Definition of employment injury insurance

Employment injury insurance is an important part of the social insurance system. It is a social security system in which the state establishes an employment injury insurance fund through social planning to provide medical treatment, living security, economic compensation, vocational rehabilitation and other assistance to the injured workers who suffer from accidents in production or work or suffer from occupational diseases.

The payment of employment injury insurance

According to the provisions of Article 33 of the Social Insurance Law and Article 10 of the Regulations on Employment Injury Insurance, all expenses for employees to participate in employment injury insurance shall be paid by the employer, and the expenses shall not be paid by employees themselves.

Employment injury insurance payment rate

According to the provisions of Article 8 of the Regulations on Employment Injury Insurance, the State determines the differential rates of work-related injury according to the degree work-related injury risk in different industries, and determines a number of rates in each industry according to the use of employment injury insurance premiums and the incidence of work-related injury. Industry differential rates and rates within the industry shall be formulated by the social insurance administrative department under The State Council and promulgated for implementation after approval by The State Council.

There are eight payment rate standards which are divided because of various degrees of risks on work-related injury in different industries. The eight payment rate standards are 0.2%, 0.4%, 0.7%, 0.9%, 1.1%, 1.3%, 1.6%, 1.9%.

The procedures employer deal with employees’ work-related injuries

(1) Identification of work-related injury

Within 30 days from the date of occurrence of the accident or the date of diagnosis or appraisal as occupational disease, the employer shall apply to the social insurance administrative department of the insured place for identification of work-related injury. If the employer fails to apply for the identification of work-related injury in accordance with the regulations, the injured employee or his close relatives or the trade union organization may apply to the social insurance administrative department of the insured place for the identification of work-related injury within one year from the date of occurrence of the accident or the date of diagnosis or appraisal as occupational disease.

Materials including: application form for identification of industrial injury, proof of labor relationship with the employer (including factual labor relationship), medical diagnosis certificate or occupational disease diagnosis certificate, etc. (different regions have different requirements)

(2) Work-related injury medical treatment

Employees who suffer from work-related accidents or occupational diseases shall receive treatment and enjoy medical treatment for work-related injuries. The expenses for the treatment of injured workers shall be paid from the employment injury insurance fund.

(3) Work-related injury rehabilitation

The cost of the injured worker's rehabilitation to the rehabilitation institution that has signed the service agreement shall be paid from the employment injury insurance fund if it complies with the relevant provisions.

(4) Labor capacity evaluation

If an employee is injured at work and has a disability that affects his working ability after his injury condition is relatively stable after treatment, he shall be evaluated for his working ability.

(5) Work-related injury insurance treatment.

Workers in the construction industry who have participated in employment injury insurance are entitled to various employment injury insurance treatments in accordance with the Regulations on Employment Injury Insurance after they have been injured in an accident or have been diagnosed or assessed as an occupational disease.

 

Contents of employment insurance treatments

(1) Expenses for medical treatment and rehabilitation of work-related injuries;

(2) Hospital food allowances;

(3) Transportation and accommodation expenses for medical treatment outside this prefecture or city (place);

(4) Expenses for the allocation of assistive devices;

(5) Living care fees;

(6) One-time disability benefits;

(7) Monthly disability allowance for employees with disabilities ranging from grade 1 to Grade 4;

(8) One-time industrial injury medical benefits to be enjoyed in case of termination or dissolution of employment relationship;

(9) Funeral subsidies, pensions for supporting relatives and one-off compensation for death of workers;

(10) Expenses for evaluation of labor capacity;

(11) Other expenses prescribed by laws and regulations for employment injury insurance.

The treatment and living care costs the employees could enjoy during the treatment of work-related injuries

During the period of suspension of work of the employee due to work-related injuries, his/her original salary and welfare benefits shall remain unchanged and be paid by the employer on a monthly basis. The suspension period is generally no more than 12 months. If the injury is serious or the situation is special, it may be extended appropriately upon confirmation by the labor ability appraisal committee, but the extension period shall not exceed 12 months.

If an injured worker who is unable to take care of himself needs nursing care during the period of suspension of work, his/her employer shall be responsible for it.

The treatments for employees who die because of work

If an employee dies at work, his or her close relatives could receive funeral subsidies, dependant relatives' pensions and one-off workers' death subsidies from the work-related injury insurance fund in accordance with the provisions.

Under what circumstances the employee could not enjoy work-related injury treatments?

Workers injured in any of the following circumstances, shall cease to enjoy employment injury insurance treatments:

(1) Loss of the conditions for enjoyment of treatment;

(2) Refusing to accept the assessment of labor capacity;

(3) Refusal of treatment.

The legal responsibilities employers will bear if do not participate in employment injury insurance

Where an employer fails to take part in employment injury insurance according to the Regulations on employment Injury Insurance, the administrative department of social insurance shall order it to take part within a time limit and pay the employment injury insurance premium that should be paid, more, starting from the day when the payment is in arrearage, impose a late fine of 5 ‱ per day. Those who still fail to pay within the time limit shall be fined not less than one time but not more than three times the amount in arrears.

If an employee of an employer who is legally required to participate in employment injury insurance but does not participate in employment injury insurance suffers a work-related injury, the employer shall pay the expenses in accordance with the employment injury insurance treatment items and standards stipulated in the Regulations on Employment Injury Insurance.

The significance of participating in employment injury insurance for employees

In accordance with the Regulations on Employment Injury Insurance, employees who have participated in employment injury insurance may enjoy timely and full benefits of employment injury medical treatment, employment injury rehabilitation, assistive equipment allocation and various living security benefits paid by the employment injury insurance fund. The living security benefits include one-time treatment and long-term treatment, so as to solve the problems of medical treatment and basic living security of employees after work-related injuries.

The significance of participating in employment injury insurance for employees

The purchase of employment injury insurance by employers will effectively protect the legitimate rights and interests of employees, also can effectively reduce the employment cost of companies, thus better adjust labor relations and maintain the stability of employees.

 

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This article is based on the analysis and references of different cited sources online and does not represent AsecorpChina's opinion. AsecorpChina won't assume any responsibility on the reader's application of the interpretation of this article.

         

Source:

https://mp.weixin.qq.com/s/ZT1buvgmSiaB0lbqm-arhw  

https://mp.weixin.qq.com/s/uo5VHt5sIF8rqM7qcAWguw  

https://mp.weixin.qq.com/s/GlK62TUiuU9K8oSUBXqNsQ  

https://mp.weixin.qq.com/s/GiYhYOAioICU7aGa_FKNoA  

https://mp.weixin.qq.com/s/kFIvuTWKmPNCYppKxGR6oA  

https://mp.weixin.qq.com/s/bBrxxma22jR9DKWKjCdSsg  

https://mp.weixin.qq.com/s/XfkTY5LIbWAv8DbeoaFnig  

https://mp.weixin.qq.com/s/g8XzxH8wEsqUbox63LHzBg  

https://mp.weixin.qq.com/s/8QIzFPfsRCZAQ9FtoMeJyg

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