Revised Laws of Saint Lucia (2021)

Schedule 5

Schedule

CHAPTER 16.01
NATIONAL INSURANCE CORPORATION ACT

SUBSIDIARY LEGISLATION

List of Subsidiary Legislation

National Insurance Regulations – Section 91

(Statutory Instrument 22/2003)

Statutory Instrument 22/2003 .. in force 3 March 2003

ARRANGEMENT OF REGULATIONS

PART 1
PRELIMINARY

PART 2
REGISTRATION OF EMPLOYERS AND EMPLOYEES

PART 3
COLLECTION AND PAYMENT OF CONTRIBUTION

PART 4
BENEFITS

A.  Sickness Benefit

B.  Invalidity Benefit

C.  Maternity Benefit

D.  Survivor's Benefit

E.   Retirement Pension

F.  Funeral Benefit

G.  Employment Injury Benefit

H.  Miscellaneous Provisions Relating to Employment Injury

I.  Hospitalisation & Medical Treatment

PART 5
PERSONS EMPLOYED ON SHIPS AND AIRCRAFT

PART 6
MISCELLANEOUS

PART 7
MISCELLANEOUS PROVISIONS RELATING TO CLAIMS AND PAYMENTS CLAIMS

J.  Payments

K.  Medical Certificate

PART 8
APPEALS

PART 9
OFFENCES

PART 10
FINANCIAL AND ACCOUNTING REGULATIONS

NATIONAL INSURANCE REGULATIONS – SECTION 91

Commencement [3rd March 2003]

PART 1
PRELIMINARY

1.   Citation

These Regulations may be cited as the National Insurance Regulations.

2.   Interpretation

In these Regulations—

“Act” means the National Insurance Corporation Act;

“Board” means the National Insurance Board established under section 5 of the Act;

“dependant” means a member of an insured person's family—

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   (a)     who was wholly or mainly maintained by the insured person at the time of his or her death;

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   (b)     who would as a result of the incapacity for work due to a relevant accident been dependent on the earnings of the insured person at the time of his or her death;

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   (c)     who is a child or grandchild of an insured person and who is under 16 years of age, or is not above 18 years of age if in full time education and was living with or wholly or mainly maintained by the insured at the time of his or her death; and

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   (d)     who is a parent or grandparent of an insured person who was wholly or mainly maintained by the insured person at the time of his or her death;

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   but does not include a person who has not received any contribution towards the ordinary necessaries of life from an insured person during the insured person's life;

“Corporation” means the National Insurance Corporation established under section 4 of the Act;

“Director” means the Director of the National Insurance Corporation;

“employee” includes any person who is engaged in employment under a contract of service or where not under a contract of service is subject to such terms and conditions as to make it similar to employment under a contract of service;

“Fund” means the National Insurance Fund established under section 3 of the Act;

“invalid” means a person incapable of work as a result of a specific disease or bodily or mental disablement which is likely to be permanent;

“medical authority” means a medical board or a registered medical practitioner nominated by the Director from a panel of registered medical practitioners approved by the Board;

“Minister” means the Minister responsible for national insurance;

“relevant accident” means the particular accident or disease in respect of which injury is sustained and for which a claim may be made for payments or employment injury benefit under these Regulations.

PART 2
REGISTRATION OF EMPLOYERS AND EMPLOYEES

3.   Application for registration

1.  

   (1)   Every employer shall within 7 days of hiring his or her first employee apply to the Director in the form set out as Form R1 in Schedule 1 for registration as an employer under the Act.

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   (2)   Every employer shall within 7 days of employing any person, present to the Director in the form set out as Form R3 in Schedule 1, an application for registration as an insured person in respect of each employee of whom he or she is the employer.

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   (3)   Employers and employees registered under the National Provident Fund Act, 1970, and the National Insurance Act, 1978 shall be treated for all requirements under these Regulations as having registered under the Act as from their respective dates of registration under the respective Acts and shall continue to carry the same registration number allotted to each of them.

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   (4)   (a)   Every employer who changes his or her business address shall within 2 weeks of such change notify the Director accordingly in the form set out as Form CF1 in Schedule 1.

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      (b)     Every employer who ceases to be an employer shall within 2 weeks of such cessation notify the Director accordingly in the form set out as Form CF2 in Schedule 1.

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   (5)   Where an employer has failed to register in accordance with subregulation (1) but has made contribution deductions from the wages of employees, such employer shall upon registration remit to the Fund the full amount of such contributions together with surcharge for such period and shall also give a written undertaking to the Board to meet the cost of any short term benefit claim which arises within 3 months of such registration.

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   (6)   (a)   Every employer who carries on business under a business name registered in accordance with the Registration of Business Names Act shall at the time of making an application under subregulation 3(1) furnish the Director with a copy of the statement of particulars and certificate of registration, of his or her business name.

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      (b)     Every employer who carries on business as a body corporate shall at the time of making an application under subregulation 3(1) furnish the Director with a copy of the following—

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         (i)     Certificate of Incorporation

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         (ii)     Notice of Directors, and

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         (iii)     Notice of registered office.

4.   Issue and security of registration card

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   (1)   Where upon receipt of an application for registration of an employee under this Part, the Director is satisfied that the person concerned is required to be registered as an insured person under the Act, he or she shall cause a national insurance card to be issued to the employee in such form as may be approved by the Director.

1.  

   (2)   Every employee to whom a National Insurance card is issued must present himself or herself at an office of the National Insurance Corporation and present a copy of his or her birth certificate or passport in order to receive the National Insurance card.

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   (3)   The national insurance card shall bear unamended, the full name and registration number of the insured person.

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   (4)   Where the entries on the national insurance card are amended in any way the card shall be invalid and shall be returned to the Director immediately.

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   (5)   A person who is issued a registration card in accordance with the provisions of regulation 4 shall be responsible for the card's safe custody.

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   (6)   If a registration card—

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      (a)     is lost;

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      (b)     is destroyed;

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      (c)     becomes defaced so as to be illegible; or

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      (d)     because of change of name of the holder the card ceases to represent the holder's identity,

the holder of that card shall apply to the Director to have the card replaced at a cost to be determined by the Director.

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   (7)   Upon making application under subregulation (6) a person shall deliver to the Director the card to be replaced if it is still in existence and furnish the Director with the required information in relation to this application.

PART 3
COLLECTION AND PAYMENT OF CONTRIBUTION

5.   Manner of payment of contribution

All payments of contributions to the Fund shall be made at any of the Corporation's offices and shall be paid—

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   (a)     in cash, to an officer of the Corporation authorised by the Director to receive such payments; or

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   (b)     by money order, postal order or crossed cheque drawn on any bank in the State or sent by post to an office of the Corporation;

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   (c)     by bank draft; or

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   (d)     in such other manner as the Director may from time to time authorise in any particular case or class of cases.

6.   Documents to accompany payment

All payment of contributions to the Fund shall be accompanied by the appropriate forms duly completed, or by such other form as the Director may in any particular case or class of cases permit.

7.   Receipts

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   (1)   The Director shall cause a receipt for the amount remitted to be sent to any employer who shall affix it in the appropriate place upon his or her duplicate copy of the remittance statement.

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   (2)   No receipt other than the authorised receipt issued at the Board's office shall be given for any payment on account of contributions or otherwise to the Fund and any receipt so made and endorsed shall be accepted as sufficient for all purposes.

8.   Monthly remittance statement

1.  

   (1)   In each month, every employer shall complete the remittance statement appropriate to that month in the form set out as Form C2 in Schedule 1 and shall forward it together with a remittance for such total amount appearing on the statement so as to reach the Director not later than 7 days after the end of the month.

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   (2)   An employer shall keep a record of monthly remittance forwarded to the Director in the form set out as Form C2 in Schedule 1.

9.   Monthly schedule

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   (1)   The Director shall dispatch at the appropriate time to every employer who is registered under these Regulations a monthly schedule of contributions in the form set out as Form C3 in Schedule 1 in respect of the relevant contribution period for the recording of payments of contributions payable to the Corporation's office under the Act.

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   (2)   On receipt of the monthly schedule, the employer shall enter thereon, the name and registration number of every person employed by him or her, and thereafter in respect of the relevant weekly contribution periods, shall enter against the name of an employee the total amount of contributions payable to the office of the Corporation on behalf of each employee.

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   (3)   Despite subregulation 9(1), where an employer has not received the Form C3 by the last day of the month he or she shall take all reasonable steps to obtain this form from the offices of the Corporation.

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   (4)   The employer shall dispatch or cause to be dispatched the monthly schedule to the Corporation within 7 days after the end of the month for which the contribution is due.

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   (5)   Where the employer's payroll records are computerised he or she shall also submit the monthly schedule in an electronic format approved by the Director.

10.   Duplicates to be kept

The employer shall keep duplicate copies of monthly schedules and of electronic files and of monthly remittance statements on copy sheets provided together with the relevant receipts and shall make them available on request for inspection by an inspector appointed under section 14 of the Act.

11.   Payment of contributions

1.  

   (1)   For each contribution period for which an insured person is paid wages, the employer's contribution and the employee's contribution shall each be 5% or such other rate as may be specified in accordance with section 30(a) of the Act, or the amount paid up to the maximum wage specified in accordance with section 30(d) of the Act.

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   (2)   For the purpose of determining the wages of an employed person under this regulation, there shall be included all the gross earnings received by or on behalf of the insured person including—

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      (a)     overtime payments;

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      (b)     all allowances;

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      (c)     commission or profits on sales;

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      (d)     payment on account of night or shift work;

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      (e)     service charge; and

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      (f)     holiday pay or other amounts set aside out of the employee's remuneration throughout the year or part of the year to be paid to him or her periodically.

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   (3)   Despite subregulation (2)

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      (a)     in the case of holiday pay and other amounts set aside out of the insured person's wages, the pay set aside shall be included in the related wages for the appropriate period for which contributions would have been payable had the wages not been set aside;

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      (b)     in the case of the payments described in subregulation (2) (a) to (e), the amount of payments so received shall, if they are not paid with the wages for the period in which they are due; be included in the wages for the period in which they are paid;

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      (c)     Christmas bonuses, annual production bonuses, severance payments and terminal gratuities shall not be included in the gross earnings of an insured person.

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   (4)   With a view to ensure that liability for the payment of contributions is not avoided or reduced by an employer using any pay practice which is abnormal for a particular employment, the Director, whether or not an application has been made to him or her, may, if he or she thinks fit, determine any question in relation to the payment of contribution where any such practice has been or is being followed as if the employer concerned had not followed such abnormal practice for the employment in question.

12.   Self employed persons

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   (1)   A person who carries on any trade or business enterprise, including professional services or any other lawful activity, which—

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      (a)     generates an income in the form of sales or payment for services rendered or any other form of income; or

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      (b)     generates pecuniary remuneration in the form of a salary, returns on investments, profits or any other form of pecuniary remuneration;

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      (c)     is over 16 years but below the pensionable age; and

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      (d)     is ordinarily resident in Saint Lucia,

shall be entitled to register as a self employed insured person under these Regulations.

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   (2)   An application to register as a self-employed person shall be in the form set out as Form SE1 in Schedule 1 and every applicant shall furnish to the Director such personal particulars as the Director may require for the purpose of these Regulations, which particulars shall be true and correct to the best of the applicant's knowledge.

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   (3)   The Director shall, if upon receipt of an application for registration is satisfied that the person is entitled to be registered as a self employed person and that person has not been issued any registration card, cause a registration card to be issued to that person.

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   (4)   Regulations 4(3) to 4(8) of these Regulations shall apply to a self employed person registered under these provisions.

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   (5)   Despite subregulation (1)—

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      (a)     where an insured person who is employed by another person subsequently becomes self-employed the insured person shall for the purposes of paying contribution as a self-employed person and other related matters register as a self-employed person;

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      (b)     where a person who is self-employed is at the same time employed by someone, then that person may elect to pay personal contributions in addition to the contributions payable by his or her employer, except that the total contributions for a contribution period shall not exceed the amount due on the maximum insurable earnings in force at the time;

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      (c)     where a self employed person subsequently becomes employed by another person he or she will cease to be liable as a self-employed person and his or her employment status will take precedence in respect of payment of contribution;

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      (d)     where a person who is employed by another person, simultaneously becomes self-employed, the employment as an employed person supersedes the employment as a self-employed person in respect of payment of contributions.

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   (6)   A self employed person shall, except where these Regulations otherwise provide, pay a contribution in respect of each contribution period during which he or she is self-employed.

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   (7)   A self-employed person shall, at the end of the month in which he or she is self-employed or within one month thereafter, pay, by a method determined by the Director, the contributions he or she is obliged to pay by virtue of these provisions.

