FAQOccupational Accident Insurance Coverage
| Q： | When does occupational accident insurance become effective if an employer fails to enroll an employee on the day of their employment, membership or training? |
| A： |
According to Article 13 of the Labor Occupational Accident Insurance and Protection Act, for workers employed by a registered employer, the insurance coverage starts from the day of employment. If the employer delays or advances the enrollment, it does not affect the insurance coverage; however, the employer may be subject to penalties for failing to insure as required by regulations. For members of occupational unions, members of category A fishing associations, trainees, and voluntary enrollees, if the insurance unit fails to notify the insurer (Bureau of Labor Insurance) on the day of membership, training, or employment, the insurance coverage will start from the day following the notification. |
| Q： | When does the occupational accident insurance coverage end if an employer fails to report the termination of insurance on the day of an employee’s resignation, membership withdrawal, or completion (withdrawal) of training? |
| A： |
According to Article 13 of the Labor Occupational Accident Insurance and Protection Act, for workers employed by a registered employer, the insurance coverage ends on the day of resignation. If the employer delays or advances the termination of insurance, it does not affect the insurance coverage. For members of occupational unions, members of category A fishing, associations, trainees, and voluntary enrollees, if the insurance unit fails to notify the insurer (Bureau of Labor Insurance) on the day of withdrawal, completion (withdrawal) of training, or resignation, the insurance coverage will end on the day of withdrawal, completion (withdrawal) of training, or resignation. Additionally, if the worker has not withdrawn or completed (withdrawn) from training, but the insurance unit processes the termination, the insurance coverage will end on the day of notification. |
| Q： | Are the regulations for reporting and adjusting insured salary under occupational accident insurance different from those under labor insurance? |
| A： |
The regulations for reporting and adjusting the insured salary under occupational accident insurance are the same as those of labor insurance. Specifically, if an insured person’s salary is adjusted between February and July of the current year, the insurance unit must notify the insurer (Bureau of Labor Insurance) of the adjusted between August of the current year and January of the following year, the insurance unit must notify the insurer by the end of February of the following year. These adjustments become effective on the first day of the month following the notification. |
| Q： | Is it mandatory for employers to report the insured salary under occupational accident insurance at the highest level? Can it be reduced? |
| A： |
Employers are required to report the insured salary under occupational accident insurance at the highest level (NTD 72,800). However, if the actual income does not reach the highest level of the insured salary classification, employers may provide evidence to adjust and reduce the reported insured salary. If the income does not reach the highest insured salary level, similar to the current labor insurance procedures, verification and adjustment are required. This includes providing documents such as the employer’s payroll details for the last three months, the most recent annual personal income withholding statement, the company’s latest profit-seeking enterprise income tax assessment notice, the latest profit and loss statement and tax calculation form, or a copy of the business tax payment slip for inspection. If the company was established or the responsible person changed within the last six months, a salary affidavit may be submitted. Additionally, according to Article 26, Paragraph 2 of the Enforcement Rules of the Labor Occupational Accident Insurance and Protection Act, the insured salary under occupational accident insurance must not be lower than the under-labor insurance. |
| Q： | If there is a discrepancy between the monthly insured salary reported by the employer for occupational accident insurance and the actual salary, which amount is used to determine the benefits? |
| A： |
Both occupational and labor insurance use a reporting system for insured salary. The employer must accurately report the insured salary based on the employee’s total monthly salary and adjust it within the legal reporting periods (by the end of February and August each year). These adjustments take effect on the first day of the month following the report. According to Article 28, Paragraph 1 of the Labor Occupational Accident Insurance and Protection Act, cash benefits are calculated based on the insured person’s average monthly insured salary and benefit criteria. Therefore, the benefits are determined based on the monthly insured salary and benefit criteria. Therefore, the benefits are determined based on the monthly insured salary reported by the employer. If the employer fails to accurately report the insured salary for occupational accident insurance, causing a loss of insurance benefits to the employee, the employer is liable for damages under the Civil Code. |
Language
close
