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(jia)為(wei)了保(bao)(bao)障職工(gong)合法權益而規(gui)定(ding)(ding)(ding)的(de)(de)強制性保(bao)(bao)險,用(yong)(yong)人單(dan)位(wei)具有為(wei)其員工(gong)參加工(gong)傷(shang)(shang)(shang)保(bao)(bao)險并繳納保(bao)(bao)險費的(de)(de)法定(ding)(ding)(ding)義務;根(gen)據大(da)陸《工(gong)傷(shang)(shang)(shang)保(bao)(bao)險條例》相(xiang)關規(gui)定(ding)(ding)(ding),應當參加工(gong)傷(shang)(shang)(shang)保(bao)(bao)險而未參加工(gong)傷(shang)(shang)(shang)保(bao)(bao)險的(de)(de)用(yong)(yong)人單(dan)位(wei)職工(gong)發生工(gong)傷(shang)(shang)(shang)的(de)(de),由(you)該用(yong)(yong)人單(dan)位(wei)按照工(gong)傷(shang)(shang)(shang)保(bao)(bao)險條例規(gui)定(ding)(ding)(ding)的(de)(de)工(gong)傷(shang)(shang)(shang)保(bao)(bao)險待遇專(zhuan)案和(he)標準支付費用(yong)(yong)。
而(er)商業(ye)(ye)保(bao)險(xian)(xian)具有自愿(yuan)性,用人(ren)單位為(wei)其員工(gong)購(gou)買商業(ye)(ye)保(bao)險(xian)(xian),一般認為(wei)屬(shu)于用人(ren)單位給予員工(gong)的(de)(de)(de)(de)福利待遇,并不能轉移用人(ren)單位承(cheng)擔的(de)(de)(de)(de)工(gong)傷保(bao)險(xian)(xian)責(ze)任(ren)。用人(ren)單位如(ru)要(yao)想實現分散(san)工(gong)傷風(feng)險(xian)(xian)的(de)(de)(de)(de)目的(de)(de)(de)(de),可(ke)在理賠時(shi)與勞動者達成保(bao)險(xian)(xian)金(jin)權(quan)益(yi)轉讓協議,將(jiang)保(bao)險(xian)(xian)金(jin)權(quan)益(yi)轉讓給用人(ren)單位。或投保(bao)財產保(bao)險(xian)(xian)的(de)(de)(de)(de)責(ze)任(ren)保(bao)險(xian)(xian)——雇(gu)(gu)(gu)主(zhu)責(ze)任(ren)險(xian)(xian)。雇(gu)(gu)(gu)主(zhu)責(ze)任(ren)險(xian)(xian)的(de)(de)(de)(de)被(bei)保(bao)險(xian)(xian)標的(de)(de)(de)(de)物為(wei)企(qi)業(ye)(ye)對雇(gu)(gu)(gu)員在雇(gu)(gu)(gu)傭(yong)期間應(ying)承(cheng)擔的(de)(de)(de)(de)法(fa)律(lv)賠償(chang)責(ze)任(ren),受益(yi)人(ren)是雇(gu)(gu)(gu)主(zhu),所以保(bao)險(xian)(xian)金(jin)是賠償(chang)給雇(gu)(gu)(gu)主(zhu),而(er)且(qie)受法(fa)律(lv)和條款的(de)(de)(de)(de)保(bao)護。因此轉移法(fa)律(lv)賠償(chang)責(ze)任(ren)應(ying)購(gou)買雇(gu)(gu)(gu)主(zhu)責(ze)任(ren)險(xian)(xian)。
二、工傷保險和商險能否兼得
工傷保(bao)險(xian)是社(she)會(hui)保(bao)險(xian)制(zhi)度的(de)(de)重要組成部(bu)分(fen),是國(guo)家和社(she)會(hui)為在生產(chan)、工作(zuo)中(zhong)遭受事故傷害和患職業性疾病的(de)(de)勞動者及親屬提供醫(yi)療(liao)救(jiu)治、生活保(bao)障、經濟補償、醫(yi)療(liao)和職業康(kang)復等(deng)物質幫(bang)助的(de)(de)一種社(she)會(hui)保(bao)障制(zhi)度。意外(wai)(wai)傷害險(xian)是指人的(de)(de)身體和生命受到外(wai)(wai)來(lai)和不可(ke)抗拒因(yin)素(su)的(de)(de)意外(wai)(wai)傷害后,根據投(tou)保(bao)對雙方合同(tong)的(de)(de)約定和投(tou)保(bao)額,從保(bao)險(xian)公司獲取相(xiang)應的(de)(de)賠償,二者并不相(xiang)同(tong)。