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   (8)   A self-employed person shall, for the purpose of payment of contributions—

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      (a)     select one of the categories of income listed in Table I of Schedule 1, which selection shall be binding for a minimum duration of 6 months, from the date of such selection;

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      (b)     be entitled to change such selection after 6 months, except that he or she shall only be entitled to change to a category of income that is immediately lower or higher than the one selected for the period immediately preceding;

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      (c)     not be entitled to change the selection to a higher category of income after attaining an age which is 6 years below the pensionable age.

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   (9)   A person who, prior to attaining an age which is 5 years below the pensionable age and has never paid contributions as a self-employed person but is subsequently entitled under these Regulations to pay contributions as a self-employed person shall not select a category of income that exceeds category E in Table I of the First Shedule.

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   (10)   Any selection of category of income made by a self-employed person shall be subject to the approval of the Director, and in making such determination he or she may make any inquiry, as he or she deems necessary.

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   (11)   Regulations 5 to 11 of these Regulations shall, apply to a self-employed person who is required to pay contributions under these Regulations.

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   (12)   Every self-employed person shall maintain records relating to his employment.

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   (13)   A self-employed person is entitled to all benefits except employment injury benefit, at the same rate as other insured persons, and in order to qualify for any short term benefit must have paid contributions for 12 consecutive months immediately preceding the date of the claim, in addition to satisfying the other qualifying conditions for the particular benefit.

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   (14)   Only paid contributions will be taken into account in calculating any benefit to be paid to a self employed person.

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   (15)   If a self-employed person is not gainfully employed for any duration he or she shall notify the Director in writing and where such period exceeds 12 months, furnish the Director with evidence of not having been employed during such period, and any person designated by the Director may inspect the records of the self-employed person to verify such claim.

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   (16)   Despite anything contained in the Act and these Regulations and for the purposes of this regulation any contribution paid later than the last day of the month following that month for which it is being paid shall not be accepted and the contribution for that month shall be treated as being unpaid for all intents and purposes.

12A.   Voluntary contributors

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   (1)   A person who—

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      (a)     is below pensionable age;

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      (b)     is ordinarily resident in Saint Lucia;

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      (c)     ceases to be eligible for payment of contributions in respect of insurable employment under the Act; and

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      (d)     has paid 60 months of contributions including any contributions credited to him or her in accordance with these Regulations,

is entitled to become a voluntary contributor under these Regulations.

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   (2)   The rate of contribution which a voluntary contributor shall pay shall be the same as that payable by an employed person during any contribution year in which a voluntary contributor is paying contributions and that rate shall be applied to the average annual wages paid to the voluntary contributor during the 2 years immediately preceding the date of the last termination of his or her employment, or to such other period as the Director may, in the particular circumstances of the case, determine.

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   (3)   Only paid contribution will be taken into account in calculating any benefit to be paid to a voluntary contributor.

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   (4)   A voluntary contributor shall be entitled to hospitalization, maternity and retirement benefit and must satisfy the prescribed conditions for the particular benefit.

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   (5)   An application to register as a voluntary contributor shall be made within 12 months of the date of cessation of insurable employment.

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   (6)   An application to register as a voluntary contributor shall be in the form set out as Form VC1 in Schedule 1.

13.   Employees of the Crown

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   (1)   In every case where a person is employed by the Crown—

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      (a)     on written terms of service or engagement for a specific duration; or

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      (b)     in a post which is not a pensionable post as defined in the Pensions Act;

the employer shall cause deductions to be made from the salary or wages of the employee and be matched by the employer and the composite sum paid into the Fund, in accordance with the Act.

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   (2)   All persons employed by the Crown after 31 January 2003 shall be deemed to be in insurable employment and shall be treated in like manner as insured persons under the Act and these Regulations.

14.   Time of deduction

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   (1)   An employer liable to pay contributions in respect of or on behalf of an insured person, shall, except as provided in this regulation, deduct these contributions from the insured person's wages before paying the wages in respect of the contribution period for which the contribution is payable.

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   (2)   Where wages are paid in advance for any period the employer shall deduct contributions in advance for that period before payment of the wages.

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   (3)   In addition to any other requirements, the employer shall, where the employment of an insured person is terminated, pay to the Corporation all contributions due from him or her together with the contributions payable by such insured person although contributions are still outstanding from the insured person, within 14 days of the termination of employment where the employment is terminated by the insured person without any notice or intimation to the employer, and forthwith on the termination of the employment where the employment is terminated in any other manner.

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   (4)   The Director may, if he or she thinks fit, and subject to such terms and conditions as he or she may impose—

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      (a)     approve any arrangement whereby contributions are paid at times or in a manner other than those prescribed by these Regulations and any such arrangement may include provision for the payment of such fees as may be determined by the Director, to represent the estimated additional expenses in the administration of the arrangement, to the Corporation; and

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      (b)     as a condition for authorising the payment of any contribution at a date later than that upon which the contribution would, apart from any authorisation under paragraph (a) be due to be paid, the Director may require the making of such deposit of money by way of security as the Board may approve.

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   (5)   These Regulations shall, subject to any such arrangements, apply to any person affected by the arrangements and any contravention of or failure to comply with any requirements of any such arrangement shall be deemed to be a contravention of or failure to comply with these Regulations.

15.   Authority to deduct and match employees' contributions

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   (1)   It shall be the responsibility of every employer, on making payment of wages during any contribution period to any employee, to make the appropriate deduction from such wages and pay the same together with his or her matching contributions to the Corporation.

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   (2)   An employer is not entitled to recover any contribution paid by the employer or to be paid by the employer on behalf of an employee otherwise than by deduction in accordance with these Regulations.

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   (3)   The surcharge payable in accordance with section 34 of the Act on late payments of contributions, shall begin to accrue as from the 8^th day of the month following that in which such contributions become due and payable.

16.   Error in deduction

If by reason of any error made in good faith, the employer, on making any payment of wages to an employee fails to deduct from the wages the full amount of contribution which he or she should deduct, he or she may, after prior notification to the employee recover the amount so under-deducted by deduction from any subsequent payment of emoluments to that employee within 6 months thereafter.

17.   Returns by employer

1.  

   (1)   Not later than the last day of February in each year the employer shall render to the Director in such form as the Director may approve, a return, in respect of each employee, containing such particulars as the Director may require for the identification of the employee and the contributions paid by and receivable for him or her, for the preceding year.

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   (2)   Where the employer is a body corporate, the return referred to in subregulation (1), shall be signed either by the Secretary or a Director of the said body corporate.

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   (3)   A return shall be made under this regulation regarding every employee in respect of whom a registration card has been issued and to whom the employer has at any time during the year made a payment of wages from which contributions were payable.

18.   Inspection of employees' records

1.  

   (1)   Every employer, whenever called upon to do so by an Inspector appointed or designated under section 14 of the Act, shall produce to such Inspector for inspection either at the employer's premises or at any office of the Corporation all wage sheets, and other documents and records whatsoever relating to the wages of his or her employees, the deduction of contributions from such wages and payment of the employer's contribution in respect of such wages for any contribution period specified by that Inspector.

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   (2)   The Director, by reference to the information obtained from inspection of the documents and records produced under subregulation (1), may on the occasion of each inspection prepare a certificate setting out—

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      (a)     the amount of contributions which the employer is liable to pay to the Fund for the relevant years or months in accordance with the documents so produced; and

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      (b)     any amount of contributions which have not been paid to the Fund.

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   (3)   The production of the certificate specified in subregulation (2) shall be sufficient evidence in any court that the employer is liable to pay to the Fund in respect of any contribution period mentioned in the certificate the amount shown therein under subregulation (2) and any document purporting to be such a certificate shall be deemed in any court to be such a certificate until the contrary is proved.

19.   Death of employer

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   (1)   If an employer dies during any contribution period, any function which he or she would have been liable to perform under these Regulations shall be performed by his or her personal representative; and in the event of the death of an employer who paid wages on behalf of another person the said functions shall be performed by the person succeeding him or her and if no person succeeds him or her, by the person on whose behalf he or she had paid the wages.

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   (2)   Where an employer is a body corporate and changes ownership or ceases operations, its directors at the time of such change or cessation shall be responsible for performing any function which it would have been liable to perform under these Regulations.

20.   Exemption from liability for contributions

1.  

   (1)   An employee and his or her employer shall be exempt from liability to pay contributions for any contribution period—

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      (a)     in which no work is done by the employee and the employee received no wages in respect of the period;

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      (b)     during which an employee is in full-time unpaid apprenticeship.

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   (2)   Nothing in this regulation shall be deemed to affect the liability of an employee, for any contribution period in which the employee is on leave if subject to subregulation (1)(a) contributions are normally payable with respect to the employment of such person.

21.   Refund of contributions

1.  

   (1)   Where the Director is satisfied that any contribution was paid to the Fund by error in respect of any employee either wholly or partly in excess of the amount that was due to be paid, the Director may, subject to subregulation (2) refund the amount so paid in excess, to the person by whom it was paid.

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   (2)   Despite subregulation (1)

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      (a)     if any amount is due to the Fund from the person to whom refund of the amount paid in excess would otherwise be made, the Director may retain the whole or any part of such excess payment and set it off against any such amount due;

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      (b)     no refund shall be made without a written application to the Director, who may require the applicant to furnish such information as may be necessary to enable the Director to determine the amount of the excess payment and no amount shall be set off without the consent of the Director;

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      (c)     no interest shall be paid on any excess payment.

22.   Treatment of late payment for purpose of benefit

Subject to these Regulations, where a contribution payable by any employer in respect of or on behalf of an employee is paid after the due date or is not paid, and the delay or failure in making payment thereof is shown to the satisfaction of the Director not to have been with the consent or connivance of or attributable to any negligence on the part of the employee, the contribution shall, for the purpose of any right to benefit, be treated as having been paid on the due date.

23.   Treatment of late contributions for the purpose of sickness or maternity benefit.

1.  

   (1)   For the purpose of any right to sickness benefit or maternity benefit, a contribution paid after the due date shall, in determining whether the relevant contribution conditions are satisfied with respect to the number of contributions paid between the commencement of payment and the day for which the benefit is claimed, be treated—

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      (a)     for the purpose of the right to any such benefit in respect of any day before the date on which payment of the contribution is made, as not paid; and

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      (b)     for the purpose of the right to any such benefit in respect of any other day, as paid on the date on which payment of the contribution is made.

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   (2)   For the purposes of subregulation (1), in determining whether the relevant contribution conditions are satisfied in whole or in part with regard to the number of contributions paid or credited in respect of the last prescribed contribution period before the day for which sickness benefit or maternity is claimed, a contribution paid after the due date shall be treated—

   1.  

      (a)     if after the commencement of incapacity for work and whilst the incapacity continues or during the period for which maternity benefit would otherwise be payable, as the case may be, as not paid in respect of any day before the expiry of a period of 42 days including Sundays from and including the date on which payment of that contribution is made and as paid at the expiry of that period in relation to the right to such benefit in respect of any other day;

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      (b)     if paid after the cessation of incapacity for work for the said period referred to in paragraph (a) as the case may be, as not paid.

24.   Treatment of late contributions for the purpose of retirement or invalidity benefits

For the purpose of any right to retirement or invalidity benefit, a contribution paid after the due date shall be treated—

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   (a)     if paid before the expiration of 6 months next following the end of the year in which it became payable, as paid on the due date;

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   (b)     if paid at any other time, as not paid.

25.   Treatment of late contributions for the purpose of funeral benefit

For the purpose of any right to funeral benefit, a contribution paid after the due date shall be treated as not paid if the contribution is paid after the date of death of the person in respect of whom the grant is claimed.

26.   Employment by 2 or more employers

1.  

   (1)   Where an employee is employed by 2 or more employers in any contribution period, each employer shall pay contributions on the respective wages paid to the employee in accordance with the Act.

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   (2)   Any contribution paid on amounts in excess of the maximum wage limit shall be refunded in accordance with regulation 21.

27.   Principal and sub-contractors

1.  

   (1)   Where a principal contractor issues a contract for service to a sub-contractor, the principal contractor shall furnish the Corporation in writing with the correct name, address and telephone number of every sub-contractor, so engaged and the date and duration of such engagement.

1.  

   (2)   The failure of a principal contractor to provide the information required under Subregulation (1) above shall constitute an offence and on summary conviction is liable to a fine not exceeding $5,000.00 or 12 months imprisonment or both.

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   (3)   Every sub-contractor who employs persons for the purpose of any engagement under subregulation (1) above shall if not already registered under regulation 3(1), register as an employer and deduct and match contributions from the wages of employees and cause the composite sum to be paid into the Fund in accordance with these Regulations.

