Employment Injury Insurance

A versatile open source solution for employment injury insurance schemes

Social insurance schemes can protect workers and their dependents in the case of occupational injuries and diseases. Such schemes ensure that injured workers have access to the health and rehabilitation services they need, and that they or their survivors promptly receive cash benefits to compensate for loss of income.

openIMIS helps to manage information flows related to employment injury insurance processes by bringing together employee, employer, healthcare provider and payer data into a single platform. Its simple accident reporting system and efficient claims procedures can help to ensure that workers or their survivors receive benefits promptly.

Business processes

openIMIS supports the following business processes for employment injury insurance:

  • Enrolment

  • Accident reporting

  • Health service utilisation

  • Health service claims generation and submission

  • Claims review process

  • Processing and payment of claims

Benefits

For employees, openIMIS simplifies enrolment procedures, makes it easy to verify one’s coverage status at point of care and ensures prompt receipt of benefits in case of injury. For employers it provides a one-stop solution for managing both enrolment and accident reporting, with seamless links to information from hospitals about treatment and rehabilitation. For health facilities, it streamlines the processes associated with a health financing scheme and makes it easy for them to receive reimbursements. For scheme operators it reduces operational costs, allows for better monitoring and analysis of the scheme’s overall performance, and enables information to be shared between different health and social protection schemes.

Example workflow

Employment injury insurance workflow

Current implementations

Nepal

Further information

Visit the wiki page or download the factsheet for this openIMIS use case: