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SINOT
SINOT
What is the Temporary Non Occupational Disability Insurance (SINOT, in Spanish)?
The Temporary Non Occupational Disability Insurance is a plan provided by the Law 139 of June 26, 1968 providing benefits to workers who have lost their income due to an illness or accident that is not related to their work or automobile accident.
Eligibility requirements for the employee?
Eligibility: The worker must have received a salary of at least $150.00 in a covered employment during his or her base year
Be unable to work due to a disability caused by an illness or accident that is not related to work or an automobile accident.
Be receiving medical treatment from an authorized physician or chiropractor.
Benefits
The insured worker will receive weekly benefits for loss of income. It also provides benefits for death and dismemberment resulting from an accident not work related or caused by an automobile accident.
The contribution is 60% of the salary paid to the employee up to a $9,000 maximum in the regular year.
Generally, the employer and the employee contribute the same amount. The employer may opt to pay the total premium amount, or a larger portion than the one the insured employee pays.
The weekly benefit for the basic plan is between $12.00 and $113.00 depending on the insured salary for the base year. Upon the employer’s request alternate plans may be offered.
There is a Federal Social Security deduction because the employer’s contribution is considered income.
The basic benefits vary, depending on the loss, between $2,000 and $4,000. The coverage losses are: loss of life or limb, hand, finger, or vision. Upon the employer’s request alternate plans may be offered with additional benefits.
Disability benefits are paid from the first day in which the worker is admitted to the hospital or on the eighth day after the disability ensued, if the worker was not hospitalized.
The insured workers receive benefits for the duration of the disability, up to a maximum of 26 weeks in any period of disability and in any period of 52 regular consecutive weeks.
Claims and Limitations
Claims
To receive benefits for which they are eligible, the insured employee must submit a claim in writing or in person with the Company’s Central Office. If the claim is for loss of income due to a disability, the employee must submit a claim within three (3) months following the disability. If the claim is for accidental death or dismemberment, the employee must submit a claim within six (6) months following the loss.
Restrictions or Exclusions
The individual will not be eligible to receive benefits under this plan:
1- If he or she is not receiving treatment from a duly licensed physician or chiropractor.
2- If he or she worked with or without receiving compensation.
3- If the disability is caused by intentional injuries, self-inflicted or sustained during the commission of an act
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