28.   Meaning of expression “husband”; “wife”; “cohabitation”

For the purpose of the Act and these Regulations and concerning any benefit, the expression—

1.  

   (a)     “husband” or “wife” in relation to a person who has been married more than once, refers to the last husband or wife respectively;

1.  

   (b)     “cohabitation” means a relationship between one man and one woman, where, although not married, they lived together as husband and wife in the same dwelling house for a continuous period of at least 5 years;

1.  

   (c)     “marriage” is extended to include the cohabitation of one woman with one man and the words wife, husband, widow, widower and spouse shall be construed accordingly.

PART 4
BENEFITS

A.  Sickness Benefit

29.   Entitlement

Subject to these Regulations, sickness benefit shall be payable to an insured person who is rendered temporarily incapable of work as a result of a specific disease, or physical or mental disablement which is not an employment injury, nor caused by habitual use of alcoholic liquor, narcotics, or drugs other than those taken under the prescription of a registered medical practitioner, and for this purpose—

1.  

   (a)     an insured person shall be treated as incapable of work for any day during which he or she is required to abstain from work because he or she is under observation by reason of being a carrier or having been in contact with a person suffering from an infectious disease;

1.  

   (b)     one day in each week as may be determined by the Director in any particular case or class of cases shall not be treated as a day of incapacity for work and shall be disregarded in computing any period of consecutive days.

30.   Day from which benefit is to commence

1.  

   (1)   An insured person who is eligible for sickness benefit shall not be entitled to receive such benefit for the first 3 days of any continuous period of incapacity for work.

1.  

   (2)   For the purpose of computing the first 3 days of any continuous period of incapacity for work under subregulation (1)—

   1.  

      (a)     public holidays shall be included;

   1.  

      (b)     one day per week shall be disregarded;

   1.  

      (c)     such computation shall commence from the first day of absence from work.

1.  

   (3)   An insured person shall not be entitled to sickness benefit on or after attaining pensionable age but this subregulation shall not apply to any person who has continued to make the appropriate contributions after pensionable age.

1.  

   (4)   Notwithstanding the above sickness benefit shall only be payable for certitified sick leave.

31.   Manner of claiming and support of claim

A claim for sickness benefit shall be made in the form set out as Form SB2 in Schedule 1 and shall be supported by—

1.  

   (a)     a certificate of a registered medical practitioner; and

1.  

   (b)     such other evidence as the Director may require for the purpose of establishing the insured person's incapacity for work.

32.   Conditions which must be satisfied

Sickness benefit shall be payable only if the insured person—

1.  

   (a)     was engaged in insurable employment immediately prior to the day on which incapacity commenced; or

1.  

   (b)     was engaged in insurable employment and has paid at least 2 months contributions in the period of 4 months immediately preceding the contribution period in which the first day of the continuous period of incapacity for work occurred; and

1.  

   (c)     had paid contributions for not less than 6 months since his or her registration under the Act.

33.   Period of payment

1.  

   (1)   Sickness benefit shall be paid for each day, excluding one day in each week as determined in accordance with these Regulations as long as the incapacity for work continues, subject to a maximum of 6 months in any continuous period of incapacity for work.

1.  

   (2)   In determining any period of incapacity, any period separated by not more than 8 weeks shall be treated as one continuous period of incapacity for work starting on the first day of the first such period.

1.  

   (3)   Where a claimant is entitled to receive from his or her employer full pay during any period of incapacity for work, the Director shall suspend payment of sickness benefit to such claimant during that period.

34.   Rate of sickness benefit

The rate of sickness benefit shall be 65% of the average insurable earnings in the last 4 months before the beginning of the period of incapacity.

B.  Invalidity Benefit

35.   Conditions for entitlement

Subject to these Regulations an insured person who—

1.  

   (a)     is an invalid otherwise than as a result of employment injury;

1.  

   (b)     has paid contributions for not less than 60 months with payments for 36 consecutive months immediately preceding the month of invalidity, or has paid not less than the qualifying number of months of contributions for a pension as outlined in Table II of Schedule 1.

1.  

   (c)     is under pensionable age; and

1.  

   (d)     is not in receipt of sickness benefit,

is entitled to an invalidity pension for so long as the invalidity continues.

36.   Rate of invalidity pension

1.  

   (1)   Where a claimant has contributed to the Fund for over 59 months but less than the qualifying number of months of contribution for the years outlined in Table II of Schedule 1, the rate of invalidity pension shall be equal to 35% of his or her average insurable earnings.

1.  

   (2)   Where a claimant has contributed to the Fund for the qualifying number of months of contribution for the years outlined in Table II of Schedule 1 or more the rate of invalidity pension shall be—

   1.  

      (a)     equal to 40% of his or her average insurable earnings for the qualifying number of months of contribution for the years outlined in Table II of Schedule 1; plus

   1.  

      (b)     one tenth of one per centum for every additional month in excess of the qualifying number of months of contribution for the years outlined in Table II of Schedule 1 that he or she has contributed to the Fund.

1.  

   (3)   For the purpose of an invalidity benefit the average insurable earnings shall be, the average of the best 5 years of insurable earnings before the commencement of the pension, and for the purposes of this regulation where the insurable earnings is in excess of $36,000 per year then the average insurable earnings shall be computed in accordance with Table III of Schedule 1 for the years outlined in the first Column of Table III

1.  

   (4)   The rate of an invalidity pension shall be increased to $200 per month, if otherwise it would have been lower.

1.  

   (5)   A full pension shall not exceed 60% of average insurable earnings.

37.   Invalidity grant

Subject to this regulation, an insured person who does not satisfy regulation 35 but who—

1.  

   (a)     is an invalid;

1.  

   (b)     has contributed to the Fund for less than 60 months; and

1.  

   (c)     is under pensionable age,

is entitled to an invalidity grant based on the insured person's balance, if any, in the National Provident Fund at the date of commencement of the Act with interest on it, together with 100% of the employee's portion of the contributions paid to the Fund under his or her account without interest.

38.   Certificate of permanent incapacity for work

All claims for invalidity benefit shall be made in the form set out as Form Inv. B1 in Schedule 1, accompanied by a certificate of permanent incapacity for work setting out the nature of the incapacity by a registered medical practitioner.

C.  Maternity Benefit

39.   Entitlement

1.  

   (1)   Subject to these Regulations, a maternity allowance shall be payable in case of pregnancy and confinement of a woman in insurable employment.

1.  

   (2)   The Director shall have access to all the relevant evidence before any payment of maternity benefit is made under subregulation (1).

40.   Conditions to be satisfied

Maternity benefits shall be payable only if a woman—

1.  

   (a)     has been in insurable employment prior to her claim for maternity allowance; and

1.  

   (b)     has paid contributions for 7 months in the 10 months immediately preceding the month of expected confinement.

41.   Duration

Maternity allowance shall be paid for a period of 3 months starting with the month preceding the month of expected confinement, or if later, starting with the month in which the benefit is claimed, but starting not later than the month of actual confinement.

42.   Rate of maternity benefits

1.  

   (1)   The rate of maternity benefits shall be 65% of the average insurable earnings of the 10 months immediately preceding the month before the month of expected confinement.

1.  

   (2)   Where a claimant is entitled to receive from an employer full pay during any period of absence from work due to pregnancy, the Director shall suspend payment of maternity benefit to such claimant during that period.

43.   Maternity grant

1.  

   (1)   A woman is entitled to a grant of $600 if—

   1.  

      (a)     she has given birth to a child; and

   1.  

      (b)     she or her husband has contributed to the Fund for 7 months in the 10 months immediately preceding the month before the month of expected confinement.

1.  

   (2)   For the purpose of this regulation the expression “husband” includes a man cohabiting with a woman in the same dwelling house for a continuous period of at least 5 years.

1.  

   (3)   Any payment made by virtue of this regulation shall in respect of the husband's contribution be made only to one such woman.

1.  

   (4)   Where a woman who qualifies for a maternity grant under subregulation (1) dies during child birth, leaving a surviving child or children from this confinement, the maternity grant shall be paid in respect of such child or children, to such person having custody or guardianship of such child or children.

44.   Support of claim

1.  

   (1)   A claim for maternity benefits shall be made in the Form set out as Form MB 1 in Schedule 1 and shall be accompanied—

   1.  

      (a)     in the case of a claim made prior to the date of confinement; by a certificate duly certified by a registered medical practitioner or a registered midwife, as to the expected date of confinement; or

   1.  

      (b)     in the case of a claim made subsequent to the date of confinement, by a certificate duly certified by a registered medical practitioner or a registered midwife, as to the actual date of confinement.

1.  

   (2)   A claim for maternity grant on the basis of a husband's contribution shall be made in the form set out as Form MB 2 in Schedule 1.

45.   Certificate of confinement

1.  

   (1)   An insured woman who has been granted maternity benefit shall as soon as possible after her confinement, obtain a certificate of her confinement from the registered medical practitioner or registered midwife in attendance and forward it to an office of the Corporation within 3 months after obtaining such certificate.

1.  

   (2)   The Director may accept other evidence in lieu of the certificate referred to in subregulation (1) if, in his or her opinion, the special circumstances of any particular case so justify.

D.  Survivor's Benefit

46.   Entitlement to survivor's pension: rate of survivor's pension and amount of survivor's grant

1.  

   (1)   Subject to regulations 47, 48 and 49, survivor's benefit shall be payable to the widow or widower, as the case may be, or children or parents or grand parents of an insured person if, at the time of death, the insured person—

   1.  

      (a)     was in receipt of a retirement or invalidity pension; or

   1.  

      (b)     could have satisfied the prescribed condition for an invalidity pension or grant had he or she been deemed to be an invalid at the time of his or her death; or

   1.  

      (c)     was of pensionable age and would have been entitled to a retirement pension or grant had he or she made a claim for such benefit; or

   1.  

      (d)     was below the pensionable age and would have been entitled to a retirement benefit, save for his or her age, or an invalidity benefit had he or she made a claim for such benefit.

1.  

   (2)   Where at the date of his or her death a deceased insured person was in receipt of an invalidity or retirement pension or would have been entitled to an invalidity or retirement pension had he or she been an invalid, the benefit payable shall be a pension, in these Regulations referred to as a “survivor's pension”.

1.  

   (3)   Where at the date of his or her death the deceased insured person would have been entitled to an invalidity or retirement grant had he or she been deemed to be an invalid, the benefit payable shall be a grant, in these Regulations referred to as a “survivor's grant”.

1.  

   (4)   Survivor's benefit shall not be payable in respect of a marriage contracted after the insured person had been granted an invalidity pension or retirement pension, except where the parties had lived together for a continuous period of at least 5 years prior to the date of such marriage.

1.  

   (5)   The rate of survivor's pension shall not exceed the rate of invalidity or retirement pension which would have been payable to the deceased insured person at the time of his or her death.

1.  

   (6)   The amount of survivor's grant shall not exceed the amount of invalidity or retirement grant which would have been payable to the deceased person at the time of his or her death.

1.  

   (7)   A claim for survivor's benefit shall be made in the form set out as Form Sur B1 in Schedule 1.

47.   Entitlement to survivor's pension

1.  

   (1)   A widow or widower who at the date of his or her spouse's death—

   1.  

      (a)     had no dependent children;

   1.  

      (b)     had been married to his or her spouse for at least 3 years; and

   1.  

      (c)     was of pensionable age or over,

is entitled to a survivor's pension for life or until his or her re-marriage or cohabitation with a person of the opposite sex as husband or wife.

1.  

   (2)   A widow or widower who at the date of his or her spouse's death was not under pensionable age, had been married to the deceased spouse for not less than 3 years; and was at the date of the death of the spouse an invalid, is entitled to a survivor's pension for life.

1.  

   (3)   A widow or widower who at the date of his or her spouse's death was under pensionable age and was an invalid is entitled to a survivor's pension during his or her invalidity.

1.  

   (4)   The benefit under subregulation (3) shall continue in the event the invalidity ceases when he or she is over the pensionable age.

1.  

   (5)   A widow or widower who was under pensionable age at the date of his or her spouse's death is entitled to survivor's pension for one year only.

1.  

   (6)   A survivor's pension payable to a widow or widower shall cease on his or her remarriage or cohabitation with a person as his or her spouse.

48.   Widower or widow with dependent children

1.  

   (1)   A widower or widow who has dependent children is entitled to a survivor's pension irrespective of his or her age at the date of his wife or her husband's death and such pension shall be payable until the children of their marriage cease to be dependent; but if he or she remarries or cohabits with a woman or a man as his wife or her husband respectively, the rate of pension set out in regulation 50 shall be payable to the dependent children, only.

