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NATIONAL HEALTH INSURANCE ACT, 1924.
CONTRIBUTORS.-(1) A weekly contribution shall be payable for each week during the whole or any part of which an employed contributor has been employed: Provided that
(a) Where one weekly contribution has been paid in respect of a contributor for any week, no further contribution shall be payable in respect of him for the same week; and
(i) no services have been rendered by a contributor during any week and no remuneration is paid in respect of that week; or
(ii) no services have been rendered by a contributor during any week and the contributor has been rendered incapable of work by Tamaso reason of some specific disease or bodily or mental disablement for the whole or any part of that week,
the employer shall not be liable to pay any contribution either on his own behalf or on behalf of the contributor in respect of that week.
(2) Where the contributor receives any wages or other pecuniary remuneration from the employer, the amount of any contribution paid by the employer on behalf of the contributor shall, notwithstanding the provisions of any Act or any contract to the contrary, be recoverable by means of deductions from the wages or other remuneration of the contributor, and not otherwise :
Provided that no such deduction may be made from any wages or remuneration other than such as are paid in respect of the period or part of the period in respect of which the contribution is payable, or in excess of the sum which represents the amount of the contributions for the period, if that period is longer than a week, in respect of which the wages or other remuneration are paid.
(3) Where the contributor does not receive any wages or other pecuniary remuneration from the employer but receives such remuneration from some other person, a contribution paid by the employer on behalf of the contributor shall, without prejudice to any other means of recovery, be recoverable summarily as a civil debt, if proceedings for the purpose are instituted within three months from the date on which the contribution was payable.
(4) Where the contributor does not receive wages or other pecuniary remuneration either from his employer or from any other person, the employer shall be liable to pay the contributions payable both by himself and the contributor, and shall not be entitled to recover any part thereof from the contributor.
(5) Where the contributor is employed by more than one employer in any week, the employer who first employs him in that week or such other employer or employers as may be prescribed shall be deemed to be the employer for the purposes of the provisions of this Act relating to the payment of contributions.
(6) Regulations may provide that in any cases or classes of cases where contributors work under the general control and management of some person other than their immediate employer, such as the owner, agent or manager of a mine or quarry, or the occupier of a factory or workshop, that person shall, for the purposes of the provisions of this Act relating to the payment of contributions, be treated as the employer, and may provide for allowing him to deduct the amount of any contributions, other than employer's contributions, which he may become liable to pay from any sums payable by him to the immediate employer, and for enabling the immediate employer to recover from the contributors the like sums and in the like manner as if he were liable to pay the contributions.
(7) Notwithstanding any contract to the contrary, the employer shall not be entitled to deduct from the wages of, or otherwise to recover from, the contributor the employer's contribution.
(8) Any sum deducted by any employer from wages or other remuneration under this section shall be deemed to have been entrusted to him for the purpose of paying the contribution in respect of which it was deducted.
(9) Regulations may provide that in the case of outworkers the contributions to be paid may be determined by reference to the work actually done, instead of by
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reference to the weeks in which work is done, and any such regulations may apply to all trades or to any specified classes or branches of trades, and may determine the conditions to be complied with by employers who adopt such a system of payment of contributions.
(10) In this section the expression "week"
means a contribution week.
Benefits conferred by the Act, and the Administration thereof.
10. BENEFITS CONFERRED BY ACT ON INSURED PERSONS.—(1) Subject to the provisions of this Act, the benefits conferred by this Act upon insured persons (in this Act referred to as "benefits ") are:
(a) Medical treatment and attendance (in this Act called "medical benefit "): (b) Periodical payments while rendered incapable of work by some specific disease or by bodily or mental disablement of which notice has been given, commencing on the fourth day of the incapacity and continuing for a period not exceeding twenty-six weeks (in this Act called "sickness benefit"):
(c) In the case of the disease or disablement continuing after the termination of the period during which sickness benefit may continue, periodical payments during the continuance of the incapacity for work (in this Act called disablement benefit "):
(d) A payment in the case of the confinement of the wife or, where the child is a posthumous child, of the widow of an insured person, or of any other woman who is an insured person (in this Act called " maternity benefit"): (e) In the case of persons entitled under this Act to any of the further benefits mentioned in the Third Schedule to this Act (in this Act called "additional benefits "), such of those benefits as those persons may be entitled to. (2) In this section the expression "medical treatment and attendance" includes the provision of proper and sufficient medicines and of the prescribed medical and surgical appliances, but does not include treatment or attendance in respect of a confinement.
