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Case analysis of work-related injury: during the period of unpaid social insurance premium, you can't refuse to pay work-related injury compensation.
Case analysis of work-related injury: during the period of unpaid social insurance premium, you can't refuse to pay work-related injury compensation.

Ma Yuan was an employee of a pharmaceutical company in Dezhou City, Shandong Province, and was transferred to a local knitting company on February 3, 20 10. 20 10, 19 On February 22nd, the former pharmaceutical company paid the industrial injury insurance premium for Ma from February 2003 to February 2009. Ma died at work on1October 3 1 1 day, and the knitting company paid Ma eight times from February to August 201year. On 2011April 2 1 day, Ma was recognized as a work-related injury. But when their relatives applied to the county social security office for compensation for work-related injuries and deaths, the superior social security office gave the county social security office an answer:? The work-related injury benefits of such workers are paid by the employer. ? Therefore, Ma's relatives filed an administrative lawsuit with the court, requesting that the social security agency of a county of the defendant immediately pay compensation for Ma's work death, and the third knitting company should bear corresponding responsibilities.

The defendant's social security agency argued that Ma had been in arrears for one year during the transfer period and should be regarded as a newly insured employee, and should not pay insurance money for his work death according to law.

The knitting company of the third party argued that Ma did not transfer to the knitting company in time after completing the social insurance payment formalities in the original unit on February 22, 20 10, and the knitting company was not responsible for the accidents that occurred when Ma handled the insurance in the knitting company.

After hearing the case, the court of first instance held that the knitting company didn't pay the industrial injury insurance premium until the time of the horse's death (20 1 1 month) to more than 6 months after the horse's death and 4 months after the work injury was confirmed, so the relatives of the deceased asked the defendant's social security agency to pay the compensation for work injury death, which was not supported. Regarding the claim of the relatives of the deceased for the knitting company to take responsibility, the court rejected the claim of the relatives of the deceased in February 20 12. The relatives of the deceased refused to accept the appeal and appealed to Dezhou Intermediate People's Court.

During the second trial, Dezhou Intermediate People's Court found that the party who had to participate in the litigation was omitted from the original judgment, that is, the superior social security agency of the defendant, and it was a common practice for local social security agencies to pay work-related injury insurance premiums irregularly. Therefore, it was considered that the refusal of social security agencies to pay insurance benefits in this case did not conform to the provisions of the Social Insurance Law and the Regulations on Work-related Injury Insurance. Finally, under the coordination of the court, the county social security office and its superior social security office agreed to pay compensation for work-related deaths and reached an agreement with the relatives of the deceased. The case ended with the relatives of the deceased applying to withdraw the lawsuit.

The judge of Dezhou Intermediate People's Court held that China's Administrative Licensing Law and the State Council's Implementation Outline for Comprehensively Promoting Administration according to Law require administrative organs to abide by the principle of "trust protection" in administrative law, that is, when the administrative counterpart has trust in a beneficial administrative act, the administrative subject shall not revoke or abolish the act at will, otherwise it must reasonably compensate the administrative counterpart for the benefits obtained by trusting the effective existence of the act. Administrative payment is a typical beneficial administrative behavior. In this case, it has long been recognized by social security agencies that local enterprises do not pay work-related injury insurance premiums in a standardized way, and it has become a practice. As the family members of the insured employees and the third party of the insured units, they have reasonable expectations for the social security institutions to pay work-related injury insurance premiums, and the social security institutions should pay insurance benefits.

(Author: Shandong Provincial People's Procuratorate and Dezhou Intermediate People's Court)

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