1.  

   (2)   Where a widower or widow during the time he or she is in receipt of a pension under this regulation attains the pensionable age, the widower's or widow's pension shall be continued for his or her lifetime or until he or she re-marries or cohabits with a person of the opposite sex as his or her spouse.

49.   Entitlement of dependents

1.  

   (1)   A survivor's pension shall be payable in respect of a dependent child until he or she attains his or her 16^th birthday or his or her 18^th birthday if he or she is in full time education.

1.  

   (2)   Despite subregulation (1), in the case of an invalid child, the pension shall be payable for the period during which the invalidity continues.

1.  

   (3)   In any case where a deceased has left a surviving child or children the entitlement will be shared in such proportion as the insured has determined and in the absence of such determination, then as the Director deems fit.

1.  

   (4)   Where no other survivor is entitled, a survivor's pension is payable to a parent or grand parent, who at the death of an insured person—

   1.  

      (a)     was of pensionable age or older; and

   1.  

      (b)     was wholly or mainly maintained by the insured person immediately prior to his or her death.

50.   Rate of survivor's pension

1.  

   (1)   Where there are no other survivor's or dependants the rate of survivor's pension payable to a widow or widower shall be 75% of a deceased spouse's pension entitlement, if such spouse were a pensioner at the date of death or 75% of the invalidity pension such spouse would have received had he or she become entitled to such pension at that date.

1.  

   (2)   If there exists any other survivor's or dependants then the rate of survivor's pension shall be 50% of the entitlement outlined in subregulation (1).

1.  

   (3)   The rate of pension payable to dependent children shall be 50% of the insured parent's entitlement at the date of his or her death, if the deceased parent were a pensioner at the date of death, or 50% of the invalidity pension the deceased parent would have received had he or she become entitled to such pension at that date, or 50% of each parent's entitlement if both are dead.

1.  

   (4)   The rate of survivor's pension to a parent or grand parent shall be equal to 50% of the insured person's pension entitlement if he or she were a pensioner at the time of his or her death, or the invalidity pension he or she would have received had he or she become entitled to such pension at that date.

1.  

   (5)   The total aggregate pension payable to survivors shall be limited to 100% of the insured person's entitlement at the time of death, or of the invalidity pension he or she would have received had he or she become entitled to such pension at that date.

51.   Distribution of survivor's grant

A survivor's grant shall be distributed on the same basis as provided in regulation 50 for a survivor's pension.

52.   Persons to be treated as survivors

1.  

   (1)   For the purpose of the regulations concerning survivor's benefit where it is a condition of entitlement to the benefit that a person shall be the widow or widower of an insured person, the following provisions shall apply—

   1.  

      (a)     in the case of an insured man, the survivor shall be a person whom the Director is satisfied is his wife or a woman with whom he cohabited as his wife;

   1.  

      (b)     in the case of an insured woman, the survivor shall be a person whom the Director is satisfied is her husband or a man with whom she cohabited as her husband.

1.  

   (2)   Where the question of marriage or re-marriage or the date of marriage or re-marriage, arises in regard to title to benefit, the Director shall, in the absence of evidence of a lawful marriage decide whether or not the person concerned should be treated as if he, she or they were married or had re-married as the case may be, and if so from what date; and in determining the question, the Director shall have regard to subregulation (1)(a) and (1)(b).

1.  

   (3)   The decision of the Director under subregulation (2) shall, unless the context otherwise requires, have the effect of extending, as regards title to survivor's benefit, the meaning of the word “marriage” to include the cohabitation of one woman and one man as aforesaid and the word “wife”, “husband”, “widow”, “widower”, and “spouse” shall be construed accordingly.

E.   Retirement Pension

53.   Entitlement to retirement pension

1.  

   (1)   Retirement pension shall be payable for life to an insured person who has attained pensionable age, is no longer employed in gainful employment and has contributed to the Fund for the respective period shown in Table II of Schedule 1.

1.  

   (2)   An insured person may elect to continue to pay contributions into the Fund until he or she has attained the age of 65 years.

54.   Rate of pension

1.  

   (1)   The rate of pension shall be equal to 40% of the insured person's average insurable earnings together with 0.1% of such earnings for every month in excess of the minimum qualifying number of months of contributions shown in Table II of Schedule 1, that he or she has contributed to the Fund.

1.  

   (2)   The average insurable earnings shall be the average of the best 5 years of insurable earnings before the commencement of the pension, and for the purposes of this regulation where the insurable earnings are in excess of $36,000 per year then the average insurable earnings shall be computed in accordance with Table III of Schedule 1 for the years outlined in the first column of Table III.

1.  

   (3)   The rate of retirement pension shall be increased to $200 if otherwise it would have been less.

1.  

   (4)   A full pension shall not exceed 60% of average insurable earnings.

55.   Entitlement to an early pension

1.  

   (1)   An insured person who has not satisfied all the requirements of regulation 53 may qualify for an early retirement pension before pensionable age under subregulation (2).

1.  

   (2)   Where an insured person has attained the age of 60, has satisfied the prescribed conditions for a full pension and is desirous of obtaining an early pension such pension shall be reduced by 0.5% for each month below the normal pensionable age, and the rate of such pension shall be in accordance with the formula set out in Table IV of Schedule 1.

56.   Entitlement to retirement grant

Subject to these Regulations, an insured person who does not satisfy the conditions under regulation 53 but who—

1.  

   (a)     has attained pensionable age; and

1.  

   (b)     has contributed to the Fund for less than the respective number of months outlined in Table II of Schedule 1,

is entitled to a retirement grant.

57.   Amount of retirement grant

The rate of retirement grant shall be equal to the insured person's balance, if any, in the National Provident Fund as at 2 April 1979 with interest on such balance from that date to the date he or she attains pensionable age together with 100% of the employee's portion of the contributions paid to the Fund under his or her account without interest.

58.   Claims

1.  

   (1)   A claim for retirement benefit shall be made in the form set out as Form RB1 in Schedule 1.

1.  

   (2)   A person who is in receipt of a retirement pension shall furnish documentary evidence that he or she is alive by completing a life certificate in the form set out as Form NI/LC in Schedule 1 and submit the completed form to the Director on or before the 30 June and 31 December in each year.

1.  

   (3)   Failure to produce a certificate under subregulation (2) will result in the pension being suspended until the date on which that certificate is furnished.

F.  Funeral Benefit

59.   Entitlement to grant

1.  

   (1)   Subject to these Regulations, a funeral grant shall be payable on the death of any insured person who—

   1.  

      (a)     at the time of his or her death could have satisfied the contribution condition for any benefit except for a grant or allowance; or

   1.  

      (b)     has paid at least 6 months contribution in the 12 months preceding his or her death; or

   1.  

      (c)     has paid contribution, the total sum of which is at least equivalent to the amount of the funeral grant.

1.  

   (2)   A funeral grant shall also be payable to an insured person upon the death of a dependent child or spouse if that insured person, at the time of the death of such dependent child or spouse satisfies the following conditions—

   1.  

      (a)     the contribution condition for any benefit excluding a grant or allowance; or

   1.  

      (b)     paid at least 6 months of contributions in the 12 months preceding the relevant date of death; or

   1.  

      (c)     has paid contributions the total sum of which is at least equivalent to the amount of the funeral grant.

60.   Person who may receive grant

1.  

   (1)   Subject to these Regulations, a funeral grant shall be paid to the person who has met or is liable to meet the funeral expenses of the deceased person.

1.  

   (2)   Where—

   1.  

      (a)     death has occurred at sea and the deceased person was buried at sea;

   1.  

      (b)     the person who has met or is liable to meet the funeral expenses of the deceased person cannot be found; or

   1.  

      (c)     the funeral expenses of the deceased person were less than the amount of the funeral grant,

the funeral grant, or as the case may be, the remainder of the funeral grant, shall be paid to such person or persons as the Director in his or her discretion may decide.

61.   Amount of grant

1.  

   (1)   The amount of funeral grant payable under regulation 59(1) shall be $1750.

1.  

   (2)   The amount of funeral grant payable under regulation 59(2) shall be as prescribed in Table V in Schedule 1.

1.  

   (3)   A claim for funeral benefit shall be made in the form set out as Form FB1 in Schedule 1.

G.  Employment Injury Benefit

62.   Entitlement to benefit

1.  

   (1)   Subject to these Regulations, employment injury benefit shall be payable to an insured person who at the time of the relevant accident was in insurable employment and who as a result of such accident or a prescribed disease as provided under these Regulations becomes incapable of work and for this purpose—

   1.  

      (a)     a person shall be treated as incapable of work for any day on which he or she is required to abstain from work as a result of an employment injury;

   1.  

      (b)     one day in each week as may be determined by the Director in any particular case or class of cases shall not be treated as a day of incapacity for work, and shall be disregarded in computing any period of consecutive days.

1.  

   (2)   Despite subregulation (1) a person in insurable employment shall not be deprived of his or her entitlement to employment benefit by reason only that under any other law he or she is deemed to be an unemployed person.

63.   Notice of accident by insured person

1.  

   (1)   An insured person who suffers personal injury through an accident in respect of which employment injury benefit is payable under these Regulations shall give notice of such accident in writing to his or her employer as soon as practicable after the accident.

1.  

   (2)   The notice required to be given by an insured person under subregulation (1) may be given by a person acting on his or her behalf and the Director may in any case authorise the employer to dispense with a written notice.

1.  

   (3)   The notice shall be given to the employer, or if there is more than one employer to one of such employers, or to any foreman or other official under whose supervision the insured person is employed at the time of the accident or to any person designated for the purpose by the employer, and shall give the appropriate particulars of the accident.

64.   Employer to complete form for accident or disease

The employer of a person who has sustained an employment injury or developed a prescribed disease shall complete the form set out as Form EIB 1 in Schedule 1, and shall cause the form, after its completion, to be delivered to the Director.

65.   Day from which benefit is to commence

1.  

   (1)   An insured person who is eligible for employment injury benefit is entitled to receive such benefit from the first day of any continuous period of incapacity for work.

1.  

   (2)   In determining whether the insured person is incapable of work on the day of the relevant accident, any part of that day before the occurrence of the accident shall be disregarded.

66.   Manner of claiming and support of claim

A claim for employment injury benefit shall be in the form set out as Form EIB 2 in Schedule 1 and shall be supported by a certificate from a registered medical practitioner or by such other evidence as the Director may deem requisite and for such purpose the Director may require—

1.  

   (a)     the claimant to submit himself or herself to examination by one or more registered medical practitioners nominated by the Director from a panel of registered medical practitioners approved by the Board;

1.  

   (b)     an inspector to conduct an inquiry and submit a report on the relevant accident including its causes and consequences.

67.   Duration and rate of payment

1.  

   (1)   Employment injury benefit shall be paid while the incapacity continues for a maximum of 12 months or until the earlier award of a permanent disability benefit.

1.  

   (2)   The rate of employment injury shall be 65% of the insurable earnings in the month in which the injury was sustained or the average of the best 2 in the last 4 months of contributions before the month in which the injury was sustained.

1.  

   (3)   Despite subregulation (1) any 2 or more periods of incapacity for work arising out of the same accident and not separated by more than 8 weeks shall be treated as one continuous period of incapacity for work starting on the first day of the first such period.

1.  

   (4)   Where a claimant is entitled to receive from an employer full pay during any period of absence from work due to employment injury, the Director shall suspend payment of employment injury benefit to such claimant during such period.

68.   Medical expenses payable for employment injury

1.  

   (1)   Subject to this regulation an insured person is entitled to the refund of medical expenses incurred by him or her as a result of the relevant accident or disease in respect of medical, surgical, dental and hospital treatment, and the supply of medicines.

1.  

   (2)   Any medical expenses refunded under this Part shall not exceed $20,000.

1.  

   (3)   The fees or charges constituting medical expenses in this regulation shall not be more than would be properly and reasonably charged.

1.  

   (4)   The amount of any such fees and charges which may be refunded under this Part in any case shall be determined by the Director.

1.  

   (5)   Medical expenses incurred in Saint Lucia for which a person is eligible during his or her absence from Saint Lucia shall be paid in Saint Lucia to such representative acting for and on behalf of the person concerned as may be authorised by him or her in writing.

1.  

   (6)   Despite anything contained in this Part, where the Director considers it necessary to do so, he or she may instead of refunding to an insured person any medical expenses incurred by that person, pay to a medical practitioner or an institution from whom or at which that person obtained treatment a sum equal to such medical expenses or such part thereof as may be refunded under these Regulations.

69.   Disqualification

An insured person entitled to payment of employment injury benefit shall be disqualified from receiving benefit for such period as the Director may decide where—

1.  

