一、給員工買商業保險可替代工傷保險責任嗎
工傷保險是國家為(wei)了保(bao)(bao)障(zhang)職工(gong)(gong)合法(fa)權益而規(gui)定的(de)強制性保(bao)(bao)險(xian)(xian)(xian)(xian),用(yong)(yong)(yong)人單(dan)位(wei)具有(you)為(wei)其員工(gong)(gong)參(can)(can)(can)加工(gong)(gong)傷(shang)保(bao)(bao)險(xian)(xian)(xian)(xian)并繳納保(bao)(bao)險(xian)(xian)(xian)(xian)費(fei)(fei)的(de)法(fa)定義務;根據大(da)陸《工(gong)(gong)傷(shang)保(bao)(bao)險(xian)(xian)(xian)(xian)條例》相關規(gui)定,應當參(can)(can)(can)加工(gong)(gong)傷(shang)保(bao)(bao)險(xian)(xian)(xian)(xian)而未參(can)(can)(can)加工(gong)(gong)傷(shang)保(bao)(bao)險(xian)(xian)(xian)(xian)的(de)用(yong)(yong)(yong)人單(dan)位(wei)職工(gong)(gong)發生工(gong)(gong)傷(shang)的(de),由該(gai)用(yong)(yong)(yong)人單(dan)位(wei)按(an)照工(gong)(gong)傷(shang)保(bao)(bao)險(xian)(xian)(xian)(xian)條例規(gui)定的(de)工(gong)(gong)傷(shang)保(bao)(bao)險(xian)(xian)(xian)(xian)待遇專(zhuan)案和標準支付費(fei)(fei)用(yong)(yong)(yong)。
而商業保(bao)(bao)險(xian)具有自愿(yuan)性,用人(ren)(ren)單(dan)(dan)位(wei)為其員工(gong)(gong)購(gou)買(mai)商業保(bao)(bao)險(xian),一般(ban)認(ren)為屬于用人(ren)(ren)單(dan)(dan)位(wei)給予(yu)員工(gong)(gong)的(de)福利(li)待遇(yu),并不能(neng)轉(zhuan)移用人(ren)(ren)單(dan)(dan)位(wei)承擔的(de)工(gong)(gong)傷保(bao)(bao)險(xian)責(ze)(ze)任。用人(ren)(ren)單(dan)(dan)位(wei)如要(yao)想實現(xian)分(fen)散工(gong)(gong)傷風(feng)險(xian)的(de)目的(de),可在(zai)理賠(pei)(pei)(pei)時(shi)與勞動者(zhe)達成保(bao)(bao)險(xian)金權益(yi)轉(zhuan)讓協議(yi),將保(bao)(bao)險(xian)金權益(yi)轉(zhuan)讓給用人(ren)(ren)單(dan)(dan)位(wei)。或投保(bao)(bao)財產保(bao)(bao)險(xian)的(de)責(ze)(ze)任保(bao)(bao)險(xian)——雇(gu)主(zhu)(zhu)(zhu)責(ze)(ze)任險(xian)。雇(gu)主(zhu)(zhu)(zhu)責(ze)(ze)任險(xian)的(de)被保(bao)(bao)險(xian)標的(de)物為企業對雇(gu)員在(zai)雇(gu)傭期間應承擔的(de)法(fa)律賠(pei)(pei)(pei)償(chang)責(ze)(ze)任,受益(yi)人(ren)(ren)是(shi)雇(gu)主(zhu)(zhu)(zhu),所以保(bao)(bao)險(xian)金是(shi)賠(pei)(pei)(pei)償(chang)給雇(gu)主(zhu)(zhu)(zhu),而且受法(fa)律和(he)條款的(de)保(bao)(bao)護。因(yin)此轉(zhuan)移法(fa)律賠(pei)(pei)(pei)償(chang)責(ze)(ze)任應購(gou)買(mai)雇(gu)主(zhu)(zhu)(zhu)責(ze)(ze)任險(xian)。
二、工傷保險和商險能否兼得
工傷(shang)保(bao)險(xian)(xian)是社(she)會保(bao)險(xian)(xian)制(zhi)度(du)的(de)(de)重要(yao)組成部分(fen),是國家(jia)和(he)(he)社(she)會為在生(sheng)(sheng)產、工作中遭受(shou)事故傷(shang)害(hai)和(he)(he)患職(zhi)業(ye)性(xing)疾(ji)病的(de)(de)勞動者及親屬提供(gong)醫療救(jiu)治、生(sheng)(sheng)活保(bao)障、經濟(ji)補償、醫療和(he)(he)職(zhi)業(ye)康復等物質幫助的(de)(de)一種社(she)會保(bao)障制(zhi)度(du)。意外傷(shang)害(hai)險(xian)(xian)是指人的(de)(de)身體和(he)(he)生(sheng)(sheng)命受(shou)到外來和(he)(he)不(bu)(bu)可抗拒因素的(de)(de)意外傷(shang)害(hai)后,根據投保(bao)對(dui)雙方合同的(de)(de)約定和(he)(he)投保(bao)額,從保(bao)險(xian)(xian)公(gong)司獲取相應的(de)(de)賠償,二者并不(bu)(bu)相同。