首先(xian),工(gong)傷保(bao)險(xian)(xian)是(shi)一種政(zheng)府行為(wei),而人身意外傷害(hai)險(xian)(xian)是(shi)一種商業行為(wei)。工(gong)傷保(bao)險(xian)(xian)所提供的(de)(de)保(bao)障水(shui)平(ping)一般僅滿足于(yu)被保(bao)險(xian)(xian)人的(de)(de)基本(ben)生活需要,高于(yu)社會貧困(kun)線,低于(yu)勞動期間的(de)(de)工(gong)資標準;人身意外傷害(hai)險(xian)(xian)所提供的(de)(de)保(bao)障水(shui)平(ping)的(de)(de)高低完全取決保(bao)險(xian)(xian)雙方當(dang)事人的(de)(de)約定和投保(bao)人交費(fei)的(de)(de)多少而決定,投保(bao)人只要有繳費(fei)能(neng)力、身體健康(kang)狀況符合合同(tong)規定的(de)(de)要求,投保(bao)金額不論多少都是(shi)可以的(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(fu)的(de)(de)勞動和社(she)(she)(she)會(hui)(hui)保(bao)(bao)(bao)(bao)障部門(社(she)(she)(she)會(hui)(hui)保(bao)(bao)(bao)(bao)險(xian)(xian)機(ji)構)管(guan)理,具有(you)(you)強(qiang)制性(xing),如果用人(ren)單位違反規(gui)定(ding)不(bu)為職工(gong)購買工(gong)傷保(bao)(bao)(bao)(bao)險(xian)(xian),將承擔一定(ding)的(de)(de)社(she)(she)(she)會(hui)(hui)責任(ren)。依照(zhao)《工(gong)傷保(bao)(bao)(bao)(bao)險(xian)(xian)條(tiao)例(li)》第(di)六十(shi)二(er)條(tiao)規(gui)定(ding),工(gong)傷保(bao)(bao)(bao)(bao)險(xian)(xian)具有(you)(you)社(she)(she)(she)會(hui)(hui)強(qiang)制性(xing)而意(yi)外(wai)傷害保(bao)(bao)(bao)(bao)險(xian)(xian)則屬于(yu)(yu)商(shang)業保(bao)(bao)(bao)(bao)險(xian)(xian),其(qi)規(gui)范調整屬于(yu)(yu)商(shang)法部門,不(bu)具有(you)(you)強(qiang)制性(xing),保(bao)(bao)(bao)(bao)險(xian)(xian)的(de)(de)賠償(chang)金額(e)可(ke)根(gen)據投保(bao)(bao)(bao)(bao)金額(e)大(da)小(xiao)而不(bu)同,體現締約自由性(xing)。
再次,從(cong)繳(jiao)費(fei)(fei)標準(zhun)看(kan),工(gong)(gong)傷保(bao)險(xian)(xian)待(dai)遇是(shi)(shi)根據社會經濟發展水平(ping)(ping)和(he)承(cheng)受能力,由政(zheng)府制定(ding)(ding)統一(yi)的(de)(de)(de)繳(jiao)費(fei)(fei)標準(zhun)。在支(zhi)付工(gong)(gong)傷保(bao)險(xian)(xian)待(dai)遇時(shi),要考慮工(gong)(gong)傷職工(gong)(gong)和(he)供養親屬的(de)(de)(de)基本生活需要。人身意外傷害險(xian)(xian)的(de)(de)(de)保(bao)險(xian)(xian)金額(e)則是(shi)(shi)保(bao)險(xian)(xian)人和(he)投(tou)(tou)保(bao)人雙(shuang)方約定(ding)(ding)的(de)(de)(de),當發生保(bao)險(xian)(xian)事故時(shi),保(bao)險(xian)(xian)人按合同規(gui)定(ding)(ding)的(de)(de)(de)金額(e)一(yi)次性賠(pei)付保(bao)險(xian)(xian)金,其保(bao)障水平(ping)(ping)是(shi)(shi)依據合同和(he)投(tou)(tou)保(bao)人交納(na)的(de)(de)(de)保(bao)險(xian)(xian)費(fei)(fei)多(duo)少(shao)而定(ding)(ding)的(de)(de)(de),多(duo)投(tou)(tou)多(duo)保(bao),少(shao)投(tou)(tou)少(shao)保(bao),不(bu)投(tou)(tou)不(bu)保(bao)。
