Can one receive compensation from both work-related injury insurance and accident insurance?
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Case: Wang, a worker in a factory workshop, was hit in the eye by flying metal shavings while operating machinery, resulting in an eighth-degree disability. Since the company had insured its employees against accidental injuries, the insurance company, after verifying the situation, made a payment to Xiao Wang. When Xiao Wang requested compensation for his work-related injury, the company’s manager refused to pay, arguing that the insurance company had already covered his medical expenses and paid out the accident insurance benefits. Case focus: Can Xiao Wang receive work-related injury benefits? Conclusion: Of course he can! Reason: Why? Today, the editor is here to share some knowledge! In accordance with Article 72 of the Labor Law and the reply issued by the Office of the Ministry of Human Resources and Social Security regarding whether it is still necessary to enroll in work-related injury insurance in addition to personal accident insurance purchased through commercial insurers, work-related injury insurance is a social security system that is **mandatory. Enterprises in China, whether they have purchased personal accident insurance as part of commercial insurance or not, must participate in work-related injury insurance in accordance with **relevant regulations. Personal accident insurance cannot replace work-related injury insurance. While participating in work-related injury insurance, enterprises can, based on their own actual circumstances, arrange personal accident insurance for their employees. It can be seen that when a company provides its employees with accident insurance, it constitutes an additional benefit for them, and it cannot serve as a substitute for work-related injury insurance. After receiving compensation from accident insurance, employees can still claim compensation under work-related injury insurance. Companies cannot use the fact that an employee has already received compensation for an accident as a defense; the employee can receive both types of compensation simultaneously. Therefore, the company still needs to pay Xiao Wang workers’ compensation.
This can be used to create case analysis questions; it’s an excellent case!
What major is this case study for?
What troubles workers the most at present is the failure to abide by the law and the lax enforcement of it； It’s a clearly simple case, with the legal provisions being very explicit; yet when it comes to companies, it’s difficult to enforce them ； Even when a judgment is issued through civil litigation and the enforcement phase begins, numerous difficulties arise; it is extremely hard for ordinary employees to protect their legitimate rights and interests, and such cases are all too common.
The two can be added together, but there must be a limit on the total amount
The two are different types of insurance, so compensation must be provided separately for each
The last edit to this post was made by A B C 123 on 2016-9-21 at 15:04. 1. According to Article 53 of the Work Safety Law, employees who suffer damage as a result of work-related accidents have the right to claim compensation from their employer, in addition to the benefits provided under work-related injury insurance; such employees also have the right to receive compensation in accordance with relevant civil laws. 2. Document No. Zhe Ren She 253 issued by the Department of Human Resources and Social Security of Zhejiang Province, notifying on various issues regarding the implementation of the revised \"Regulations on Work-related Injury Insurance\" issued by the State Council. In the event of a traffic accident or other type of accident that results in injury, if an employee suffers physical harm due to the wrongful acts of a third party outside of the employment relationship, and this constitutes an occupational injury, the employee is entitled to benefits under occupational injury insurance in accordance with the law. If an employee receives compensation for infringement, the corresponding benefits they are entitled to shall have deducted from them the following five expenses paid by a third party: medical expenses, costs for disability aids, and nursing fees, transportation costs, and hospital meal allowances incurred by the injured employee during the period of suspension from work with pay. 3. Article 8 of the “Provisions on Several Issues Concerning the Trial of Administrative Cases Related to Work-Related Injury Insurance”: “If an employee is injured as a result of the actions of a third party, and the social insurance administration department decides not to accept the application for work-related injury recognition or refuses to recognize it on the grounds that the employee or his/her close relatives have already filed a civil lawsuit against the third party or obtained civil compensation, the people’s court shall not support such a decision.” If an employee is injured due to the actions of a third party, and the social insurance administration authority has recognized it as an occupational injury, and the employee or their close relatives have not filed a civil lawsuit against the third party or have not yet received any civil compensation, then the people’s court shall support the claim made by the employee to have the social insurance agency pay the corresponding occupational injury benefits. If an employee suffers a work-related injury due to the actions of a third party, and the social insurance agency refuses to pay the work-related injury benefits on the grounds that the employee or his/her close relatives have already filed a civil lawsuit against the third party, the people’s court shall not support such refusal, except for medical expenses already paid by the third party. ”