   (a)     the claimant has become incapable of work through his or her own misconduct;

1.  

   (b)     the injury was self-inflicted;

1.  

   (c)     the claimant fails, without good cause, to comply with a notice in writing by the Director requiring him or her to submit himself or herself to medical or other examination; or

1.  

   (d)     the claimant fails, without good cause, to

   1.  

      (i)     refrain from behaviour which retards his or her recovery, or to answer any reasonable enquiry by an officer of the Corporation to ascertain whether he or she is doing so,

   1.  

      (ii)     refrain from doing work for which remuneration is or would ordinarily be payable.

70.   Disablement pension

1.  

   (1)   If the relevant accident results in permanent total disability of the insured person or disability assessed at over 30%, as set out in Schedule 2, a disablement pension shall be paid at the same rate as an invalidity pension, subject to a minimum of 65% of the insured person's average insurable earnings in the month of the relevant accident.

1.  

   (2)   A claim for disablement benefit shall be made in the form set out as Form DB1 in Schedule 1.

71.   Entitlement to disablement benefit

1.  

   (1)   For the purpose of this regulation, the extent of disablement shall be assessed, by reference to the disabilities incurred by the claimant as a result of the relevant loss of faculty, in accordance with the following general principles—

   1.  

      (a)     the disabilities to be taken into account shall be all disabilities to which the claimant may be expected, having regard to his or her physical and mental condition at the date of assessment, to be subject during the period taken into account by the assessment as compared with a person of the same age and sex whose physical and mental conditions are normal;

   1.  

      (b)     no such disability shall be treated as having been incurred as a result of the relevant loss of faculty in so far as the claimant either—

      1.  

         (i)     would in any case have been subject thereto as a result of congenital defect or of any injury or disease received or contracted before the relevant accident, or

      1.  

         (ii)     would not have been subject thereto but for some injury or disease received or contracted after, and not directly attributable to, the relevant loss of faculty,

      1.  

         (iii)     the assessment shall be made without reference to the particular circumstances of the claimant other than age, sex and physical and mental condition.

1.  

   (2)   The period to be taken into account for an assessment of the extent of a claimant's disablement shall be the period—

   1.  

      (a)     beginning on the first day of entitlement to benefit and limited either to the claimant's life or to a definite date; and

   1.  

      (b)     during which the claimant has suffered and may be expected to suffer from the relevant loss of faculty.

1.  

   (3)   Despite subregulation (2), if on any assessment the condition of the claimant is not such, having regard to the possibility of changes therein, whether predictable or not, as to allow a final assessment being made up to the end of the said period—

   1.  

      (a)     a provisional assessment shall be made, taking into account such shorter period only as seems reasonable having regard to his or her condition and the possibility aforesaid; and

   1.  

      (b)     on the next assessment the period taken into account shall begin with the day after the end of the period taken into account by the provisional assessment.

1.  

   (4)   An assessment shall state the degree of disablement in the form of a percentage, which shall be determined in accordance with Schedule 2, and shall also specify the period taken into account for the assessment and where that is limited by reference to a definite date as in subregulation (2), whether the assessment is provisional or final.

1.  

   (5)   Despite subregulation (4)—

   1.  

      (a)     the said percentage and period shall not be specified more particularly than is necessary for the purpose of determining in accordance with this regulation the claimant's right to disablement benefit;

   1.  

      (b)     a percentage above 14 which is not a multiple of 10 shall be treated—

      1.  

         (i)     if it is a multiple of 5, as being the next higher percentage which is a multiple of 10;

      1.  

         (ii)     if it is not a multiple of 5, as being the nearer percentage which is a multiple of 10;

   1.  

      (c)     where a medical authority has given a final assessment of the degree of disablement of a claimant, the assessment may be reviewed at any time at the initiative of the medical authority or at the request of the Director and the new assessment, if different from the previous one, shall be taken into consideration in determining the claimant's right to disablement benefit.

72.   Rate of disablement grant

Where the degree of disablement is assessed for the period taken into account as amounting to less than 30% the Director shall commute the disablement benefit into a lump sum equivalent to the benefit payable over a period of 60 months.

73.   Increase of disablement benefit during approved hospital treatment

Where an insured person entitled to disablement benefit enters any hospital for the purpose of receiving approved hospital treatment or rehabilitation, then if the degree of disablement in respect of which a pension is payable was assessed at less than 100%, it shall be treated for the period during which he or she received such treatment as if it had been assessed at 100%.

74.   Death benefits entitlement of dependents

1.  

   (1)   Subject to these Regulations, where an insured person in insurable employment dies as a result of a relevant accident, death benefit shall be payable—

   1.  

      (a)     to or for the benefit of the dependants of the deceased, other than those specifically excluded by subregulation (2) of this regulation; and

   1.  

      (b)     either as a periodical payment or as a lump sum, calculated in accordance with these Regulations.

1.  

   (2)   The dependants of a person entitled to claim a benefit under subregulation (1) shall not include an adult dependant who—

   1.  

      (a)     died before an award of such benefit in respect of the deceased had been made; or

   1.  

      (b)     is the widow of the deceased unless at the time of his death—

      1.  

         (i)     she is over pensionable age or incapable of work and the incapacity is likely to be permanent, or

      1.  

         (ii)     she is pregnant by her late husband, or

      1.  

         (iii)     she has the care of a child of his or of their marriage who is under the age of 16 years; or is under 18 years and is in full time education, or

      1.  

         (iv)     she was either residing with him or receiving, or entitled to receive from him periodical payments for the maintenance of herself or their children or both;

   1.  

      (c)     is the widower of the deceased unless at the time of her death—

      1.  

         (i)     he is over pensionable age and incapable of work and this incapacity is likely to be permanent, or

      1.  

         (ii)     he has the care of a child of hers or of their marriage who is under 16 years of age; or is under 18 years and is in full time education, or

      1.  

         (iii)     he was either residing with her or receiving, or entitled to receive from her periodical payments for the maintenance of himself or their children or both;

   1.  

      (d)     was married to the insured person less than 6 months before his or her death.

1.  

   (3)   For the purposes of subregulation 2 the term widow and widower has the same meaning assigned under regulation 52(1).

75.   Prior entitlement of widow, widower and child

1.  

   (1)   A widow or widower qualifying as a dependant under regulation 74 is entitled to death benefit in preference to all other claimants.

1.  

   (2)   Every unmarried dependent child who becomes an orphan as a result of the death of—

   1.  

      (a)     an insured person whose death was caused by the relevant accident; or

   1.  

      (b)     a widow or widower in receipt of a death benefit, and who has no stepmother or stepfather with a prior claim,

shall, in preference to all other claimants, be entitled to death benefit from the day after the death of the deceased if he or she is then under 16 years or is 18 years and is in full-time education and was wholly or mainly maintained by the deceased and shall, subject to the conditions specified in regulation 74 continue to receive such benefit until he or she reaches the age of 18 years.

76.   Entitlement of parent to death benefit

If the insured person dies as a result of the relevant accident and is not survived by a widow, widower or child, entitled to death benefit, a parent of the deceased who is permanently incapable of self-support and who was being wholly or mainly maintained by the deceased or who would, but for the relevant accident have been so maintained is entitled to death benefit.

77.   Entitlement of other relatives to death benefit

1.  

   (1)   Where an insured person dies as a result of a relevant accident and is not survived by a widow, widower, child or parent entitled to death benefit, then a death benefit shall be payable to a dependant or dependants being members of the family of the deceased if at the time of the death such dependant was wholly or mainly maintained by the deceased or would, but for the relevant accident, have been so maintained; and

   1.  

      (a)     if the dependant is a man, is permanently incapable of self-support or living with his wife who is permanently incapable of self-support;

   1.  

      (b)     if the dependant is a woman, is herself permanently incapable of self support or is living with her husband who is permanently incapable of self-support;

   1.  

      (c)     if the dependant is a child, who is under the age of 18 years, or being above that age is permanently incapable of self-support.

1.  

   (2)   If there is more than one dependant, the death benefit payable under subregulation (1) shall be distributed in proportion to the contribution made by the deceased during his or her lifetime to each dependant or in such manner as the Director may, in his or her discretion, consider reasonable.

1.  

   (3)   Where an insured person dies as a result of a revelant accident and leaves no dependant entitled to death benefit, there shall be payable to his or her creditors or his or her estate a lump sum not exceeding the smaller of the following amounts—

   1.  

      (a)     a sum equal to the reasonable expenses for medical attendance of the deceased arising from the relevant accident and the reasonable expenses of his or her burial; or

   1.  

      (b)     a grant calculated at 12 months of any pension the deceased would have been entitled to receive had he or she made a claim for such benefit.

78.   Claim for death benefit

1.  

   (1)   A claim for death benefit shall be made in the form set out as Form Sur. B1 in Schedule 1.

1.  

   (2)   Except for lump sums payable under regulation 77 all death benefits shall be paid as pensions.

79.   Period for which pension is payable

1.  

   (1)   A death benefit in the form of pensions shall be payable for the undermentioned periods—

   1.  

      (a)     to a widow for life commencing from the date of the death of her husband;

   1.  

      (b)     to a widower for life commencing from the date of the death of his wife;

   1.  

      (c)     to an orphan from the date of death of his or her surviving parent until he or she reaches the age of 16 years or, being between the ages of 16 and 18, he or she is an unpaid apprentice and not otherwise employed for gain or is receiving full-time education; or

   1.  

      (d)     to a parent for life commencing from the date of the deceased's death or until the Director is satisfied that the circumstances of the parent have so changed by re-marriage or otherwise that he or she would no longer have been dependent on the deceased person if he or she had survived.

1.  

   (2)   Despite paragraphs (a) and (b), where a widow or widower re-marries or co-habits with a person of the opposite sex who is not his or her spouse, the payment of benefit shall cease from the date of his or her re-marriage or his or her co-habitation, as the case may be.

80.   Rate of death benefit

The rate of a death benefit for the beneficiaries described in these Regulations shall be the rate payable for pensions under these Regulations.

81.   Prescribed disease

Where a person has developed any of the diseases specified in the first column of Schedule 3, being a disease due to the nature of his or her insurable employment in any occupation set out against that disease in the second column of that Schedule, the benefits specified in these Regulations shall be payable subject to the conditions set out in these Regulations and for this purpose—

1.  

   (a)     any reference to a relevant accident or employment injury shall include a reference to a prescribed disease;

1.  

   (b)     any reference to the date of such an accident or injury shall include—

   1.  

      (i)     if the first claim in respect of the prescribed disease is for employment injury benefit, the first day the claimant is incapable of work as a result of a prescribed disease,

   1.  

      (ii)     if the first claimant in respect of the prescribed disease is for disablement benefit, the first day the claimant is suffering from loss of physical or mental faculty as a result of a prescribed disease.

82.   Re-occurence of prescribed disease

Where a person claims employment injury or disablement benefit in respect of a prescribed disease for which he or she has previously received employment injury or disablement benefit, his or her earlier claim in respect of that disease shall be disregarded if he or she is incapable of work and if his or her incapability is predominantly due to further exposure to risk of that disease in his or her insurable employment in any occupation set out against that disease in the second column of Schedule 3.

H.  Miscellaneous Provisions Relating to Employment Injury

83.   Obligations of claimants and beneficiaries in respect of employment injury benefit or disablement benefit

1.  

   (1)   Subject to these Regulations every claimant for and every beneficiary of employment injury benefit or disablement benefit shall comply with every direction given to him or her by the Director, which requires him or her either—

   1.  

      (a)     to submit himself or herself to a medical examination by a medical authority for the purpose of determining the effect of the relevant accident or the treatment appropriate to the relevant injury or loss of faculty; or

   1.  

      (b)     to submit himself or herself to such medical treatment for the said injury or loss of faculty as is considered appropriate in his or her case by the registered medical practitioner in charge of the case or by the medical authority to whose examination he or she has submitted himself or herself in accordance with the foregoing provisions to these Regulations; or

   1.  

      (c)     to attend any vocational training or industrial rehabilitation course that might be provided, and which, in the opinion of the Board, is appropriate in his or her case.

1.  

   (2)   Every direction given to a claimant or beneficiary requiring him or her to submit himself or herself to medical examination shall be given in writing.

1.  

   (3)   A claimant or beneficiary who, in accordance with the foregoing provisions of this regulation, is required to submit himself or herself to a medical examination or to medical or other treatment for the relevant injury shall attend at such time and place as may be required.

1.  

   (4)   A claimant or beneficiary shall, as soon as may be practicable, notify the Director of any change in circumstances arising after his or her claim has been made or benefit has been made or benefit has been granted which he or she might reasonably be expected to know might affect the continuance of his or her right to any benefit awarded to him or her or to the receipt thereof.

