A worker on your site slips on a wet floor and fractures his wrist. He is hospitalised for two days and given four weeks of medical leave. You know you have Work Injury Compensation insurance. But what actually happens next?
Most employers in Singapore know that WIC insurance is mandatory and that it pays out when a worker is injured. Very few know what the claim process actually looks like from the moment of the accident to the final settlement, what their obligations are at each step, and how a claim affects their policy going forward. This post walks through all of it.
What changed on 1 November 2025
Before getting into the claim process, one important update. MOM revised the WICA compensation limits with effect from 1 November 2025. The updated limits apply to accidents occurring on or after that date.
The maximum medical expenses claimable increased from S$45,000 to S$53,000 per accident, or one year from the accident date, whichever is reached first. For permanent incapacity, the minimum lump-sum compensation floor increased from S$97,000 to S$116,000, and the maximum ceiling increased from S$289,000 to S$346,000, both multiplied by the assessed percentage of permanent incapacity. For fatal accidents, the minimum compensation increased from S$76,000 to S$91,000 and the maximum from S$225,000 to S$269,000.
If your policy was arranged before November 2025 and has not been reviewed since, it is worth confirming with your adviser that the policy limit is sufficient to cover the updated statutory amounts.
Step 1: The accident happens. What must you do, and when?
The moment a worker is injured, two timelines start running simultaneously.
First, get the worker medical attention. This is both a duty of care and a practical necessity, because the medical documentation from the first treatment is the foundation of every subsequent step in the claim. Keep all medical certificates, receipts, and clinical notes.
Second, report the accident to MOM. The reporting obligation under WICA is specific.
If the accident results in more than three days of medical leave, you must submit a Work Injury Report (WIR) to MOM within 10 days of the accident, through MOM's iReport system. If the worker is hospitalised for 24 hours or more, the 10-day reporting obligation also applies. If the accident results in death, you must notify MOM immediately, and submit the formal report within 10 days.
Failure to report within the prescribed timeframe is an offence under the Act. MOM takes non-reporting seriously, and a late or missing report can also complicate the insurer's handling of the claim.
Step 2: Notify your insurer
Alongside the MOM report, notify your WIC insurer of the accident. From the moment you notify the insurer, the insurer becomes responsible for processing the claim.
The employer is required to continue paying the worker's medical leave wages and medical expenses throughout the recovery period, even while waiting for reimbursement from the insurer. This is a point many employers misunderstand: the insurer does not pay the worker directly from day one. The employer pays first and is reimbursed. Stopping or delaying medical leave wages while a claim is pending is not permitted under WICA.
Medical leave wages under WICA are calculated at the worker's average monthly earnings over the 12 months before the accident, or over the period of employment if shorter. For workers on fixed salaries, this is straightforward. For workers with variable earnings including overtime, the calculation requires an accurate average.
Step 3: The medical assessment
Once the worker's condition has stabilised, they are referred to a designated doctor for a medical assessment. This assessment is the pivotal step in the claim process for anything beyond a simple medical leave claim.
The doctor determines whether the worker has suffered Permanent Incapacity (PI), meaning any lasting physical or functional limitation caused by the injury. If PI is assessed, the doctor assigns a percentage figure from 0% to 100% reflecting the degree of permanent loss of function. This percentage, combined with the worker's age and average monthly earnings, drives the lump-sum compensation calculation.
For a simple medical leave case with no permanent incapacity, the claim is relatively straightforward: medical expenses reimbursed up to the cap, and medical leave wages paid for the duration of leave. For cases involving permanent incapacity or death, the claim process extends through the assessment and the Notice of Assessment stage.
Step 4: The Notice of Assessment
Based on the medical report and the worker's earnings records, MOM issues a Notice of Assessment (NOA) setting out the compensation amount payable. Both the employer or insurer and the worker have 14 days from the date of the NOA to file an objection if either party disputes the assessment.
If no objection is filed within 14 days, the compensation becomes final and must be paid within 21 days of the NOA. The insurer pays the compensation directly at this stage.
