Bulletin case: Employers should not be exempted from work-related injury insurance for the reason th

Bulletin case: Employers should not be exempted from work-related injury insurance for the reason that employees purchase commercial personal accident insurance!

 

In the practice of enterprise employment, many employers did not pay for work-related injury insurance for employees in consideration of various factors such as cost savings, but instead purchased industrial casualty insurance to replace work-related injury insurance, in an attempt to break down or transfer it. Work injury compensation liability. Then, after the employer has insured the commercial personal accident insurance for the employees, can the employer claim to be exempt from the work injury insurance liability and not pay for the work injury insurance? The "Some of the Supreme People's Court Bulletin" published in the 12th issue of 2017, "Anmou, Lan Moumou v. Shenzhen Shuiwan Ocean Fisheries Co., Ltd. work injury insurance treatment dispute case" made a clear answer to this question.

 

[referee summary]

The employer purchases commercial personal accident insurance for employees, and therefore does not exempt him from the statutory obligation to purchase workers' injury insurance. After the employee obtains the personal accident insurance for the purchase of the employee, he still has the right to claim the work injury insurance treatment from the employer.

 

[Basic case]

On August 8, 2012, Anmou joined the Shuiwan Company as a large-scale management officer. The employment period is two and a half years. From the September 1st of the departure date of Anweiwei to the arrival date or contract of the ship of Anmouwei. On the expiration date; Shuiwan Company is responsible for insuring personal accident insurance for Anmouwei. If there is a work-related injury or death during the employment period, it shall be implemented in accordance with the relevant accident insurance clause. On August 22, 2012, Shuiwan Company, as an insured, insured group accident insurance for the 48 crew members including Anmouwei, and the protection project was accidental death, disability, burn payment, and the amount of insurance per person. It is 600,000 yuan and the insurance period is from August 23, 2012 to August 22, 2013.

On August 5, 2013, when Anmou Wei was working on the “Zhongyang 26” round, he fell into a sea near the island of Lapa in the southern French island of French Polynesia. On January 16, 2014, Anmouwei was declared dead by the People's Court of Luanchuan County, Henan Province. After the incident, PICC actually paid the compensation of Anmouwei 600,000 yuan to the plaintiff Anmou and Lan Moumou (a security parent). On March 16, 2015, Shenzhen Human Resources and Social Security Bureau found that Anmouwei was in danger of being out of danger in the waters near Lapa Island in the southern French island of French Polynesia on August 5, 2013.

The plaintiff An Moumou and Lan Moumou claimed that his son An Weiwei was found to be a work-related injury and was entitled to work-related injury insurance according to law. Therefore, he requested the Water Bay Company to pay the wages of the arrears, and the funeral subsidies and dependents. Pension insurance, one-time work-stay subsidy and other work injury insurance benefits. The defendant Shuiwan Company argued that it had agreed to replace industrial injury insurance with commercial insurance before Anmou Health. The plaintiff had already received commercial insurance compensation of 600,000 yuan and had no right to claim work injury insurance.

 

[referee opinion]

The first instance of the Guangzhou Maritime Court held that:

Anmouwei and Shuiwan Company have labor contract relationship. Shuiwan Company did not purchase work-related injury insurance for Anmouwei. According to Article 43 of the “Regulations on Industrial Injury Insurance of Guangdong Province”, “the employer’s employer has not paid the work-related injury insurance premium according to law. In the event of a work-related accident, the employer shall pay the work-related injury insurance benefits and the first paragraph of Article 57 on "the employer shall not participate in the work-related injury insurance in accordance with the provisions of these Regulations, or fail to pay the work-related injury insurance premium on time, and the employee has a work-related injury, The provisions of the employer's payment of expenses to workers in accordance with the work injury insurance benefits items and standards stipulated in these Regulations shall be paid by the Shuiwan Company to the plaintiff in this case for the work injury insurance benefits that Anmouwei shall enjoy. Although the Water Bay Company purchased the accidental injury commercial insurance for Anmouwei, and in the employment contract, Anmou agreed to perform the accident insurance according to the relevant accident insurance clause during the employment period, but the work-related injury insurance is the employer’s A legal obligation that cannot be waived by the parties’ consultations. After An and Lumou obtained commercial insurance compensation as the beneficiary of the accident insurance policy, they still have the right to claim compensation for work injury insurance.

