The Workers Compensation Release of Information Form is a critical document required in the Indian workplace injury claims process. It becomes necessary when an employee has suffered a work-related injury or illness and needs to authorize the release of their personal, medical, and employment information to process their compensation claim. This form, governed by the Employees' Compensation Act, 1923, and various data protection regulations in India, ensures that sensitive information is shared only with authorized parties while maintaining compliance with privacy laws. The document is essential for insurance providers, employers, and medical practitioners to access and share relevant information necessary for processing the compensation claim efficiently.
Your data doesn't train Genie's AI
You keep IP ownership of your information
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
OR
Let Genie AI's market-leading legal AI identify missing terms, unusual language, compliance issues and more - in just seconds.
Upload your Doc
1. Employee Information: Basic details of the employee including full name, employee ID, contact information, and date of birth
2. Employer Information: Details of the current employer, including company name, address, and contact information
3. Accident/Injury Details: Information about the work-related injury or illness, including date, nature of injury, and claim number if available
4. Authorization Statement: Clear statement of what information is being authorized for release and for what purpose
5. Information Recipients: Specific individuals or entities authorized to receive the information
6. Duration of Authorization: Time period for which the authorization remains valid
7. Rights and Revocation: Statement of rights to revoke authorization and any limitations
8. Signature Block: Space for employee signature, date, and witness signature if required
1. Previous Employer Authorization: Additional section when information needs to be obtained from previous employers
2. Mental Health Records: Specific authorization for release of mental health treatment records, if applicable
3. Third-Party Representative: Authorization for legal representative or family member to act on behalf of injured worker
4. International Transfer Consent: Required when information may be transferred outside India
5. Specific Exclusions: Section to explicitly state any information that should not be released
1. Schedule A - Medical Providers List: List of all medical providers who have treated the employee for the work-related injury
2. Schedule B - Required Documentation: Checklist of specific documents to be released
3. Appendix 1 - Privacy Notice: Detailed privacy notice explaining how the information will be used and protected
4. Appendix 2 - Authorized Recipients: Detailed list of all parties authorized to receive the information with their contact details
Relevant legal definitions
Authorized Recipients
Claim
Compensation
Confidential Information
Employee
Employer
Health Care Provider
Injury
Insurance Provider
Medical Records
Occupational Disease
Personal Information
Protected Health Information
Release Authorization
Revocation
Sensitive Personal Data
Treatment Records
Work-Related Injury
Workers Compensation Benefits
Workers Compensation Board
Claim
Compensation
Confidential Information
Employee
Employer
Health Care Provider
Injury
Insurance Provider
Medical Records
Occupational Disease
Personal Information
Protected Health Information
Release Authorization
Revocation
Sensitive Personal Data
Treatment Records
Work-Related Injury
Workers Compensation Benefits
Workers Compensation Board
Clauses
Authorization and Consent
Data Privacy
Information Access
Medical Records Release
Duration and Validity
Revocation Rights
Information Use and Disclosure
Confidentiality
Rights and Obligations
Liability and Indemnification
Governing Law
Certification and Attestation
Witness Requirements
Document Authentication
Information Scope
Data Privacy
Information Access
Medical Records Release
Duration and Validity
Revocation Rights
Information Use and Disclosure
Confidentiality
Rights and Obligations
Liability and Indemnification
Governing Law
Certification and Attestation
Witness Requirements
Document Authentication
Information Scope
Relevant Industries
Manufacturing
Construction
Mining
Healthcare
Transportation
Logistics
Industrial Production
Agriculture
Retail
Hospitality
Chemical Industry
Textile Industry
Infrastructure
Automotive
Warehousing
Relevant Teams
Human Resources
Legal
Compliance
Risk Management
Operations
Occupational Health & Safety
Workers Compensation
Employee Relations
Insurance
Administrative Services
Relevant Roles
HR Manager
Safety Officer
Compliance Officer
Risk Manager
Operations Manager
Factory Manager
Site Supervisor
Legal Counsel
Insurance Coordinator
Occupational Health Nurse
Workers Compensation Specialist
Employee Relations Manager
Health and Safety Manager
Claims Administrator
HR Business Partner
Find the exact document you need
Medical Information Request Form
An India-compliant form for requesting and authorizing the release of medical information, meeting local healthcare and data protection requirements.
find out more
Medical Information Disclosure Consent Form
An Indian-compliant consent form for medical information disclosure that meets healthcare privacy regulations and protects patient rights while enabling necessary information sharing.
find out more
Medical Consent
An Indian-law compliant medical consent form documenting patient authorization for medical procedures and treatments, incorporating all necessary legal and medical requirements.
find out more
Motor Vehicle Record Disclosure And Release Form
An Indian legal form authorizing the release of motor vehicle records from transport authorities while ensuring compliance with local regulations and privacy laws.
find out more
Medical Treatment Authorization And Consent Form For Adults
A comprehensive medical treatment authorization and consent form compliant with Indian healthcare laws, documenting patient consent for medical procedures and protecting both patient and provider rights.
find out more
Medical Release Form For Nanny
An Indian jurisdiction-compliant legal document authorizing a nanny to make medical decisions for children under their care when parents are unavailable.
find out more
Information Release
An Indian law-governed agreement that establishes terms for controlled information sharing between parties, ensuring legal compliance and data protection.
find out more
Health Care Release Form
An Indian-compliant legal document authorizing the release of medical information and/or treatment consent between healthcare providers and patients, following national healthcare regulations.
find out more
Generic Waiver Form
An Indian law-compliant waiver document that releases liability for specified activities or services while ensuring legal enforceability under Indian jurisdiction.