If either party objects, MOM conducts a hearing to determine the appropriate compensation. Legal representation is permitted at these hearings but is not required.
For most claims involving only medical leave and medical expenses, the process does not reach the formal NOA stage. The insurer reimburses the employer for medical expenses and medical leave wages paid, and the claim closes. The NOA process is primarily relevant for permanent incapacity and fatal claims.
Step 5: Restrictions during a live claim
Two employer obligations are worth understanding clearly while a claim is active.
An employer cannot terminate a worker's employment during the medical leave period or while a WICA claim is pending, without MOM's approval. This restriction applies regardless of the reason for termination. An employer who terminates an injured worker without MOM's approval faces enforcement action.
The one-year limitation period also applies from the worker's side: a worker has up to one year from the date of the accident or disease diagnosis to file a claim. Late reporting by the worker can be used by an insurer to dispute the cause of injury, which is one reason early documentation matters.
What happens to your policy after a claim?
This is the question most employers do not ask until renewal arrives.
WIC insurance in Singapore is written on an occurrence basis for a policy year. A claim notified during the policy year is handled by the insurer on cover at the time of the accident. The claim settlement itself may extend into the following policy year, particularly for permanent incapacity cases where the medical assessment and NOA process takes time.
At renewal, a WIC policy with claims history is reassessed by the insurer. How the claims record affects the renewal premium depends on the insurer's underwriting approach and the specific policy structure. Several factors typically come into play.
The number and severity of claims in the expiring policy year is the primary factor. A single minor medical leave claim in a policy covering 50 workers may have no discernible effect on the renewal premium. Multiple claims, or a single severe claim involving permanent incapacity or fatality, will attract scrutiny at renewal.
The nature of the work and the employer's safety record are also assessed. MOM's incident data for your workplace, accessible by the insurer, reflects your site's WSH compliance history. An employer with outstanding WSH notices or a history of MOM investigations will face a more difficult renewal conversation than one with a clean record.
Declared wages and headcount accuracy matter. A policy that was declared at a lower headcount than actual, or with occupations that do not reflect the actual work being done, creates both a coverage gap and a potential claim disputes problem. Insurers review declared information against the claim details when a claim is submitted. Discrepancies between what was declared and what is found in the claim documentation are a common source of coverage disputes.
In practice, the most important thing an employer can do after a claim is document everything: the accident circumstances, the treatment provided, the medical leave wages paid, and all communications with the worker and the insurer. Clean documentation supports a clean claim. It also supports a cleaner renewal conversation.
The worker's right to elect common law instead
One aspect of WICA that employers should be aware of: a worker who is covered under WICA generally cannot claim under both WICA and pursue a civil lawsuit for the same injury simultaneously. Once a WICA claim is accepted and compensation paid, the worker gives up the right to sue the employer under common law for that injury.
For the employer, this no-fault framework is a practical protection: liability is defined by the statutory compensation formulas rather than open-ended civil damages. A worker who could potentially succeed in a large common law negligence claim is instead compensated under WICA's defined schedule. The WIC policy covers that defined liability.
The exception arises where the worker elects to pursue common law instead of WICA, which is permitted before a WICA claim is settled. A common law claim is not covered by a WIC policy. It would instead fall under an employer's liability policy, which is a separate product from WIC insurance.
You can read more about our WIC cover on the products page, and about related workforce essentials in our posts on WICA and WIC Insurance in Singapore and Workforce Essentials: WIC, FWMI and Foreign Worker Bond in Singapore.
If you have had a WIC claim recently and would like to understand how it may affect your renewal, or if you would like to review whether your current policy declarations accurately reflect your workforce, we would be glad to work through it with you.
This article provides general information only. It is not insurance or legal advice. Policy availability, terms, conditions, and exclusions vary by insurer and product, and cover is subject to the full policy wording. Compensation limits cited reflect MOM's updated figures effective 1 November 2025. Please contact TZY CO for advice on your specific situation.