Adam Frankel
General Counsel · Technology & AI
15+ years as General Counsel to technology, cloud & AI companies
Agreement for Compromise Between Employer and Workman for Payment of Compensation (India) by OLL
Open Legal LibraryUpdated 19 Oct 2026
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Agreement for Compromise between the Employer and Workman for Payment of Compensation Under Workmen's Compensation Act
THIS AGREEMENT is made at __________ on this ______ day of ___________, 2000,
between
A B Co. Ltd.,
a company incorporated under the Companies Act, 1956 and having its registered office at ________________
hereinafter called "the Employer" (which expression shall unless repugnant to the context or meaning thereof include its successors and assigns) of the ONE PART
and
Mr. X S/o _________,
R/o _______________
hereinafter called "the workman" (which expression shall unless repugnant to the context or meaning thereof, include his heirs, executors, administrators and assigns) of the OTHER PART.
WHEREAS the workman was employed by the employer in its factory in the capacity of ___________ and on ________ he was injured by an accident arising out of and in the course of his employment, in respect of which he claims that the employer is liable to pay him compensation under the Workmen's Compensation Act.
WHEREAS in order to avoid litigation in respect of the said claim, the parties hereto are desirous that the liability of the employer (if any), shall be satisfied by the compensation herein agreed to be made.
NOW THIS DEED WITNESSETH THAT IT IS HEREBY AGREED AS FOLLOWS:
1. The employer shall pay the workman the sum of Rs. __________ as compensation for such injury as aforesaid on __________.
2. The employer shall also pay the workman the sum of Rs. _________in respect of the costs of his medical attendance and other expenses.
The workman shall accept the before mentioned payments in full discharge of all liability of the employer to pay compensation under the Workmen's Compensation Act or any law for the time being in force and doth hereby release the employer from any and all liability in respect of the injury caused to the workman and from any and all liability for any damages, which may result to the said workman in future on account of the said injury.
IN WITNESS WHEREOF, the employer hereto has set its hands and seal and the workman has set his hands hereunto and to a duplicate hereof, the day and the year first hereinabove written.
The common seal of ABC Co. Ltd. has been hereunto affixed pursuant to the Resolution of its Board of Directors dated the _____ day of __________, 200-__, in the presence of Shri ______________ and _________________Directors who have signed in token thereof.
Signed and delivered by A, the with in named workman
WITNESSES;
1. Name & Signature
2. Name & Signature
This template facilitates a formal settlement between an employer and an employee regarding compensation for workplace injuries. It outlines the agreed-upon payment amount and ensures the employer is released from further liability under the Workmen's Compensation Act.
About this template
What is this template?
This document is a formal settlement deed for workplace injury claims in India. It contains specific fields for Rupees, medical costs, and a release of liability under the Workmen's Compensation Act. It is not an employment contract or a general release for termination of employment.
When should you use it?
Use this when a worker has been injured during employment and both parties agree to a financial settlement to avoid litigation. Use a standard Settlement Agreement if the payment relates to redundancy or unfair dismissal instead of physical injury.
What's inside
| Clause | Name | What it does |
|---|---|---|
| 1 | Compensation Amount | The Employer agrees to pay the workman a specific sum in Rupees as compensation for the injury on a stated date. |
| 2 | Medical Expenses | The Employer agrees to pay an additional sum in Rupees covering the costs of medical attendance and other related expenses. |
| 3 | Release of Liability | The workman accepts the payments as full discharge of all liability under the Workmen's Compensation Act and releases all future damage claims. |
Who it's for
- an Indian company settling a compensation claim with an injured worker outside of court
- a workman in India waiving future claims in exchange for a lump sum medical payment
How long it runs and how it's signed
How long
Runs until the work is done
Survives the end
Release of Liability
Signed by
Directors, Workman
Witness
Required
Notarisation
Not required
Also needed
affix common seal of the company; Board of Directors resolution dated
Law it's drafted under
Governed by
Workmen's Compensation Act
Refers to
Companies Act, 1956
Jurisdiction
India
Document info
MS Word. Document created on Fri Jul 17th, 2026. Last updated on Mon Oct 19th, 2026.
This document is public
Licensed under CC BY 4.0 (Attribution).
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