(3) For the purposes of paragraph (b) of subsection (1) of this section, a day on which the incapacitated person was prevented by the incapacity from doing any effective work shall be treated as a day of incapacity, but a Sunday shall not be so treated, unless the incapacitated person would but for the incapacity have worked on that day.
11. FUTURE EXTENSION OF BENEFITS.- -As soon as the sums credited to approved societies as reserve values have been written off in manner provided by this Act, the benefits payable to insured persons under this Act shall be extended in such manner as Parliament may determine.
12. MEDICAL BENEFIT.-(1) Medical benefit shall be administered by and through the insurance committee.
(2) A person who is of the age of sixty-five years or upwards at the time of entering into insurance shall not be entitled to medical benefit after he attains the age of seventy, unless the number of weekly contributions paid by or in respect of him exceeds twenty-six.
(3) A voluntary contributor whose total income from all sources exceeds two hundred and fifty pounds a year shall not be entitled to medical benefit.
(4) An employed contributor or a voluntary contributor who by virtue of the provisions of this Act remains an insured person after ceasing to be employed or to pay contributions, as the case may be, shall be entitled to medical benefit until the thirtieth day of June or the thirty-first day of December, whichever first occurs, next after the expiration of a period of six months from the date on which he ceases to be an insured person.
(5) Provision shall be made by regulations for applying the contributions paid in respect of exempt persons in providing medical benefit for those persons and defraying the cost of the administration thereof, and those persons shall, if they fulfil the
NATIONAL HEALTH INSURANCE ACT, 1924.
prescribed conditions, become entitled to medical benefit as if they were members of approved societies, and the provisions of this Act with respect to the provision and administration of medical benefit (including provisions relating to the application of moneys provided by Parliament towards the cost of medical benefit and of the administration thereof) shall, subject to any prescribed modifications, adaptations and exceptions, apply accordingly :
(a) the prescribed conditions shall not require payment of upwards of twentysix weekly contributions before the person becomes entitled to benefit ; and
(b) where the total income from all sources of an exempt person exceeds one hundred and sixty pounds a year, he shall be required to make his own arrangements for receiving medical treatment and attendance, and the provisions of this Act relating to persons allowed to make such arrangements shall apply accordingly.
(6) Subject to the consent of the Treasury, provision may be made by regulations for the administration of any medical treatment and attendance the cost of which may be defrayed out of any sums which may be voted by Parliament in addition to the moneys required for defraying the two-ninths share of the cost of benefits under this Act and of the expenses of the administration thereof.
(7) A person shall not be disentitled to medical benefit by reason that he is, under the rules of an approved society or insurance committee, suspended from sickness or disablement benefit on the ground that his disease or disablement was caused by his own misconduct.
13. ADMINISTRATION AND RATES OF, AND GENERAL PROVISIONS AS TO, SICKNESS AND DISABLEMENT BENEFITS.-(1) Sickness benefit and disablement benefit shall, in the case of an insured person who is a member of an approved society, be administered by and through the society or a branch thereof, and, in the case of an insured person who is not such a member, shall, subject to the provisions of this Act, be administered by and through the insurance committee.