1.  

   (5)   Where a beneficiary entitled to a disablement benefit attends a vocational training or industrial rehabilitation course at the request of the Director, then if the degree of disablement in respect of which the disablement benefit is payable is assessed at less than 100%, it shall, for the period for which he or she is required by the Corporation to attend such vocational training or industrial rehabilitation, be treated as if it had been assessed at 100%.

84.   Credited contribution for weeks of employment injury benefit

For every contribution week for the whole of which an insured person has received employment injury benefit or disablement benefit or approved hospital treatment under these Regulations, a contribution shall be credited to that person without actual payment thereof.

I.  Hospitalisation & Medical Treatment

85.   Hospitalisation and medical benefit

1.  

   (1)   Hospitalisation and medical benefit shall be in the form of a quarterly payment to the Government for the provision in Saint Lucia, by the Government, of medical services and supplies for insured persons at an approved hospital.

1.  

   (2)   The amount of such quarterly payments shall be mutually agreed upon by the Board and the Government.

1.  

   (3)   The Minister of Health shall fix an equitable allocation of the quarterly payments and decide how it will be apportioned between all approved hospitals.

1.  

   (4)   The quarterly payment made in accordance with this regulation shall cease from the day when the Regulations under the Act, for a scheme of medical insurance, come into operation.

1.  

   (5)   Hospitalisation and medical benefits shall apply only if an insured person has satisfied the conditions stipulated in regulation 32 (b) and (c).

1.  

   (6)   Approved hospitals for the purposes of this regulation shall be every public hospital operating in Saint Lucia or any hospital or clinic incorporated under any law in force and approved by the Minister by order published in the Gazette.

PART 5
PERSONS EMPLOYED ON SHIPS AND AIRCRAFT

86.   Application to persons employed on ships and aircraft

1.  

   (1)   This Part shall apply to persons in insurable employment as masters, members of the sea service on a ship registered in Saint Lucia or as pilots, commanders, navigators and members of the crew of any aircraft registered in Saint Lucia or in any other capacity on board any such ship or aircraft, with the following modifications—

   1.  

      (a)     the notice of the accident and the claim for benefit except where the person injured is the master or other person in charge of the ship or aircraft (in these regulations called the “person in charge”) may be given to the person as if he or she were the employer, but, where the accident happened and the incapacity commenced on board the ship or aircraft it shall not be necessary to give any notice of the accident;

   1.  

      (b)     in case of the death of the person in charge or of a member of the crew resulting from the relevant accident, the application for death benefit under these Regulations shall be made within 3 months after news of the death has been received by the claimant; and

   1.  

      (c)     where the injured person is discharged or left behind in a foreign country, depositions respecting the circumstances and nature of the injury may be taken by a diplomatic or consular officer of Saint Lucia or any judge or magistrate of that foreign country, and such depositions or certified copies of the depositions shall be admissible in evidence in any proceedings for enforcing the claim.

1.  

   (2)   In this regulation the word “ship” has the same meaning as in the Shipping Act.

PART 6
MISCELLANEOUS

87.   Entitlement to more than one benefit

1.  

   (1)   Where a person is entitled to 2 or more benefits at the same time, only one benefit shall be payable to such person.

1.  

   (2)   The benefit payable under subregulation (1) shall be the one at a higher rate, but where the last mentioned higher benefit ceases to be payable then an award or reinstatement of a benefit to which such person is entitled may be made.

1.  

   (3)   Despite subregulations (1) and (2)—

   1.  

      (a)     a person is entitled to receive 2 or more disablement benefits at the same time in so far as the sum of the weekly rates of these benefits do not exceed the weekly rate of disablement benefit to which he or she would be entitled for loss of faculty which is assessed at 100% of the relevant wage applicable in his or her case or of the higher or highest relevant wage where the disablement benefits are assessed on different relevant wages;

   1.  

      (b)     any benefit under these Regulations may be paid with funeral benefit.

1.  

   (4)   Nothing contained in this regulation shall—

   1.  

      (a)     preclude payment of employment injury benefit or disablement at the same time as death benefit or survivor's benefit under these Regulations;

   1.  

      (b)     preclude the payment of sickness benefit or maternity benefit with death benefit.

1.  

   (5)   Despite any provision of these Regulations where any 2 benefits together do not exceed an amount determinable by the Board such benefits shall be payable.

88.   Benefits payable as grant or periodical payments

1.  

   (1)   Where a question arises regarding one or more benefits which are not allowed to be paid together, and one or more are grants and the rest periodical payment, the benefits payable shall be a periodical payment unless a grant has already been paid.

1.  

   (2)   Subject to subregulation (3) on cessation of the periodical payment under subregulation (1) which is less in total than the grant, the grant may be paid subject to a deduction therefrom of the total amount of the periodical payment.

1.  

   (3)   Where the period covered by the periodical payment referred to in subregulation (2) coincides only in part with the period covered by the grant, the deduction shall not exceed the total amount of the periodical payment for the coincidental period.

1.  

   (4)   Where a grant to which this regulation refers has already been paid, the periodical payment may be made subject to a deduction therefrom of an amount not exceeding 20% until the whole amount of the grant, or the amount applicable to the coincidental period, if any, has been deducted or the periodical payment, has ceased, whichever first occurs.

89.   Refund of benefit improperly paid

1.  

   (1)   Where it is found that any person has received any sum by way of benefit to which he or she is not entitled, he or she is liable to repay to the Fund the sum so received.

1.  

   (2)   Where any person is liable to repay any sum received by him or her by way of benefit, that sum may be recovered, without prejudice to any other remedy, by means of deductions from any other benefit to which he or she thereafter becomes entitled.

1.  

   (3)   Any such sum not recovered shall be treated as expenditure on, and charged to the Fund.

90.   Credited contribution

1.  

   (1)   For every contribution period for which an insured person receives any short-term benefit or employment injury benefit, a contribution shall be credited to that person without actual payment thereof.

1.  

   (2)   A contribution credited under subregulation (1) shall, subject to these Regulations, be valid for the short contribution condition for short term benefits and employment injury benefits, and shall be at the level of the insured person's insurable earnings corresponding to or most closely corresponding to that on the basis of which the first benefit had been paid.

91.   Persons abroad

1.  

   (1)   A person shall be disqualified from receiving any benefit for any period during which that person is absent from Saint Lucia, except that—

   1.  

      (a)     during such period as the Director may allow, having regard to the particular circumstances of the case, a person shall not be disqualified from receiving short-term benefits or employment injury benefits;

   1.  

      (b)     a person shall not be disqualified from receiving retirement benefit, survivor's benefit or death benefit by reason of being absent from Saint Lucia;

   1.  

      (c)     a person shall not be disqualified from receiving invalidity benefit by reason of being absent from Saint Lucia for such period as the Director may allow, having regard to the particular circumstances of the case.

1.  

   (2)   The Director may arrange payment of any long-term benefit to a person who is entitled to a benefit under these Regulations and who has taken up permanent residence in another country in any case where no reciprocal agreement exists between Saint Lucia and any other country.

92.   Payment of benefit for which person is eligible under regulation 91

Any benefit for which a person is eligible by virtue of regulation 91 shall be paid to that person or to such representative acting for and on behalf of the person concerned as may be approved by the Director and the receipt of the person so approved shall be a good discharge to the Corporation and the Fund for any sum so paid.

93.   Persons under-going imprisonment or detention in legal custody

A person shall be disqualified from receiving any benefit for any period during which that person is in prison or detention in legal custody except that where the Director is satisfied that the person undergoing such imprisonment or detention, has dependants who immediately prior to such imprisonment or detention were wholly maintained by him or her, the Director may authorise payment to, and in respect of those dependants, of an amount not exceeding one half of the benefit which would otherwise be payable for such period as he or she may allow, having regard to the particular circumstances of the case.

PART 7
MISCELLANEOUS PROVISIONS RELATING TO CLAIMS AND PAYMENTS CLAIMS

94.   Claims, to be in writing

1.  

   (1)   Every claim for benefit shall be made in writing to the Director on the prescribed form or where there is no prescribed form, in such other manner in writing as the Director may accept as sufficient in the circumstances of any particular case or class of cases.

1.  

   (2)   Every prescribed form of claim shall be supplied without charge by the Director.

1.  

   (3)   Where a claim for benefit has been made on a prescribed form other than the form appropriate to the benefit claimed, the claim may, if it contains sufficient particulars, be treated as if it had been made on the appropriate form.

1.  

   (4)   Despite subregulation (3) where a claim for a benefit is made on a prescribed form other than the appropriate form, the Director may require the claimant to complete the appropriate form.

95.   Information to be given

1.  

   (1)   A person who makes a claim for benefit shall furnish such certificates, documents, information and evidence for the purpose of determining the claim as the Director may require, and shall, for that purpose, attend at such office or place as the Director may direct.

1.  

   (2)   A person who makes a claim for benefit shall, in particular, furnish, if required by the Director the following information concerning himself or herself or in respect of the person for whom the benefit is claimed—

   1.  

      (a)     his or her identity, date of birth, usual place of residence, occupation and relationship to the claimant;

   1.  

      (b)     his or her position in regard to any benefit under the Act, available sources of income and the amounts contributed by any person towards his or her maintenance; and

   1.  

      (c)     in the case of a claim in respect of or based on a relationship to an insured person of a wife, husband, widow or a widower, a certificate of the marriage, or proof of registration as beneficiary, together with a declaration signed by him or her and, where appropriate, by the claimant that the information is true to the best of his or her knowledge and belief.

1.  

   (3)   A person who makes a claim for benefit in respect of a child, shall, in particular furnish such certificate relating to the birth of the child and such other information as the Director may require.

1.  

   (4)   A person who makes a claim for funeral benefit shall furnish, if required, the following information—

   1.  

      (a)     a death and burial certificate relating to the deceased;

   1.  

      (b)     the estimate or account of the undertaker;

   1.  

      (c)     in the case of any corporate body, association or other authority, such particulars relating to the relevant person as may be required by the Director.

1.  

   (5)   A person who makes a claim for survivor's benefit or death benefit shall furnish, if required by the Director, a death and burial certificate relating to the deceased.

1.  

   (6)   The Director may accept in support of claims and in the absence of the certificate or documents aforementioned—

   1.  

      (a)     as proof of kinship or marriage, evidence of a third person or other documentary evidence;

   1.  

      (b)     as proof of age, extracts from baptismal records or school records or other evidence as he or she considers satisfactory.

96.   Date of claim

For the purpose of any claim for a benefit, the day of receipt of the claim at the office of the Corporation shall be deemed to be the date of the claim.

97.   Defective and incomplete claim

1.  

   (1)   If a claim is defective in any material particular or incomplete at the date of its receipt by the Director, the Director may refer the claim to the claimant and if the form is returned properly completed within one month from the date on which it is so referred, or such other period as the Director may in any special circumstances specify, the claim may be treated as if it had been properly made in the first instance.

1.  

   (2)   Any person who has made a claim for benefit in accordance with these Regulations, may amend his or her claim at any time before a decision has been given on it by notice in writing delivered or posted to an office of the Board, and any claim so amended may be treated as if it had been properly made in the first instance.

1.  

   (3)   Where it appears to the Director that a person who made a claim for benefit may be entitled to some other benefit, any such claim may be treated by the Director as a claim in the alternative for that other benefit.

98.   Time for claiming benefits

1.  

   (1)   The prescribed time for claiming benefits is—

   1.  

      (a)     in the case of sickness and injury benefit, not later than 3 months from the date of expiration of sick leave;

   1.  

      (b)     in the case of maternity benefit, not later than 3 months after the date of confinement;

   1.  

      (c)     in the case of—

      1.  

         (i)     disablement benefit, and increases thereof on account of incapacity or hospital treatment, or

      1.  

         (ii)     invalidity, retirement, survivor's or death benefit,

   1.  

      the period of 3 months from the date on which apart from satisfying the condition of making a claim, the claimant becomes entitled thereto;

   1.  

      (d)     in the case of funeral grant, the period of 6 months from the date of death of the deceased;

   1.  

      (e)     in the case of medical expenses, not later than 3 months from the date on which the relevant expenses were incurred.

1.  

   (2)   Failure to submit a claim within the stipulated time limit shall result in the loss of the benefit unless it can be shown by the claimant to the satisfaction of the Director that there was good cause for delay in submitting the claim, in which case the claimant shall not be disqualified from receiving any benefit to which he or she would have been entitled if the claim had been made on the earlier date.

1.  

