenced.
- Divide item (a) by 2 = Average Monthly Insurable Earnings
- Monthly Rate = item (b) x 70%
- Daily Rate = item (c)÷ 26
Duration of Benefit
Sickness Benefit is not paid for the first three days of incapacity, but for each day (excluding Sunday) commencing on the fourth day, for as long as incapacity for work continues, subject to a maximum of twenty-six (26) weeks in any continuous period of incapacity for work.
Where there are two or more periods of incapacity for work which are not separated by more than eight (8) weeks, the periods will be treated as one continuous period of incapacity for work, starting on the first day of the first period.
The Daily Rate of Benefit payable for the second and subsequent periods of incapacity, which are to be treated as one continuous period, shall be the same as that paid during the first period.
Method of Payment
Payment of Sickness Benefit is made by way of Benefit Payment Vouchers, which can be encashed at any of The National Insurance Offices, Post Offices and Commercial Banks.
Method of Claiming
A Claim for Sickness Benefit is made by the Insured Person completing the Form - Claim for Sickness Benefit (reverse of the Form SB6) after the Doctor has completed the Medical Certificate (Form SB6).
If the Insured Person is employed, his/her Employer must complete the Form SB1 - Sickness Benefit Statement of Earnings, and this is submitted along the Form SB6 to National Insurance.
If the Insured Person is self-employed, he/she must complete the Form SB6A1 - Certificate by Self-Employed Person in Support of Sickness Benefit, and this is submitted along with the completed SB6 Form.