(2) The ordinary rate of sickness benefit shall be, in the case of a man, the sum of fifteen shillings a week, and, in the case of a woman, the sum of twelve shillings a week, throughout the whole period of twenty-six weeks, and the rate of disablement benefit shall be a sum of seven shillings and sixpence a week for men and women alike:
Provided that, until one hundred and four weeks have elapsed since the entry of an insured person into insurance and one hundred and four weekly contributions have been paid by or in respect of that person, the rate of sickness benefit to which that person shall be entitled shall be, in the case of a man, nine shillings a week, and, in the case of a woman, seven shillings and sixpence a week.
(3) An insured person shall not be entitled to
(a) sickness benefit, until twenty-six weeks have elapsed since his entry into insurance, and twenty-six weekly contributions have been paid by or in respect of him:
(b) disablement benefit, until one hundred and four weeks have elapsed since his entry into insurance, and one hundred and four weekly contributions have been paid by or in respect of him.
(4) Where an insured person who claims to be entitled to sickness or disablement benefit fails to give notice of the disease or disablement on or before the third day of the incapacity, benefit shall, subject as hereinafter provided, commence only on the day following the date on which the notice is given, or, if the disease or disablement is under the provisions of this section deemed to be a continuation of a previous disease or disablement, on the day next but one before that date:
Provided that, if the society or committee administering the benefit are satisfied, or if in the case of a dispute it is decided in manner provided by this Act, that in the circumstances of the case the insured person was not reasonably able to give notice either before the date on which it was in fact given or before some earlier
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date being a date more than three days after the commencement of the incapacity, he shall be entitled to benefit commencing on the fourth day of the incapacity, or, in the case of a disease or disablement which is deemed as aforesaid to be a continuation of a previous disease or disablement, commencing on the first day of the incapacity, so, however, that where the insured person only proves inability to give notice before some date earlier than the date on which notice was in fact given, he shall not be entitled to benefit for the period commencing on the day next after that earlier date and ending on the date of the notice.
For the purposes of this subsection, notice sent by post shall be deemed to have been given on the day on which the letter containing the notice was posted.
(5) Where an insured person who has been in receipt of sickness benefit recovers from the disease or disablement in respect of which the benefit was payable, any disease or disablement occurring subsequently (whether the same disease or disablement or not), shall be deemed to be a continuation of the previous disease or disablement unless in the meantime a period of at least one year has elapsed.
(6) Where by virtue of the special provisions of this Act applicable to contributors entitled to compensation or damages, a part only of sickness benefit has been paid to an insured person, he shall, for the purpose of determining the rate and duration of benefit, be treated as having been in receipt of sickness benefit for a period bearing the same proportion to the whole period in respect of which that part benefit was paid to him as that part bears to the whole benefit, and the period so resulting shall be deemed to have been continuous and to have expired on the last day of the incapacity in respect of which the partial benefit was paid.
(7) A woman who is a married woman or a widow confined of a posthumous child shall not in any case be entitled to sickness benefit or disablement benefit for a period of four weeks after her confinement, and no other woman shall be entitled to sickness benefit or disablement benefit for the period aforesaid unless she is an insured person and suffering from disease or disablement not connected directly or indirectly with her confinement.
(8) The right of an insured person to sickness benefit and disablement benefit shall cease on his attaining the age of seventy.
(9) Where a pension or superannuation allowance is payable by an approved society in whole or in part as an additional benefit under this Act, or out of any fund to which contributions have been made in accordance with paragraph 10 of the Third Schedule to this Act, it may be made a condition of the grant of the pension or allowance that the person entitled to the payment shall, while in receipt thereof, be excluded in whole or in part from his right to sickness benefit and disablement benefit, or to either of such benefits.
14. MATERNITY BENEFIT.-(1) The amount of maternity benefit shall be a sum of forty shillings.
(2) Maternity benefit shall, in the case of an insured person who is a member of an approved society, be administered by and through the society or a branch thereof, and, in the case of an insured person who is not such a member shall, subject to the provisions of this Act, be administered by and through the insurance committee. (3) No insured person shall be entitled to maternity benefit until forty-two weeks have elapsed since his entry into insurance, and unless in the case of a person who entered into insurance on or after the seventh day of February, nineteen hundred and eighteen, forty-two weekly contributions have been paid by or in respect of him, or, in the case of a person who entered into insurance before that date twentysix, or if he is a voluntary contributor fifty-two, weekly contributions have been so paid.