首先,工(gong)傷保(bao)(bao)險(xian)(xian)是(shi)一(yi)種政府(fu)行為,而(er)人(ren)身意(yi)外傷害(hai)(hai)險(xian)(xian)是(shi)一(yi)種商(shang)業行為。工(gong)傷保(bao)(bao)險(xian)(xian)所(suo)提供的(de)(de)(de)保(bao)(bao)障水(shui)平一(yi)般僅滿(man)足(zu)于被保(bao)(bao)險(xian)(xian)人(ren)的(de)(de)(de)基(ji)本生活需(xu)要,高于社(she)會貧困線(xian),低于勞動期間的(de)(de)(de)工(gong)資標準;人(ren)身意(yi)外傷害(hai)(hai)險(xian)(xian)所(suo)提供的(de)(de)(de)保(bao)(bao)障水(shui)平的(de)(de)(de)高低完全取決保(bao)(bao)險(xian)(xian)雙(shuang)方(fang)當事人(ren)的(de)(de)(de)約定和投保(bao)(bao)人(ren)交費的(de)(de)(de)多少而(er)決定,投保(bao)(bao)人(ren)只要有繳費能力、身體健康狀況符合合同規定的(de)(de)(de)要求,投保(bao)(bao)金額不論多少都是(shi)可以的(de)(de)(de)。
其次,從性質上說,工傷保險屬于法定的社會保險,由政府的(de)勞動和社(she)會(hui)(hui)保(bao)障(zhang)部門(社(she)會(hui)(hui)保(bao)險(xian)機構)管理,具(ju)有(you)強制(zhi)性(xing),如果(guo)用人單位違反規(gui)(gui)定(ding)(ding)不(bu)為職(zhi)工(gong)購買工(gong)傷保(bao)險(xian),將承擔(dan)一定(ding)(ding)的(de)社(she)會(hui)(hui)責任。依(yi)照《工(gong)傷保(bao)險(xian)條(tiao)例》第(di)六十二條(tiao)規(gui)(gui)定(ding)(ding),工(gong)傷保(bao)險(xian)具(ju)有(you)社(she)會(hui)(hui)強制(zhi)性(xing)而意外傷害(hai)保(bao)險(xian)則屬于商業保(bao)險(xian),其規(gui)(gui)范調整屬于商法部門,不(bu)具(ju)有(you)強制(zhi)性(xing),保(bao)險(xian)的(de)賠(pei)償金額(e)可根(gen)據投保(bao)金額(e)大小而不(bu)同,體現締約自由性(xing)。
再次(ci),從繳(jiao)費(fei)標(biao)準(zhun)看,工(gong)傷保(bao)險(xian)待(dai)遇是(shi)(shi)根據社會經濟發展水(shui)平(ping)和(he)承(cheng)受(shou)能(neng)力,由(you)政府(fu)制定(ding)統一(yi)(yi)的(de)(de)繳(jiao)費(fei)標(biao)準(zhun)。在支付工(gong)傷保(bao)險(xian)待(dai)遇時,要考慮工(gong)傷職(zhi)工(gong)和(he)供(gong)養親(qin)屬(shu)的(de)(de)基本生(sheng)活需要。人(ren)(ren)身意(yi)外傷害險(xian)的(de)(de)保(bao)險(xian)金(jin)額則(ze)是(shi)(shi)保(bao)險(xian)人(ren)(ren)和(he)投(tou)保(bao)人(ren)(ren)雙方(fang)約定(ding)的(de)(de),當發生(sheng)保(bao)險(xian)事(shi)故時,保(bao)險(xian)人(ren)(ren)按合(he)同規(gui)定(ding)的(de)(de)金(jin)額一(yi)(yi)次(ci)性(xing)賠(pei)付保(bao)險(xian)金(jin),其保(bao)障水(shui)平(ping)是(shi)(shi)依據合(he)同和(he)投(tou)保(bao)人(ren)(ren)交納的(de)(de)保(bao)險(xian)費(fei)多(duo)少而定(ding)的(de)(de),多(duo)投(tou)多(duo)保(bao),少投(tou)少保(bao),不投(tou)不保(bao)。
