Can you get workers compensation after a car accident at work after the perpetrator pays compensati

Huang Songyou, Vice President of the Supreme People's Court, answered reporters' questions on the "Interpretation of the Supreme People's Court on Several Issues Concerning the Application of Law in the Trial of Personal Injury Compensation Cases".

A: The relationship between work-related injury insurance and civil compensation for damages has been debated for a long time in trial practice. In terms of nature, work-related injury insurance belongs to the category of social insurance, which is fundamentally different from the nature of civil damages.

However, since the work-related injury insurance compensation is based on the occurrence of work-related accidents, which are related to labor safety accidents or labor protection defects, work-related accidents are evaluated as civil torts in civil law. This raises the question of the relationship between work-related injury insurance compensation and civil damages. Countries around the world have four ways to deal with this problem:

First, work-related injury insurance replaces civil damages; Second, the victim can receive both work-related injury insurance benefits and civil damages, but the individual worker needs to pay a high insurance premium; Third, the victim can choose to receive work-related injury insurance benefits or civil damages; Fourth, the difference between civil damages and insurance benefits should be complementary. The Regulations on Work-related Injury Insurance, promulgated this year, will come into force on 1 January 2004. According to the regulations of the relevant departments, enterprises, institutions and individual industrial and commercial households in China must participate in the overall planning of work-related injury insurance and pay work-related injury insurance premiums for workers.

If an enterprise that should participate in the insurance fails to pay insurance premiums in violation of the law, and a work-related accident occurs, it shall also bear the responsibility of paying the corresponding insurance benefits to the injured employees in accordance with the provisions of the work-related injury insurance regulations. Compared with civil damages, work-related injury insurance has special advantages: work-related injury insurance implements the employer's no-fault liability, and does not consider whether the employee is at fault, as long as the work-related injury occurs, the work-related injury insurance agency shall give full compensation.

The civil tort considers whether the victim is negligent or not, and implements negligence offset, that is, the amount of compensation is reduced accordingly according to the degree of negligence of the victim. In addition, work-related injury insurance implements social pooling, which is conducive to the timely and adequate relief of victims; The participation of enterprises in work-related injury insurance disperses the liability for compensation, which is conducive to getting rid of the predicament caused by high compensation and avoiding unfavorable competition due to excessive industry risks; Work-related injury insurance is also conducive to harmonious labor-management relations and avoids labor-management conflicts and disputes. In view of the above reasons, we believe that it is beneficial for both the employer and the employee to assume responsibility by paying insurance premiums.

Therefore, if a work-related accident occurs and it is the responsibility of the employer, the injured employee shall enjoy work-related injury insurance benefits in accordance with the provisions of the Regulations on Work-related Injury Insurance, and can no longer obtain double compensation through civil litigation. However, if the work-related injury suffered by the worker is caused by the tortious act of a third party, the third party cannot be exempted from civil liability for compensation. For example, if an employee encounters a traffic accident due to a business trip, although the injured employee is entitled to work-related injury insurance benefits in accordance with the law, the third party responsible for the traffic accident shall still bear civil liability for compensation.

Theoretically, it is possible to obtain the benefits of work-related injury insurance. Medical expenses should not be reimbursed repeatedly. For the legal basis that traffic accident compensation and work-related injury insurance benefits can be combined, please refer to the Interpretation of the Supreme People's Court on Several Issues Concerning the Application of Law in the Trial of Personal Injury Compensation Cases.

It should be the shortfall after the car accident compensation is compensated by the workers' compensation insurance. Medical expenses must have been paid for in a car accident

Legal analysis: If the employee suffers a work-related injury, the employer needs to compensate, and if there is work-related injury insurance, it can apply for insurance claims. Generally speaking, injuries caused at work are only considered work-related injuries, and car accidents on the way to work are considered work-related injuries.

The following four necessary elements should be considered when determining whether an employee's road traffic accident is a work-related injury: (1) the prescribed time for commuting to and from work; (2) Necessary routes for commuting to and from work; (3) There is no personal responsibility or non-personal responsibility; (4) Motor vehicle accidents.