   (3)   No payment shall be made by way of sickness, maternity, employment injury (or disablement benefit, or increases of disablement benefit on account of incapacity or the need for constant attendance or hospital treatment), invalidity, retirement, survivor's or death benefit or medical expenses in respect of any period more than 12 months after the date on which the claim for the benefit is duly made.

1.  

   (4)   No sum shall be paid by way of a funeral grant if the claim for the funeral grant is not made within 12 months after the date of the death of the person in respect of whom the grant is payable.

99.   Claim in advance

1.  

   (1)   Despite regulation 98, where it has been certified that a person is incapable of work for the period specified in the certificate, a claim for sickness or employment injury benefit may, unless the Director otherwise directs, be made by the person in respect of the period or such shorter period as the Director may in the circumstances determine, in either case commencing immediately after the date on the certificate.

1.  

   (2)   Any claim for sickness or employment injury benefit made under subregulation (1), may, if it is made on the form containing the certificate be treated as a claim made also in respect of any days in the said period or in any such shorter period, as the case may be.

J.  Payments

100.   Time and manner of payment of benefits other than pensions

1.  

   (1)   Subject to these Regulations, a benefit shall be paid in accordance with an award thereof as soon as is reasonably practicable after such an award has been made by the Director, by means of drafts, cheques or other means payable through the bank, post office, or office of the Corporation, including cash payment at the home of the claimant, if the circumstances of any particular case appears to the Director to render this appropriate.

1.  

   (2)   Payments made under subregulation (1) shall be made weekly, fortnightly or monthly but where payment is due for a period covering less than one week, there shall be paid after the end of that period an amount equal to the proportion of the rate of benefit which the number of days in the period, (one day of each week being disregarded), bears to 6.

1.  

   (3)   In the case of those benefits payable only by way of lump sum or single payment, payment would be made by means of cheques or other means as appears to the Director to be appropriate in the circumstances of any particular case.

1.  

   (4)   Any benefit payable by way of a single lump sum payment, may be payable by instalments of such amounts and at such times as appears reasonable to the Director in the circumstances of the case, and an appeal shall not be brought against either any decision that such grant shall be payable by installments or the time of payment thereof but any decision may be varied by the Director at any time.

101.   Time and manner of payment of pensions

Subject to these Regulations, retirement pensions shall be paid monthly in arrears by means of cheques or at such post office, bank, or office of the Corporation as the Director, after enquiry of the pensioner, may from time to time determine.

102.   Other arrangements for payment of pension

Despite anything contained in these Regulations the Director may arrange—

1.  

   (a)     in any case where the date from which a pension would commence or as from which a change in the rate of pension would take effect is other than a date immediately following the payment date;

1.  

   (b)     in any case where the date from which a pension would cease to be payable is a day other than the payment date for the payment of that pension,

that the pension shall continue to be payable up to but not including the day following such day.

103.   Other times and methods of payment of pension

Despite anything contained in these Regulations, the Director may in any particular case or class of cases arrange for the payment of a pension otherwise than monthly or otherwise than by means of cheques payable to the pensioner.

104.   Extinguishment of right to sum payable by way of benefit which is not obtained within the prescribed time

1.  

   (1)   The right to any sum payable by way of benefit shall be extinguished where payment thereof is not obtained within the period of 6 months or such longer period as the Director may determine in the circumstances of any particular case, after the date on which the sum becomes payable.

1.  

   (2)   In calculating the period of 6 months under subregulation (1), no account shall be taken of—

   1.  

      (a)     any period during which a cheque or bank draft containing the sum is in the possession of the Corporation or any post office or bank at which it is payable other than a period after written notice has been given that the cheque or, bank draft is available for collection;

   1.  

      (b)     any period during which the Corporation has, after consideration, represented that a cheque or bank draft containing the sum has not been received, or has been lost, mislaid or stolen;

   1.  

      (c)     any period during which determination of any question as to such extinguishment is pending.

105.   Information to be given when obtaining payment of benefit

Every beneficiary and every person by whom or on whose behalf sums payable by way of benefit are received shall furnish in such manner and at such times as the Director may determine, such certificates and other documents and such information or facts affecting the right to benefit or to receipt thereof as may be required either as a condition on which any sum or sums shall be receivable or otherwise by the Director, and in particular, shall notify the Director in writing of any change in circumstances which he or she might reasonably be expected to know might affect the right to benefit or to the receipt thereof, as soon as reasonably practicable after the occurrence thereof.

106.   Forfeiture or suspension of payment of benefit

1.  

   (1)   If in respect of any incapacity, expected or actual confinement, a person claiming or entitled to sickness, maternity, invalidity, employment injury or disablement benefit or to any increases in any such benefit on account of incapacity, as the case may be—

   1.  

      (a)     has become incapable of work through his or her misconduct or negligence;

   1.  

      (b)     without good cause behaves in any manner calculated to retard his or her recovery or without good cause fails to answer any officer of the Corporation directed to ascertain whether he or she is behaving in a manner that is calculated to retard his or her recovery;

   1.  

      (c)     undertakes work for which remuneration is or would ordinarily be payable,

he or she shall forfeit that benefit for such period as the Director determines.

1.  

   (2)   If, without good cause—

   1.  

      (a)     a claimant fails to furnish any information required for the determination of a claim, or any question arising in connection therewith; or

   1.  

      (b)     a beneficiary fails to give notice of any change of circumstances affecting the continuance of the right to benefit or to the receipt thereof, or to furnish any information required for the determination of any question arising in connection with the award; or

   1.  

      (c)     a claimant for, or a beneficiary of sickness, maternity, invalidity, injury or disablement benefit, or a claimant for medical expenses fails to comply with any requirement of these Regulations,

he or she shall, if the Director so decides, forfeit any benefit claimed in respect of the period of such failure.

1.  

   (3)   If a person who is entitled to any claim or benefit under these Regulations willfully obstructs, or is guilty of misconduct in connection with any examination or treatment to which he or she is required under these Regulations to submit himself or herself, or in connection with any proceedings under the Act for the determination of his or her right to benefit or to the receipt thereof, he or she shall, subject to subregulations (4) to (6), forfeit any benefit claimed, for such period as the Director determines.

1.  

   (4)   In any case to which subregulations (1), (2) or (3) relates, proceedings on the claim or payment of benefit, as the case may be, may be suspended for such period as the Director determines.

1.  

   (5)   Nothing in this regulation providing for the forfeiture of benefit for—

   1.  

      (a)     failure to comply with the requirements of subregulation (1);

   1.  

      (b)     failure to comply with the requirements of these Regulations; or

   1.  

      (c)     obstruction or misconduct in connection with medical examination or treatment,

shall authorise the disentitlement of a claimant or beneficiary to benefit for a period of more than 6 weeks on any forfeiture.

1.  

   (6)   A person who would be entitled to any benefit but for the operation of this regulation shall be treated as if he or she was entitled thereto for the purpose of any rights or obligations under the Act whether of himself or herself or any other person who depends on his or her being so entitled, other than the right to payment of the benefit.

107.   Obligations of beneficiary to notify change of circumstances

1.  

   (1)   A person in receipt of benefit shall inform the Director of any change in his or her circumstances affecting his or her continued right to receive such benefit or the rate at which the benefit is payable within one week of the occurrence of the change.

1.  

   (2)   The Director may require any person entitled to a benefit to furnish from time to time documentary evidence in the form set out as Form NC/LC in Schedule 1 that he or she is alive and the conditions governing the grant of such benefit continue to be fulfilled, and if such evidence is not given to the Director within the time required, the Board may suspend payment of the benefit until the date on which the evidence is given.

108.   Person unable to act

1.  

   (1)   In the case of any person to whom benefit is payable or who is alleged to be entitled or by whom or on whose behalf a claim for benefit has been made, and who is a child or is unable for the time being to act, where no person or authority has been duly appointed by law to have charge of such person or his or her estate, the Director may, upon written application being made to him or her, appoint a person to exercise on behalf of the child or person any right to which he or she may be entitled under the Act and to receive and deal with any sums payable on behalf of such child or person.

1.  

   (2)   Despite subregulation (1)—

   1.  

      (a)     any such appointment by the Director shall terminate on the date immediately prior to the date on which the Director is notified that a person or authority has been duly appointed by law;

   1.  

      (b)     a person who has not attained the age of 18 shall not be capable of being appointed to act under this regulation;

   1.  

      (c)     the Director may at any time in his or her absolute discretion revoke any appointment made under this regulation; and

   1.  

      (d)     any person appointed under this regulation may, on giving the Director one month's notice in writing of his or her intention to do so, resign his or her office.

1.  

   (3)   Anything required by these Regulations to be done by or on behalf of any child or any person who is for the time being unable to act, may be done by any person or authority duly appointed by law to have charge of that child or person or of his estate or by or to the person appointed under this regulation to act on behalf of such child or person, and the receipt by a person appointed under this regulation shall be a good discharge to the Corporation and the Fund for any sum paid, although such person has not attained the age of 21.

109.   Payment of death benefit to person appointed by the Director

1.  

   (1)   On the death of a person who has made a claim for benefit or who is alleged to have been entitled to benefit or in respect of whose death a funeral grant is alleged to be payable, the Director may appoint such person as he or she thinks fit to proceed with or to make a claim for the benefit, and this regulation shall apply subject to necessary modifications to any such claim.

1.  

   (2)   Despite subregulation (1) in the case of funeral grant a claim may be made by any person specified in subregulation (3).

1.  

   (3)   Subject to these Regulations, any sum payable by way of benefit which is payable under an award or on claim proceeded with or made under subregulation (1) may be paid or distributed to or amongst persons claiming as personal representatives, legatees, next-of-kin, or creditors of the deceased and these Regulations shall apply to any such payment or distribution.

1.  

   (4)   Despite subregulation (3)—

   1.  

      (a)     the receipt by a person who has attained the age of 18 shall be a good discharge to the Corporation and the Fund for any sum so paid; and

   1.  

      (b)     where the Director is satisfied that any such sum or part thereof is needed for the benefit of any person under the age of 18, the Director may obtain a good discharge thereof to a person over that age who need not be a person specified in the Regulation who satisfies the Director that he or she will apply the sum so paid for the benefit of the person under the age of 18.

1.  

   (5)   Subject to this regulation, any benefit due to a deceased person, payment of which he or she had not obtained at the date of his or her death, may unless the right thereto was already extinguished at that date, be paid or distributed to or amongst such persons as are mentioned in subregulation (3).

1.  

   (6)   For the purposes of regulation 104 the period of 6 months shall be calculated from the date on which the sum was received by any such person, and not from the date it was received by the deceased and for those purposes the reference in regulation 103 to the date on which the sum became payable, shall be construed as a reference to the date of application to the Corporation made in accordance with these Regulations.

K.  Medical Certificate

110.   Evidence of incapacity to be given

1.  

   (1)   Every person claiming sickness benefit, or invalidity benefit shall furnish evidence of incapacity in respect of the day or days for which the claim is made by means of a certificate given by a registered medical practitioner in accordance with the provisions for medical certification set out in Part A of Schedule 4 in the Form appropriate to the circumstances of any particular case or class of cases.

1.  

   (2)   Every woman by whom or on behalf of whom a claim for maternity benefit is made shall furnish evidence—

   1.  

      (a)     where the claim is made in respect of expectation of confinement, that she is pregnant and the stage of her pregnancy; or

   1.  

      (b)     where the claim is made by virtue of the fact of confinement, that she has been confined,

by means of a certificate given in accordance with the provisions for certification set out in Part C of Schedule 4 on the appropriate form as set out in Part B of that Schedule or by such other means as the Director may accept as sufficient in the circumstances of any particular case or class of cases.

1.  

   (3)   For the purpose of this regulation the expression “certificate” shall not include a certificate which is given only by the person whom or on whose behalf the claim is made.

PART 8
APPEALS

111.   Appeals

1.  

   (1)   A person dissatisfied with the decision of the Director in respect of—

   1.  

      (a)     his or her liability to pay any contribution under the Act;

   1.  

      (b)     the amount of contribution due and payable by him or her;

   1.  

      (c)     any contribution due by him or her under the Act which has not been paid;

   1.  

      (d)     his or her entitlement to a benefit under the Act; or

   1.  

      (e)     the fulfilment by him or her of any prescribed conditions of entitlement of any benefit under the Act,

may within one month from the date of the Director's decision appeal to the Board against that decision.

1.  

   (2)   Notice of appeal shall be addressed to the chairperson of the Board and shall be in the form set out as Form APP1 in Schedule 1.

1.  

   (3)   A copy of the notice shall also be addressed to the Director.

1.  