最(zui)后,從承(cheng)擔責任的(de)主體看,建立工傷保(bao)險(xian)的(de)目的(de)是為了分散用人(ren)(ren)單(dan)(dan)位(wei)承(cheng)擔責任的(de)風(feng)險(xian),調動社會(hui)力(li)量以保(bao)證用人(ren)(ren)單(dan)(dan)位(wei)損失減(jian)少(shao),因(yin)此,用人(ren)(ren)單(dan)(dan)位(wei)在(zai)繳納一(yi)定(ding)數額保(bao)險(xian)金后,最(zui)后由國家統一(yi)管理的(de)社會(hui)基金支付(fu)賠償金。而人(ren)(ren)身意(yi)外傷害保(bao)險(xian)其賠償是由保(bao)險(xian)公(gong)司從收取的(de)保(bao)費中(zhong)支付(fu)。
根據(ju)(ju)勞(lao)動和(he)社(she)(she)會保(bao)(bao)障部(bu)辦公廳《關于參(can)加(jia)商業(ye)保(bao)(bao)險(xian)(xian)中(zhong)的(de)(de)(de)(de)(de)(de)人(ren)身(shen)意(yi)外(wai)傷(shang)(shang)害(hai)(hai)險(xian)(xian)后是(shi)(shi)否還應(ying)當(dang)參(can)加(jia)工(gong)傷(shang)(shang)保(bao)(bao)險(xian)(xian)問題的(de)(de)(de)(de)(de)(de)復函》的(de)(de)(de)(de)(de)(de)有關規(gui)定,工(gong)傷(shang)(shang)保(bao)(bao)險(xian)(xian)是(shi)(shi)社(she)(she)會保(bao)(bao)險(xian)(xian)的(de)(de)(de)(de)(de)(de)一個重要組成部(bu)分,是(shi)(shi)國(guo)家強制實施的(de)(de)(de)(de)(de)(de)一項社(she)(she)會保(bao)(bao)障制度(du)。按(an)(an)照勞(lao)動法(fa)第七十二(er)條“用人(ren)單位和(he)勞(lao)動者必(bi)須(xu)依(yi)法(fa)參(can)加(jia)社(she)(she)會保(bao)(bao)險(xian)(xian),繳納社(she)(she)會保(bao)(bao)險(xian)(xian)費”的(de)(de)(de)(de)(de)(de)規(gui)定,中(zhong)國(guo)境內的(de)(de)(de)(de)(de)(de)企業(ye)無論是(shi)(shi)否參(can)加(jia)了商業(ye)保(bao)(bao)險(xian)(xian)中(zhong)的(de)(de)(de)(de)(de)(de)人(ren)身(shen)意(yi)外(wai)傷(shang)(shang)害(hai)(hai)險(xian)(xian),都(dou)必(bi)須(xu)按(an)(an)照國(guo)家規(gui)定參(can)加(jia)工(gong)傷(shang)(shang)保(bao)(bao)險(xian)(xian)。人(ren)身(shen)意(yi)外(wai)傷(shang)(shang)害(hai)(hai)險(xian)(xian)不(bu)能代替工(gong)傷(shang)(shang)保(bao)(bao)險(xian)(xian)。企業(ye)在參(can)加(jia)工(gong)傷(shang)(shang)保(bao)(bao)險(xian)(xian)的(de)(de)(de)(de)(de)(de)同時,可以根據(ju)(ju)本單位的(de)(de)(de)(de)(de)(de)實際(ji)情(qing)況(kuang),為職工(gong)辦理人(ren)身(shen)意(yi)外(wai)傷(shang)(shang)害(hai)(hai)險(xian)(xian)。用人(ren)單位的(de)(de)(de)(de)(de)(de)投保(bao)(bao)行為純(chun)粹屬于給員工(gong)的(de)(de)(de)(de)(de)(de)額外(wai)福利,無法(fa)起到替代工(gong)傷(shang)(shang)保(bao)(bao)險(xian)(xian)的(de)(de)(de)(de)(de)(de)功能。
綜(zong)上,職工(gong)(gong)(gong)在(zai)獲(huo)得人(ren)身意外(wai)傷(shang)害險賠(pei)(pei)償(chang)后,仍可以(yi)主(zhu)張(zhang)工(gong)(gong)(gong)傷(shang)保(bao)險賠(pei)(pei)償(chang)。用人(ren)單(dan)位(wei)不(bu)能以(yi)職工(gong)(gong)(gong)已(yi)獲(huo)得人(ren)身意外(wai)傷(shang)害賠(pei)(pei)償(chang)為由進行抗辯,職工(gong)(gong)(gong)可以(yi)同時得到該兩種賠(pei)(pei)償(chang)。