Legal basis: Social Insurance Law of the People's Republic of China

Article 38 The following expenses incurred due to work-related injuries shall be paid from work-related injury insurance** in accordance with the provisions of the State:

1) Medical expenses and expenses for work-related injuries;

2) Hospitalization meal subsidy;

3) Transportation and accommodation expenses for medical treatment outside the overall planning area;

4) The cost of installing and configuring assistive devices for the disabled;

5) For those who are unable to take care of themselves, the living care expenses confirmed by the Labor Ability Appraisal Committee;

6) A one-time disability allowance and a monthly disability allowance for employees with disabilities of grades 1 to 4;

7) A one-time medical subsidy to be enjoyed when the labor contract is terminated or dissolved;

8) In the event of a work-related death, the funeral allowance, the pension for dependent relatives and the work-related death allowance received by the surviving family members;

9) Labor ability appraisal fee.

Article 39 The following expenses incurred as a result of work-related injuries shall be paid by the employer in accordance with the provisions of the State:

1) Wages and benefits during the work-related injury;

2) The monthly disability allowance received by the disabled employees of the fifth and sixth grades;

3) A one-time disability employment subsidy that shall be enjoyed when the labor contract is terminated or dissolved.

Article 41 Where an employee's employer fails to pay work-related injury insurance premiums in accordance with law, and a work-related injury accident occurs, the employer shall pay work-related injury insurance benefits. If the employer does not pay, it shall be paid in advance from the work-related injury insurance**. The work-related injury insurance benefits paid in advance from the work-related injury insurance** shall be reimbursed by the employer.

If the employer fails to repay, the social insurance agency may recover compensation in accordance with the provisions of Article 63 of this Law.

Legal analysis: According to the provisions of the regulations on work-related injury insurance, on the way to and from work, the injury caused by a motor vehicle accident should be recognized as a work-related injury, so it depends on whether the traffic accident is caused by a motor vehicle, if not, it cannot be regarded as a work-related injury, if it is a work-related injury, then in addition to the compensation of the perpetrator, the unit or individual can apply to the local labor administrative department for work-related injury identification, and after the work-related injury is identified, go to the local labor ability appraisal committee to identify the labor ability disability level. If the unit pays the work-related injury insurance and dust insurance, it can enjoy the work-related injury insurance benefits, and if the unit does not pay the work-related injury insurance, the relevant expenses incurred must be paid by the unit. Therefore, it is recommended to retain relevant evidence and actively ask the unit to apply for work-related injury determination.

Article 14 of the Regulations on Work-related Injury Insurance shall be deemed to be a work-related injury if an employee has any of the following circumstances: (1) he or she is injured in an accident during working hours and in the workplace due to work-related reasons; (2) Being injured in an accident while engaging in work-related preparatory or finishing work in the workplace before or after working hours; (3) Suffering violence or other accidental injuries during working hours and in the workplace as a result of performing work duties; (4) Suffering from an occupational disease; (5) During the period when they are away for work, they are injured due to work reasons or their whereabouts are unknown in an accident; (6) Being injured in a traffic accident or an urban rail transit, passenger ferry, or train accident for which they are not primarily responsible while commuting to or from work; (7) Other circumstances that laws and administrative regulations provide shall be recognized as work-related injuries.

1. The injured person can apply for work-related injury recognition.

If an employee is injured in an accident or is diagnosed or appraised as an occupational disease in accordance with the provisions of the Law on the Prevention and Control of Occupational Diseases, the unit to which he or she belongs shall, within 30 days from the date of occurrence of the accident injury or the date of diagnosis or appraisal of an occupational disease, submit an application for recognition of work-related injury to the social insurance administrative department of the coordinating area. In case of special circumstances, the time limit for application may be appropriately extended with the consent of the social insurance administrative department. If the employer fails to submit an application for work-related injury recognition in accordance with the provisions of the preceding paragraph, the injured employee or his close relatives or trade union organization may directly submit an application for work-related injury determination to the social insurance administrative department of the co-ordinating area where the employer is located within one year from the date of occurrence of the injury in the Jianxiang accident or the date of diagnosis or appraisal of the occupational disease.

