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Workers Comp Waiver Form
"I need a Workers Comp Waiver Form for my construction company in Auckland, with specific provisions for high-risk work activities and additional private insurance coverage we offer above the ACC scheme, to be implemented by March 2025."
1. Parties: Identification of the employer and employee, including full legal names, addresses, and relevant identification numbers
2. Background: Context of the employment relationship and purpose of the document
3. Definitions: Key terms used in the document, including specific workplace terminology and legal concepts
4. ACC Scheme Acknowledgment: Statement acknowledging understanding of NZ's ACC scheme and its universal coverage
5. Employee Declarations: Employee's confirmations regarding understanding of their rights and obligations under the ACC scheme
6. Employer Obligations: Outline of the employer's commitments regarding workplace safety and injury management
7. Reporting Requirements: Procedures for reporting workplace incidents and injuries
8. Execution: Signature blocks for all parties, including witness requirements
1. Additional Benefits: Details of any supplementary benefits offered by the employer beyond ACC coverage
2. Return to Work Provisions: Specific procedures and commitments regarding return to work after injury, if the employer has a formal program
3. Overseas Coverage: Special provisions for employees who may work overseas temporarily
4. Third Party Claims: Provisions regarding claims involving third parties or contractors
5. Medical Examination Requirements: Any specific requirements for medical examinations or assessments, if applicable to the role
1. Schedule 1: Employee Details: Detailed employee information including emergency contacts and relevant medical history
2. Schedule 2: Workplace Safety Procedures: Summary of relevant workplace safety procedures and protocols
3. Schedule 3: Incident Reporting Form: Standard form for reporting workplace incidents and injuries
4. Appendix A: ACC Information Sheet: Standard ACC information sheet explaining the scheme and coverage
5. Appendix B: Employee Rights Summary: Summary of employee rights under NZ employment and health and safety laws
Authors
Construction
Manufacturing
Mining
Agriculture
Healthcare
Transportation
Retail
Hospitality
Education
Professional Services
Maritime
Forestry
Industrial Services
Entertainment
Sports and Recreation
Human Resources
Health and Safety
Legal
Operations
Risk Management
Compliance
Industrial Relations
Workplace Relations
Employee Relations
Occupational Health
Operations Manager
Health and Safety Officer
Human Resources Manager
Risk Management Specialist
Compliance Officer
Site Supervisor
Factory Worker
Construction Worker
Healthcare Worker
Mining Engineer
Forestry Worker
Machine Operator
Warehouse Manager
Field Service Technician
Production Line Worker
Agricultural Worker
Maritime Worker
Professional Athlete
Industrial Worker
Laboratory Technician
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