   (4)   The chairperson of the Board shall not later than 14 days after receipt of a notice of appeal as provided in this regulation, summon a meeting of the Board for the purpose of hearing the appeal.

1.  

   (5)   The Board shall be duly constituted for the purpose of hearing appeals if any 4 members of the Board excluding the Director are present.

1.  

   (6)   On receipt of a copy of a notice of appeal the Director shall prepare and submit to the Board a memorandum containing the reasons for his or her decision, any document considered by him or her and evidence taken in making his or her decision.

1.  

   (7)   The Director and the appellant shall both be entitled to be present at the hearing of the appeal.

1.  

   (8)   The Director shall, if required by the Board, assist with any further information which the Board requires.

1.  

   (9)   The Board shall hear evidence on oath which it considers to be relevant and useful from the appellant and from any other person presented by the appellant, and may also summon the employer of the appellant if it considers it necessary to do so.

1.  

   (10)   The decision of the Board shall be made by no fewer than 4 members, excluding the Director who shall not sit as a member of the Board.

1.  

   (11)   The Board may affirm or reverse the decision of the Director or make such order as appears to the Board, that the justice of the case demands.

PART 9
OFFENCES

112.   Offences and penalties

1.  

   (1)   Any employer who without reasonable excuse—

   1.  

      (a)     fails to obtain, complete or forward any registration document as required under these Regulations;

   1.  

      (b)     fails to complete or submit any monthly remittance statements as required under these Regulations;

   1.  

      (c)     fails or refuses to make available to an Inspector the duplicate copy of any monthly schedule of contributions or any monthly contribution remittance statement or any deduction in accordance with these Regulations;

   1.  

      (d)     fails to deliver to any of his or her employees any document he or she is required to deliver under these Regulations;

   1.  

      (e)     fails to match the employees contribution with the employer's portion;

   1.  

      (f)     deducts the full composite sum from the wages of an employee; or

   1.  

      (g)     fails to comply with any requirements under these Regulations,

commits an offence and is liable on summary conviction to a fine not exceeding $50,000 or to imprisonment for a term not exceeding 6 months, or to both such fine and imprisonment.

1.  

   (2)   Any employee who without reasonable excuse—

   1.  

      (a)     fails to make his or her signature or mark as required by these Regulations; or

   1.  

      (b)     fails to provide his or her employer with any information required by these Regulations,

commits an offence and is liable on summary conviction to a fine not exceeding $2,000 or to imprisonment for a term not exceeding 6 months, or to both such fine and imprisonment.

1.  

   (3)   Any employer or employee convicted of any offence under subregulation (1) or (2) shall be ordered by the magistrate to comply with the respective provisions within 24 hours of such conviction or face a term of imprisonment not exceeding 6 months for disobedience to such order.

PART 10
FINANCIAL AND ACCOUNTING REGULATIONS

113.   Interpretation

In these Regulations—

“expenditure” means payment out of the Fund in accordance with section 3(2) of the Act;

“income” means payments into the Fund in accordance with section 3(1) of the Act;

“reserve” means any one of the reserves constituted under these Regulations.

114.   Benefit branches

1.  

   (1)   Subject to these Regulations, benefit provided under the Act shall be grouped into separate benefit branches as follows—

   1.  

      (i)     long-term benefits branch, comprising retirement, invalidity and, survivor's benefits,

   1.  

      (ii)     short-term benefits branch, comprising sickness, maternity, employment injury, funeral and hospitalization benefits;

1.  

   (2)   Despite the foregoing, all other funds and accounts falling under the control of the Board shall be established and maintained separately in accordance with regulations 123 to 143.

115.   Financial year

The financial year for the purpose of the budget and accounts shall be the year ending on 30 June.

116.   Submission of estimates

1.  

   (1)   Before 30 April of each year, the Director shall, in respect of each of the branches, funds and accounts specified in these Regulations, submit to the Board for its approval estimates of income and expenditure expected to be received and incurred in the financial year beginning on 1 July next following, including administrative expenditure, which shall be shown separately.

1.  

   (2)   These estimates shall be accompanied by a memorandum giving full explanations of any variations of the amounts expected to be received or spent as compared with the corresponding amounts included in the approved estimates in the current year, and of any receipts or expenditure of a type not included in the approved estimates in the current year. The memorandum shall also state how it is proposed to finance administrative expenditure and expenditure of an extra-ordinary nature.

1.  

   (3)   The Board may add to or otherwise alter the heads under which the estimates are to be submitted to it, and may require information relating to the make up, calculations or reasons for inclusion of any items in the estimates as submitted.

1.  

   (4)   The estimates submitted in accordance with this regulation, as and when approved by the Board, shall show the income which is expected to be collected and shall set limits to the expenditure which may be incurred under each of the relevant heads. Expenditure shall not be incurred in any head in excess of the limit set for that head without the prior approval of the Board; but the Director shall have the authority to incur expenditure in excess of any head or heads, where such expenditure was necessary and unavoidable and was in accordance with the provisions of the Act, and the Director shall be personally accountable for such expenditure pending approval by the Board.

1.  

   (5)   If the budget estimates have not been approved by the Board before the beginning of the financial year to which they relate, the Director shall be authorized by the Board to incur expenditure under the various heads subject to such conditions as it may deem fit to impose until such time as the budget is duly approved.

117.   Financial authorities of staff

The Director shall draw up a list which shall contain the names of such of the officers of the Board as, from time to time, shall be authorized by the Board to approve payment vouchers, sign cheques approve accounting transfers or exercise other similar functions, and the list may specify such limits, financial or otherwise, as the Board may approve, within which each officer whose name appears on the list shall be authorized to exercise the function or functions allotted to him or her.

118.   Fidelity bond

Insurance by way of fidelity bond or other similar security may be arranged by the Board giving cover, up to such amounts as may be approved by the Board, against risk of defalcation by the cashiers, store-keepers or other custodians of the property of the Board.

119.   Loss deficiencies and other payments

If a loss, damage, overpayment or destruction of cash, equipment or other assets of the Corporation, occurs, it shall be within the discretion of the Board to approve the write-off of the asset involved; but when the Board is satisfied that the loss, damage, overpayment or destruction is due to the fault or negligence of an officer, the Board, in the absence of a satisfactory explanation, shall direct that the officer be surcharged with the whole or such part of the value of the loss as it shall deem appropriate in the circumstances of the particular case. The amount of the surcharge shall be deducted from any moneys owing by the Corporation to the officer over such period as the Director may determine and shall be credited to the revenues of the Corporation.

120.   Unserviceable assets

If in the opinion of the Director an asset becomes unserviceable, redundant or uneconomical to upkeep, it shall be within his or her discretion to dispose of it, in such manner, including sale or destruction as he or she thinks fit. The asset thus disposed of shall be written-off the inventory and the proceeds of any sale credited to the revenues of the Corporation.

121.   Financial audit

The Director shall ensure that adequate arrangements shall be made for the internal audit of the financial procedures, benefit payments and the maintenance and operation of the accounts of the Fund and the principal functions of the internal audit may be specified in Financial and Accounting Rules, orders or administrative directions issued by the Director.

122.   Periodical reports to the board

1.  

   (1)   The Director shall submit to the Board periodical reports on the financial situation of the Fund with reference to income and expenditure at such intervals and in such form as the Board may direct, together with any comments or remarks that may be called for.

1.  

   (2)   The Director shall submit to the Board any report concerning fraud, administrative abuse and serious irregularities.

123.   Accounting systems

The Director shall open accounts for each of the heads under which the estimates of income and expenditure, as approved, have been arranged, and such other heads or sub-divisions of heads as may be necessary, and shall record therein, by the double-entry system of book-keeping the financial transactions of the Fund.

124.   Quarterly accounts

At the end of each quarter, the accounts as a whole shall be balanced and income and expenditure statements for the quarter together with projections to the end of the year shall be prepared and submitted to the Board not later than the 25^th day of the month following that quarter.

125.   Annual accounts

At the end of each financial year the account shall be balanced and summary accounts and balance sheet shall be prepared, namely—

1.  

   (i)     a consolidated income and expenditure account for the Fund as a whole,

1.  

   (ii)     a statement of cash flows,

1.  

   (iii)     the income and expenditure account in respect of each benefit branch, fund and account under the control of the Board,

1.  

   (iv)     a balance sheet for the Fund as a whole,

1.  

   (v)     any other account or statement which the Board may from time to time request to be included, the details of which shall be specified in the financial and accounting orders.

126.   Statement of cash flows

The statement of cash flows shall reflect funds provided from or used in operations separately from other sources or uses of funds. Unusual items which are not part of the ordinary activities of the Board shall be separately disclosed in the statement. The income and expenditure account shall show the income and expenditure recorded during the financial year and the balance sheet shall show the liabilities and assets as at the end of the financial year.

127.   Preparation of accounts and balance sheets

The accounts and balance sheet specified in these Regulations shall be prepared as soon as practicable after the end of the financial year and shall be submitted to the Board not later than 30 September in the year following the financial year, but if the Board is satisfied that for certain practical reasons the accounts could not be submitted to it by that date, it may extend that date by a period not exceeding 30 days.

128.   Distribution of income of the Fund

All sums collected as contributions shall be distributed among the benefit branches in such proportions, as the Minister shall, on the recommendation of the Board and after consultation with an actuary, determine by order or regulations, but a sum collected as contribution which is payable in respect of a specified branch, fund or account shall be allocated to the branch, fund or account of which such benefit forms part with due regard to the provisions of this regulation.

129.   Income from investment of reserves

The income from the investment of the reserves shall be allocated in such proportions as the total reserves bears to separate branch reserves at the beginning of the financial year.

130.   Unidentified income

All other income to the Fund which cannot be identified shall be allocated as the Board may from time to time direct.

131.   Distribution of expenditure

The expenditure on each benefit branch, fund or account shall be ascribed to that benefit branch fund or account.

132.   Administrative expenditure

The administrative expenditure of the Fund shall be distributed among the benefits in such proportions as the Board may direct.

133.   Unallocated expenditure

All other expenditure which cannot be specifically allocated shall be distributed as the Board may direct.

134.   Reserves to be constituted

A short-term benefit reserve shall be constituted by transferring thereto annually the excess of income over expenditure of the short-term benefit account, and any amount in excess of the expected expenditure for the ensuing financial year shall be transferred to the long term benefit reserve.

135.   Long term benefit reserve

A long-term benefit reserve shall be constituted by transferring thereto annually the excess of income over expenditure of the long-term benefit account, together with the excesss amounts from the short term benefit reserve which is over the expected expenditure for the ensuing 12 months.

136.   Other reserves

The Minister on the advice of the Board, may by regulations constitute other reserves if and when this becomes necessary.

137.   Minimum sums of reserves to be maintained by the board

The Board shall ensure that minimum levels of reserves are maintained to meet any unforeseen or abnormal expenditure which the current income may not be sufficient to cover, but where it is anticipated that both the reserve and the current income for any benefit branch will become insufficient to meet the current expenditure, actuarial advice shall be sought in accordance with the Act.

138.   Audit of accounts

The Board shall require the Director to produce the accounts and balance sheet to the auditor appointed under section 22(1) of the Act on or before 30 August following the close of the financial year in which they relate; but in the case of an extension of time the Board may extend the date by a period not exceeding 30 days.

139.   Accounts to be audited

The Director shall submit to the auditor all accounts required for the purpose of the audit and any other documents, information or explanation which the auditor may require for that purpose.

140.   Auditor's Report

Subject to section 22 of the Act, the auditor shall perform the audit of the accounts prescribed by regulation 125 in accordance with international accounting standards, and shall submit in accordance therewith an auditor's report to the Board.

141.   Submission of audit finding

Without limiting the generality of regulation 145 should the audit prescribed thereby reveal—

1.  

   (i)     any material impropriety or irregularity in the expenditure, in the recovery of moneys due to the Fund or in the accounts under the control of the Board, or

1.  

   (ii)     any loss or waste of money or other property owned by or vested in the Board which has been caused by neglect or misconduct,

the auditor shall submit to the Board a separate statement, if necessary, detailing such audit findings.

142.   Director to report to Minister

The Board shall forthwith require the Director to remedy any defect or irregularity pointed out by the auditor, and shall determine responsibility therefor and report to the minister on the action taken thereon.

143.   Powers of Director

The Director should have power to make administrative, financial and accounting orders for the effective implementation of these Regulations.

144.   Validation of actions

Any action done by the Board or its servants or agents under the provisions of these Regulations prior to the publication of the Regulations or the Gazette is hereby validated and given the force of law as from 1 January 2001.

Schedule 1

TABLE I

TABLE II

TABLE III

TABLE IV

TABLE V

Schedule 2

Schedule 3