1. How to apply for advance payment from the industrial injury insurance fund?
First of all, there are two conditions for applying for advance payment: first, the provisions of Article 42 of the Social Insurance Law; The other is the stipulation in Article 41 of this Law: "If an employee's employer fails to pay work-related injury insurance premiums according to law, the employer will pay work-related injury insurance benefits if an accident occurs. If the employer does not pay, it will be paid in advance from the industrial injury insurance fund. "
Secondly, the procedure of applying for advance payment should comply with the provisions of Articles 17 and 18 of the Regulations on Work-related Injury Insurance, and submit to the administrative department of social insurance a certificate of labor relationship with the employer, as well as a medical diagnosis certificate or an occupational disease diagnosis certificate. The administrative department of social insurance will review the nature of work-related injuries according to relevant regulations, and make a decision on the determination of work-related injuries. Second, individuals or their close relatives hold the "Work-related Injury Determination Decision" and related materials (including original bills of medical diagnosis and appraisal fees, etc. ), and apply in writing to the social insurance agency for advance payment of the industrial injury insurance fund. If the third party fails to pay the medical expenses for work-related injuries or cannot identify the third party, it shall also inform the third party of the failure to pay or the inability to identify the third party.
Thirdly, according to different situations, the prepaid items are different. First, for work-related injuries caused to a third person, the advance payment of work-related injury insurance fund is limited to medical expenses, excluding work-related injury insurance benefits. Second, because the employer does not pay work-related injury insurance benefits, it includes nine expenses listed in Article 38 of the Social Insurance Law. That is, medical expenses for work-related injury treatment, rehabilitation expenses, food subsidies for hospitalization, transportation and accommodation expenses for medical treatment outside the co-ordination area, expenses for installing assistive devices for the disabled, living nursing expenses confirmed by the labor ability appraisal committee because of inability to take care of themselves, one-time disability allowance and monthly disability allowance received by disabled employees of Grade I to IV, one-time medical subsidy, funeral subsidy, pension for supporting relatives, work-related death subsidy and labor ability appraisal fee received by survivors of work-related deaths when the labor contract is terminated or dissolved.
After the social insurance agency pays in advance from the industrial injury insurance fund, it shall require the employer to repay or claim compensation from the employer according to law.
Second, what is the content of the law?
Article 4 1 of the Social Insurance Law stipulates: "If the employer where the laborer works fails to pay the work-related injury insurance premium according to law, the employer shall pay the work-related injury insurance benefits if an accident occurs. If the employer does not pay, it shall pay in advance from the industrial injury insurance fund. The industrial injury insurance benefits paid in advance from the industrial injury insurance fund shall be repaid by the employer. If the employer fails to repay, the social insurance agency may recover the compensation in accordance with the provisions of Article 63 of this Law. " The Interim Measures for Advance Payment of Social Insurance Fund (OrderNo. of Ministry of Human Resources and Social Security 15) further stipulates this point. According to this method,
(1) The subject applying for advance payment must be the employee himself or his near relatives. Workers with work-related injuries who have the capacity to act shall apply by themselves; If I am unable to apply or unwilling to apply on my own, I may entrust my close relatives or other qualified personnel to apply according to law. The employee's death or illness is proposed by his close relatives.
(2) It must have been recognized as a work-related injury. Employees or their close relatives who apply to the social insurance agency for advance work-related injury insurance benefits must submit the work-related injury identification decision and related materials.
(three) the application for advance payment of work-related injury insurance benefits must be made in writing.
(4) The employer fails to pay or is unable to pay the industrial injury insurance benefits, including: the employer has its business license revoked or its registration cancelled according to law; The employer refuses to pay all or part of the expenses; In accordance with the law, after arbitration and litigation, it is impossible to obtain work-related injury insurance benefits, and the court issues a document to suspend execution; Other circumstances in which the employee thinks that the employer does not pay.
(5) The social insurance agency shall, after receiving the application submitted by employees or their close relatives according to Article 6, issue a written reminder notice to the employer within 3 working days, requiring it to verify and pay the industrial injury insurance benefits according to law within 5 working days, and inform it that if it fails to pay in full and on time within the prescribed time limit, the industrial injury insurance fund shall obtain the right to demand repayment after paying in advance according to the regulations.
(6) If an individual applies for paying medical expenses, work-related injury medical expenses or work-related injury insurance benefits in advance, all original bills and other evidence of medical diagnosis and appraisal expenses shall be submitted.
After a work-related injury occurs in contemporary society, it is possible to apply for compensation from work-related injury insurance. However, some people may be anxious and want to pay this fee first, but they must meet the pre-payment conditions stipulated by law before applying.