Matters that shall be determined by the provincial-level social insurance administrative department in accordance with the provisions of the first paragraph of this Article shall be handled by the social insurance administrative department at the districted-city level where the employer is located in accordance with the principle of territoriality. If an employer fails to submit an application for determination of work-related injury within the time limit specified in the first paragraph of this Article, the employer shall bear the relevant expenses such as work-related injury benefits incurred during this period that comply with the provisions of these Regulations.

2. In addition, according to the sixth paragraph of Article 14 of the Regulations on Work-related Injury Insurance: on the way to and from work, the person is injured by a traffic accident for which he is not primarily responsible, or an accident involving urban rail transit, passenger ferry, or train; It should be recognized as a work-related injury.

3. With regard to the payment of work-related injury benefits, if an employee is injured due to a third party, and the social insurance administrative department makes a decision not to accept the application for recognition of work-related injury or not to recognize the work-related injury on the grounds that the employee or his close relatives have already filed a civil lawsuit against the third party or obtained civil compensation, the people's court shall not support it. Where an employee is injured due to a third party, and the social insurance administrative department has already made a determination of work-related injury, and the employee or his close relatives have not filed a civil lawsuit against the third party or have not yet received civil compensation, and the lawsuit is filed to demand that the social insurance agency pay work-related injury insurance benefits, the people's court shall support it. Where an employee suffers a work-related injury due to a third party, and the social insurance agency refuses to pay work-related injury insurance benefits on the grounds that the employee or his close relatives have already filed a civil lawsuit against the third party, the people's court will not support it, except for the medical expenses already paid by the third party.

If the work-related injury caused by a car accident on the way to work has been recognized as a work-related injury, the compensation items that can be obtained according to the regulations are as follows: Article 38 of the Social Insurance Law The following expenses incurred due to work-related injuries shall be paid from the work-related injury insurance** in accordance with national regulations: (1) Medical expenses and expenses for work-related injuries; 2) Hospitalization meal subsidy; 3) Transportation and accommodation expenses for medical treatment outside the co-ordination area; (4) The cost of installing and configuring the disability auxiliary segment laughing equipment; 5) For those who are unable to take care of themselves, the living care expenses confirmed by the Labor Ability Appraisal Committee; 6) A one-time disability allowance and a monthly disability allowance for employees with disabilities of grades 1 to 4; 7) A one-time medical subsidy to be enjoyed when the labor contract is terminated or dissolved; 8) In the event of a work-related death, the funeral allowance, the pension for dependent relatives and the work-related death allowance received by the surviving family members; 9) Labor ability appraisal fee.

Article 39 The following expenses incurred as a result of work-related injuries shall be paid by the employer in accordance with the provisions of the state: (1) Wages and benefits during the work-related injury; (2) The disability allowance received by the disabled employees of the fifth and sixth grades on a monthly basis; 3) A one-time disability employment subsidy that shall be enjoyed when the labor contract is terminated or dissolved.

If a car accident on the way to work is considered a work-related injury, the specific compensation needs to be based on the actual cost of hail and the results of the appraisal of labor ability, and the compensation is generally based on the actual cost, and if the perpetrator has already paid, the employer will not compensate.

[Legal basis].

Article 30 of the Regulations on Work-related Injury Insurance.

Employees who are injured in accidents or suffer from occupational diseases due to work are entitled to medical treatment for work-related injuries.

Employees who are injured at work shall seek medical treatment in a medical institution that has signed a service agreement, and in case of emergency, they can first go to the nearest medical institution for first aid.

**If the expenses required for work-related injuries meet the requirements of work-related injury insurance diagnosis and treatment items, work-related injury insurance drug lists, and work-related injury insurance hospitalization service standards, they shall be paid from work-related injury insurance**. The catalogue of work-related injury insurance diagnosis and treatment items, the catalogue of work-related injury insurance drugs, and the hospitalization service standards of work-related injury insurance shall be prescribed by the social insurance administrative department in conjunction with the health administrative department, the food and drug supervision and administration department and other departments.

The food subsidy for the hospitalization of the employee and the work-related injury, as well as the transportation and accommodation expenses required for the work-related injury employee to seek medical treatment outside the co-ordination area shall be paid by the work-related injury insurance department after the certificate issued by the medical institution and approved by the handling agency, and the specific standard of payment shall be stipulated by the people of the co-ordination area.