最后(hou),從(cong)承(cheng)擔責任的(de)(de)(de)(de)主體看,建立工傷保(bao)險的(de)(de)(de)(de)目(mu)的(de)(de)(de)(de)是為了分散用人單位承(cheng)擔責任的(de)(de)(de)(de)風險,調動(dong)社(she)(she)會力量(liang)以保(bao)證用人單位損(sun)失減(jian)少,因此,用人單位在繳納一(yi)定(ding)數額保(bao)險金后(hou),最后(hou)由(you)(you)國家統一(yi)管理的(de)(de)(de)(de)社(she)(she)會基金支付賠償(chang)金。而人身意外(wai)傷害保(bao)險其(qi)賠償(chang)是由(you)(you)保(bao)險公司(si)從(cong)收取的(de)(de)(de)(de)保(bao)費(fei)中支付。
根據(ju)勞動(dong)和社(she)(she)(she)會保(bao)(bao)(bao)障(zhang)部辦公廳《關于(yu)參(can)加(jia)商(shang)業保(bao)(bao)(bao)險(xian)(xian)(xian)(xian)中的(de)(de)人身意外(wai)(wai)傷害險(xian)(xian)(xian)(xian)后是否還應當參(can)加(jia)工(gong)(gong)(gong)傷保(bao)(bao)(bao)險(xian)(xian)(xian)(xian)問(wen)題的(de)(de)復(fu)函》的(de)(de)有關規定,工(gong)(gong)(gong)傷保(bao)(bao)(bao)險(xian)(xian)(xian)(xian)是社(she)(she)(she)會保(bao)(bao)(bao)險(xian)(xian)(xian)(xian)的(de)(de)一(yi)個(ge)重要(yao)組成(cheng)部分,是國(guo)家強(qiang)制實施的(de)(de)一(yi)項社(she)(she)(she)會保(bao)(bao)(bao)障(zhang)制度(du)。按(an)照勞動(dong)法(fa)第七十(shi)二條“用(yong)人單(dan)位和勞動(dong)者必須(xu)依法(fa)參(can)加(jia)社(she)(she)(she)會保(bao)(bao)(bao)險(xian)(xian)(xian)(xian),繳納社(she)(she)(she)會保(bao)(bao)(bao)險(xian)(xian)(xian)(xian)費”的(de)(de)規定,中國(guo)境內的(de)(de)企業無論(lun)是否參(can)加(jia)了(le)商(shang)業保(bao)(bao)(bao)險(xian)(xian)(xian)(xian)中的(de)(de)人身意外(wai)(wai)傷害險(xian)(xian)(xian)(xian),都(dou)必須(xu)按(an)照國(guo)家規定參(can)加(jia)工(gong)(gong)(gong)傷保(bao)(bao)(bao)險(xian)(xian)(xian)(xian)。人身意外(wai)(wai)傷害險(xian)(xian)(xian)(xian)不能(neng)代(dai)替(ti)工(gong)(gong)(gong)傷保(bao)(bao)(bao)險(xian)(xian)(xian)(xian)。企業在參(can)加(jia)工(gong)(gong)(gong)傷保(bao)(bao)(bao)險(xian)(xian)(xian)(xian)的(de)(de)同時,可以根據(ju)本(ben)單(dan)位的(de)(de)實際情況,為職工(gong)(gong)(gong)辦理(li)人身意外(wai)(wai)傷害險(xian)(xian)(xian)(xian)。用(yong)人單(dan)位的(de)(de)投保(bao)(bao)(bao)行(xing)為純粹屬于(yu)給員(yuan)工(gong)(gong)(gong)的(de)(de)額外(wai)(wai)福利,無法(fa)起到(dao)替(ti)代(dai)工(gong)(gong)(gong)傷保(bao)(bao)(bao)險(xian)(xian)(xian)(xian)的(de)(de)功(gong)能(neng)。
綜上,職工(gong)在獲得人(ren)(ren)身意(yi)外傷害險賠(pei)償(chang)后,仍可以主張工(gong)傷保險賠(pei)償(chang)。用人(ren)(ren)單位不能以職工(gong)已獲得人(ren)(ren)身意(yi)外傷害賠(pei)償(chang)為由(you)進(jin)行(xing)抗辯,職工(gong)可以同時得到該兩種賠(pei)償(chang)。