find out more
Employment Records Release Authorization Form
An Indian law-compliant authorization form for the release of employment records, ensuring proper consent and data protection compliance.
find out more
Emergency Medical Release Form For Grandparents
An Indian law-compliant authorization form enabling grandparents to make emergency medical decisions for their grandchildren when parents are unavailable.
find out more
Dental X Ray Release Form
An Indian-compliant consent form for dental X-ray procedures, ensuring legal protection for practitioners and informed consent from patients under Indian healthcare regulations.
find out more
Consent Form For Pictures On Social (Media)
An Indian law-compliant consent form for authorizing and managing the use of photographs on social media platforms, addressing privacy rights and usage permissions.
find out more
Consent Form For Release Of Information
An India-compliant legal document authorizing the release of personal or confidential information between specified parties, aligned with Indian data protection laws.
find out more
Caregiver Medical Release Form
An Indian-compliant legal document authorizing a caregiver to make medical decisions and obtain treatment on behalf of a care recipient, following Indian healthcare and contractual regulations.
find out more
Auto Lien Release Request Letter
A formal request letter used in India to obtain release of a bank's security interest in a vehicle after loan repayment, complying with Indian banking and motor vehicle regulations.
find out more
Authorization To Release Protected Health Information Form
An Indian law-compliant authorization form for the release of protected health information, allowing controlled sharing of medical records while maintaining patient privacy rights.
find out more
Authorization For Release Of Records Form
An Indian law-compliant authorization form for the structured and consent-based release of records from one party to another, adhering to the Digital Personal Data Protection Act 2023.
find out more
Authorization For Disclosure
A legal document under Indian law that authorizes the disclosure of specific confidential or sensitive information between designated parties.
find out more
Universal Release Of Information Form
An Indian law-compliant form authorizing the release and sharing of specific information between designated parties, with provisions for data protection and privacy.
find out more
Transcript Release Authorization Form
An Indian legal document authorizing educational institutions to release academic transcripts to designated recipients, complying with local education and privacy regulations.
find out more
Tenant Release Form
A legal document under Indian law that mutually releases landlord and tenant from their lease obligations and documents the terms of lease termination.
find out more
Simple Medical Release Form For Minor
An Indian legal document authorizing medical treatment for minors through parental/guardian consent, compliant with Indian healthcare and guardianship laws.
find out more
Release Of Financial Obligation Form
An Indian law-compliant document that legally releases a party from their financial obligations or debts owed to another party.
find out more
Publicity Consent Form
An Indian law-compliant consent form authorizing the use of an individual's personal attributes (image, name, likeness) for publicity purposes.
find out more
Patient Release Form
An Indian healthcare document formalizing patient discharge from medical facilities, including treatment summary and liability releases, compliant with Indian medical regulations.
find out more
Patient Authorization For Disclosure Of Health Information
An Indian-compliant legal document authorizing healthcare providers to share patient medical information with specified recipients, adhering to Indian privacy laws and healthcare regulations.
find out more
Authorization For Release Of Medical Record Information
An Indian law-compliant authorization form for the release of medical records, ensuring proper consent and data privacy protection in healthcare information transfers.
find out more
Doctor Release Form To Return To Work
An Indian-compliant medical certification document authorizing an employee's return to work after medical leave, including any necessary work restrictions or accommodations.
find out more
Authorization For Release Of Protected Health Information
An Indian-compliant authorization form for the release of protected health information, enabling controlled sharing of medical records while maintaining patient privacy rights.
find out more
Court Release Form
An Indian legal document that formalizes the terms and conditions for releasing an individual from custody or legal restraint, subject to Indian court jurisdiction and procedures.
find out more
Release Waiver Agreement
An Indian law-compliant legal document where one party voluntarily waives their right to bring future claims against another party for specified activities or circumstances.
find out more
Employee Medical Release Form
An Indian-law compliant medical release form authorizing the sharing of employee medical information while ensuring data privacy and confidentiality.
find out more
Consent To Disclose Medical Information
An Indian law-compliant authorization document for the disclosure of medical information to specified recipients, incorporating patient privacy protections and healthcare regulations.
find out more
Consent Form For Social (Media)
An India-compliant consent form for social media data collection and content usage, aligned with IT Rules 2021 and data protection requirements.
find out more
3rd Party Release Form
An Indian law-governed release form enabling third parties to grant permissions and waive specific rights or claims, typically used for media, events, or research participation.
find out more
General Release Of Medical Information Form
An Indian-compliant legal form authorizing the release and transfer of patient medical information between specified parties while ensuring data privacy and consent documentation.
find out more
Counseling Release Form
An Indian jurisdiction counseling agreement that establishes the professional relationship between mental health practitioners and clients, ensuring legal compliance and informed consent.
find out more
Release Of Medical Records To Patient Form
An Indian-compliant form for authorizing the release of patient medical records from healthcare providers to patients or their authorized representatives.
find out more
Generic Medical Release Form
An Indian law-compliant medical release authorization form enabling controlled sharing of patient medical information between authorized parties.
find out more
Genie’s Security Promise
Genie is the safest place to draft. Here’s how we prioritise your privacy and security.
Your documents are private:
We do not train on your data; Genie’s AI improves independently
All data stored on Genie is private to your organisation
Your documents are protected:
Your documents are protected by ultra-secure 256-bit encryption
We are ISO27001 certified, so your data is secure
Organizational security:
You retain IP ownership of your documents and their information
You have full control over your data and who gets to see it
.png)
.png)