|
Q：
|
What types of occupational accident insurance benefits are provided under the Labor Occupational Accident Insurance and Protection Act?
|
|
A：
|
The types of occupational accident insurance benefits include five categories: medical injury and illness, disability, death, and missing person benefits.
|
|
Q：
|
Can workers apply for occupational accident insurance benefits in all cases of occupational accidents?
|
|
A：
|
Workers who suffer an occupational injury or contract an occupational disease while enrolled in occupational accident insurance can claim benefits for medical, injury and illness, disability, death, or missing person incidents in accordance with the regulations. Additionally, within one year after the insurance coverage ends, workers can still claim medical, injury and illness, disability, or death benefits for the same injury or any related illnesses.
|
|
Q：
|
In what situations can workers claim occupational accident insurance benefits without being enrolled in the insurance? How is the benefit amount calculated?
|
|
A：
|
-
For workers who are mandatorily covered under Article 6 of the Labor Occupational Accident Insurance and Protection Act, insurance coverage takes effect from the date of employment. Even if the employer fails to complete the insurance enrollment process as required, workers can still apply for occupational accident insurance benefits in the event of an insured accident. However, workers in labor unions, fishermen’s associations, vocational training units, or those who voluntarily enroll in the insurance must be actively enrolled to be eligible for benefits.
-
The benefit amount is calculated the same way as for insured workers, based on the average monthly insured salary over the six months prior to the accident. If the employer fails to complete the enrollment, the Bureau of Labor Insurance will determine the insured salary using the salary data provided, in accordance with the insured salary classification table, but it cannot exceed the average monthly insured salary of all insured individuals in the most recent year before the accident. If no salary data is provided, the lowest classification in the insured salary table will be used for calculation.
|
|
Q：
|
Do occupational accident insurance benefits need to be claimed in place of other social insurance benefits?
|
|
A：
|
-
If the insured person, beneficiary, or the person covering funeral expenses qualifies for benefits from multiple insurance programs (such as occupational accident insurance, labor insurance, farmers’ health insurance, farmers’ occupational accident insurance civil servant insurance, military insurance, or the national pension) due to the same insurance event, they must choose only one the claim. For example, if an insured person passes away from an occupational accident, Beneficiary A claims the occupational accident death benefit, while Beneficiary B, also insured under labor insurance, can claim the labor insurance family death benefit. In this case, the funeral allowance from the occupational accident death benefit must be claimed instead of the labor insurance family death benefit.
-
If the insured person and beneficiary qualifies for pension benefits from occupational accident insurance or other social insurance programs due to different insurance events, they can claim both benefits simultaneously. However, the occupational accident insurance pension benefit will be adjusted and reduced.
|
|
Q：
|
How long is the statute of limitations for claiming insurance benefits?
|
|
A：
|
The right to claim insurance benefits expires if not exercised within five years the date the benefits become claimable.
|
FAQ