(4) Where a woman confined of a child is herself an insured person and is a married woman, or, if the child is a posthumous child, a widow, she shall be entitled to receive a maternity benefit (in this Act referred to as the second maternity benefit") from the society of which she is a member or the insurance committee, as the case may be, in addition to any maternity benefit to which she may be otherwise entitled in respect of her husband's or her own insurance, and every approved
NATIONAL HEALTH INSURANCE ACT, 1924.
society and insurance committee shall make rules to the satisfaction of the Minister requiring any woman in respect of whom any such sum is payable in respect of her own insurance to abstain from remunerative work during a period of four weeks after her confinement.
(5) Where a woman who is an employed contributor is the wife, or, if the child is a posthumous child, the widow, of an insured person, then
(a) If her husband is, or was at the date of his death, a member of an approved society, and by reason of an insufficient number of contributions having been paid by or in respect of him, or on account of arrears, no maternity benefit is payable in respect of his insurance, she shall, on her confinement, be entitled to receive in respect of her own insurance such sum as she would have been entitled to receive if her husband had not been an insured person; and
(b) If her husband is, or was at the date of his death, a deposit contributor, and by reason of an insufficient number of contributions having been paid by or in respect of him, or of the insufficiency of the sum standing to his credit in the Deposit Contributors Fund, no maternity benefit or a sum less than the full maternity benefit is payable in respect of his insurance, she shall, on her confinement, be entitled to receive in respect of her own insurance, such sum as, with the sum, if any, payable in respect of her husband's insurance, is equal to the sum she would have been entitled to receive if her husband had not been an insured person.
(6) Maternity benefit shall in every case be the mother's benefit and shall be administered in the interests of the mother and child in cash or otherwise by the approved society of which she is, or, where she is entitled to benefit in respect of her husband's insurance, her husband is or was, a member, or if she or, where she is entitled to benefit in respect of her husband's insurance, her husband, is or was not a member of an approved society, by the insurance committee:
Provided that the mother shall decide whether she shall be attended by a duly qualified medical practitioner or by a duly certified midwife and shall have free choice in the selection of the medical practitioner or midwife.
(7) Where the benefit is payable in respect of the husband's insurance, the wife's receipt, or his receipt, if authorised by her, shall be a sufficient discharge to the society or committee, and where the benefit is paid to the husband he shall pay it to the wife.
15. POWER TO PRESCRIBE REDUCED RATES OF BENEFIT WHERE CONTRIBUTIONS ARE IN ARREAR.-(1) Regulations may be made for the following purposes(a) for providing, subject to the provisions of this section, for the reduction, postponement or suspension of benefits (other than medical benefit) in the case of insured persons who are in arrears, and with respect to the effect and amount of payments made and to be made by insured persons by way of cancelling arrears, and any regulations with respect to the matters aforesaid may make with respect to voluntary contributors provisions differing from those made with respect to employed contributors: (b) for empowering approved societies to terminate the membership of any person, being a voluntary contributor, whose arrears during the prescribed period exceed the prescribed number, or of any person, being an employed contributor, whose arrears during the prescribed period exceed the prescribed number, and who is entitled to obtain a certificate of exemption under this Act as being a person who has not been employed for the prescribed number of contribution weeks during any prescribed period:
(c) for prescribing the period to which any contribution paid by a voluntary contributor who is in arrears is to be allocated, and providing that for any prescribed purposes any such contribution shall be deemed to have been paid in respect of the period to which it is allocated.
(2) For the purpose of any regulations made under this section, any person who has been employed within the meaning of this Act for less than the prescribed