Shuiwan Company appealed to the Guangdong Higher Court for dissatisfaction with the judgment of the first instance. After the second instance of the Guangdong Higher People’s Court, it was considered:

According to the Regulations of the People's Republic of China on Industrial Injury Insurance, it is a statutory obligation of Shuiwan Company to pay work-related injury insurance for employees. This legal obligation may not be exempted or disguised in any form. The commercial accident insurance that Water Bay Company purchased for Anmouwei is in nature a kind of welfare treatment provided by Shuiwan Company for Anmouwei. It cannot exempt Water Bay Company from the statutory payment of work-related injury insurance premiums as an employer. Obligation or obligation to pay for work injury insurance. In addition, legal and judicial interpretations do not prohibit double compensation for workers or their families who are injured by work. Article 8 (3) of the Supreme People's Court's Provisions on Several Issues Concerning the Trial of Industrial Injury Insurance Administrative Cases stipulates that: “Employees may cause work-related injuries due to third-party reasons, and social insurance insurers may have third-person employees or their close relatives. If a civil action is filed and the workers' compensation is refused, the people's court will not support it, except for the medical expenses already paid by the third party. This shows that the above provisions do not prohibit workers who are injured at work from obtaining civil compensation and work-related injuries at the same time. Insurance benefits compensation. The appellant Water Bay Company stated that the appellee's simultaneous payment of insurance and work injury insurance is a matter of two compensations, violation of the principle of fairness, no legal basis and no support.

 

[Lawyer's opinion]

Judging from the results of the above-mentioned cases, we have already provided detailed answers to the questions raised in this article. The payment of work-related injury insurance according to law is a statutory obligation for the employer and cannot be exempted by any form. The purchase of commercial accident insurance for employees is an act of voluntary choice by the employer and is only a welfare treatment for employees. Article 39, paragraph 2, of the Insurance Law amended on October 1, 2009: “Insured persons shall insure their personal insurance for laborers with whom they have labor relations, and shall not designate persons other than the insured and their close relatives as beneficiaries. "This clause indicates that the employer purchases accident insurance for employees, and the beneficiary can only be employees and their close relatives. It is impossible to be a unit. The Insurance Law does not have this clause before the amendment. Therefore, after the amendment of the Insurance Law, the employer has been unable to act as a beneficiary when insuring personal accident insurance for employees. It is impossible to decompose or replace the liability for work-related injury through the insurance. The wrong understanding of the employer is only given Employees provide an additional benefit insurance for accident insurance, which should be paid by the employer for work-related injury insurance. The majority of employers should take this as a warning!

In view of this, the author has the following two suggestions for the employer:

1. In accordance with the law, timely apply for work-related injury insurance for employees who are employed. In the case of workers' work-related injuries, they shall compensate workers for work-related injury insurance in accordance with the Regulations on Industrial Injury Insurance and local regulations.

2. In the case of purchasing work-related injury insurance for employees, the work-related injury insurance fund can bear most of the compensation for work-related injury, but there are still some compensation for work-related injuries that need to be borne by the employer itself. If the employer wants to further break down the liability for compensation, it can be considered. Purchase employer liability insurance from a commercial insurance company. Employer liability insurance is different from group accident insurance. Employer liability insurance belongs to property insurance. The insured is the enterprise, and the beneficiary is also the enterprise. After the employer assumes the liability for work injury compensation to the employee, the insurance company can pay the employer liability insurance. To make up for its losses.