Occupational Accident Insurance Benefit Claim Guidelines
Q: | After suffering an occupational injury, if an insured person works half a day and spends the other half at the hospital for rehabilitation and receiving partial salary, can they apply for occupational accident insurance sickness benefit? |
A: |
Occupational accident insurance sickness benefit is only provided when the insured person is “unable to work all day” for more than 4 days due to an occupational injury or illness. Therefore, even if the insured person has experienced an occupational injury, they are not eligible to claim the occupational injury insurance sickness benefit if they continue to work, regardless of the length of their working hours. |
Q: | If an individual is insured under two units at the time of an accident or illness, which insured unit should they apply through for occupational accident insurance sickness benefits? |
A: |
If the insured person sustains an injury or occupational illness while performing their duties, the application for occupational accident insurance sickness benefits should be submitted through the insured unit where they were working at the same of the incident. If the insured person has more than one insured salary in the same month, the calculation of the average monthly insured salary for the occupational accident benefits will use the highest salary, averaged with the monthly insured salaries from other months. |
Q: | During a period od unpaid work suspension due to accident or illness, can I still apply for occupational accident insurance sickness benefits? |
A: |
If an insured person under occupational accident insurance continues to be insured during a period of unpaid work suspension due to an occupational accident or illness, and they are still undergoing outpatient or inpatient treatment for the same occupational accident or illness and are unable to work, they can continue to receive occupational accident insurance sickness benefit in accordance with the regulations. |
Q: | During a period of unpaid work suspension due to accident or illness, can I still apply for occupational accident insurance sickness benefits? |
A: |
If an insured person under occupational injury insurance continues to be insured during a period of unpaid work suspension due to an occupational accident or illness, and they are still undergoing outpatient or inpatient treatment for the same occupational accident or illness and are unable to work, they can continue to receive occupational injury insurance sickness benefits in accordance with the regulations. |
Q: | Can an insured person apply for occupational accident insurance sickness benefits after withdrawing from the insurance following an occupational accident or illness? |
A: |
If an occupational accident or illness occurs during the period when the insurance is still valid, the insured person can apply for occupational accident insurance sickness benefits for the same injury or illness, including any related conditions, within one year after the insurance coverage has ended. |