Number of people
Under 20 people
20-50 people
50-70 people
70-200 people
200-500 people
More than 500 people
Rates
(Gross)
No insurance
30 yuan/ person and a minimum premium of $1,000
$26
$19
$17
$15
Under what circumstances can an insured person be eligible for Supplemental Workers' Compensation Insurance?
l 1. Accidental injury caused by work during working hours and in the workplace;
l 2. Accidental injury caused by work-related preparatory or finishing work in the workplace before or after working hours;
l 3. Accidental injury caused by violence or other accidental injuries due to the fulfillment of work duties during working hours and in the workplace;
l 4, suffering from occupational disease;
l 5, during the period of going out for work, being injured due to work reasons, or the whereabouts of the accident is unknown;
l 6, being injured in a motor vehicle accident on the way to and from work;
l 7, other cases which should be recognized as work-related injuries as stipulated by the laws and administrative regulations.
How to enjoy the supplementary work injury insurance treatment?
l If an employee of an enterprise who chooses to participate in the supplemental work injury insurance becomes disabled on duty and is appraised to be 5-10 grade of disability, the insured person can be paid a one-time work injury benefit by the Company according to the grade of disability: after the medical treatment of the insured person's work injury is completed and the insured person is appraised to be 5-10 grade of disability,
l The Company will pay a one-time work injury benefit to the insured person according to the product of the insured person's own wage and the multiplier of the payment.
l If your salary is higher than 300% of the average monthly salary of employees in the same area in the previous year, it will be calculated according to 300% of the average monthly salary of employees in the same area in the previous year:
l If your salary is lower than 60% of the average monthly salary of employees in the same area in the previous year, it will be calculated according to 60% of the average monthly salary of employees in the same area in the previous year.
l Specific calculation methods: 60 months for level 5, 48 months for level 6, 31 months for level 7, 19 months for level 8, 10 months for level 9, and 5 months for level 10.
l The determination of one's own salary is based on the contribution salary for participating in social insurance coordination.
l After the medical treatment of work-related accidents is completed, the unit will go to the supplementary work-related injury processing center to claim compensation with the relevant documents (the appraisal conclusion of the disability grade and the decision on the treatment of work-related accidents in social insurance), and the Company will pay the lump-sum work-related injury benefit after the verification of the correctness of the claim.
Supplementary Work Injury Claim Documents
l Original Supplementary Work Injury Treatment Decision of China Pacific Property and Casualty Insurance Company Limited, Shenzhen Branch (one or two copies);
l Copy of Work Injury Accident Report;
l Original Approval of Work Injury Treatment;
l Original Certificate of Appraisal of Labor Ability;
l Copy of Certificate of Recognition of Work Injury;
l Copy of Work Injury Certificate;
l Copy of Work Injury Benefits A copy of the certificate of recognition of work injury;
l A copy of ID card;
l A copy of passbook (bank card) (for benefit payment);
l A copy of the insurance policy;
l A copy of the roster of the supplemental work-related injury insurance;
l The original of the statement.
Case introduction (a)
l 1, Longgang District *** Accessories Factory in July 1, 2007, all 200 people to participate in our company's supplemental work-related injury insurance, each person contributes ￥ 19 yuan / month, a year **** contribution of ￥ 45,600 yuan. Employee Liu Mou on July 11, 2005 in the cutting of oxygen-free water empty barrels, due to residual oxygen-free water caused by the fire, resulting in fifth-degree disability. My average monthly salary of ￥ 700, not exceeding the co-ordinated area of the previous year, sixty percent of the average monthly salary of employees that ￥ 1,756 yuan, the Company to ￥ 1,756 yuan as the basis for the 60-month one-time injury benefit * * * * ￥ 105,360 yuan.
l If the company did not purchase supplemental workers' compensation insurance, the company will be in accordance with the provisions of the regulations to bear the ￥ 105,360 one-time injury benefit.
Downtown **** Furniture Factory in July 3, 2007, all 150 people to participate in our company's supplemental workers' compensation insurance, each person contributing ￥ 19 yuan / month, the monthly fee of 2,850 yuan. July 5, its production supervisor accidentally injured at work resulting in a disability of 7. The company's own company for 2,000 yuan / month, the monthly fee of ￥ 1,000 yuan. The company's own company for 2,000 yuan / month, higher than the local average standard in Shenzhen 1756 yuan / month, the company according to ￥ 2,000 as the basis for a one-time injury benefit for 31 months * * * * ￥ 62,000 yuan.
Frequently Asked Questions (I)
? What should I do if my business has changed its name?
! Subject to the information from the Social Security Administration. Just provide the supporting information of the name change from the Business Bureau when you make a claim.
? Can Supplemental Work Injury be covered outside of Shenzhen?
! The basis of our Supplementary Occupational Injury Clause is the Guangdong Provincial Occupational Injury Insurance Regulations, which is applicable to Guangdong Province, so we are able to carry out supplementary occupational injury business in Guangdong Province. However, due to the different wage levels in different places, the base amount of the compensated wage is also different, and the corresponding premium level is also different. The main consideration is the local wage level.
Can a one-year policy be issued at one time?
! In order to facilitate timely rate adjustments, in principle, the policy is taken out on a monthly basis. For companies with ideal rate levels and low risk, the maximum period is six months.
? How does the changeover work?
! Currently the system cannot issue a batch list. The customer provides a list of replacements and our company confirms it with an underwriting stamp.
Group Supplementary Worker's Compensation Insurance Terms
Article I: Composition of the Insurance Contract
The Group Supplementary Worker's Compensation Insurance Contract (hereinafter referred to as the Contract) of China Pacific Property Insurance Company Limited consists of the Insurance Policy and the accompanying clauses, declarations, endorsements, and approvals, as well as the related application form and other written agreements***similar to the Insurance Policy.
Article II Scope of Insurance
I. Employees who are between the ages of eighteen (18) and sixty (60) years old, in good health, able to work normally and who have participated in the local work-related injury insurance may be the insured under this Contract.
2. The unit of the insured may take out this insurance with China Pacific Property Insurance Company Limited (hereinafter referred to as the insurer) as the policyholder. The number of insured persons shall account for more than 75% and not less than 8 of the number of employees of the insured organization at the time of application.
Article 3 Insurance Liability
During the validity of this contract, the insurer shall be liable for the following insurance liabilities:
I. If the insured person is disabled as a result of work-related injuries and the degree of disability is determined to be from grade 5 to grade 10 according to the national "Determination of Disability Degree of Workers' Work-related Injuries and Occupational Diseases" (GB/Tl6180-1996) by the labor capacity appraisal institution recognized by the insurer, the insurer shall pay the monthly premium for the insured person's own monthly salary, and the insurer shall pay the premium for the insured person's own monthly salary. The insurer shall pay the lump-sum injury benefit according to the product of the insured person's monthly salary and the multiplier of the benefit, and the insurance liability of this contract for the insured person shall be terminated. If the insured person's salary is higher than 300% of the average monthly salary of the employees in the previous year in the co-ordination area, it will be calculated according to 300% of the average monthly salary of the employees in the previous year in the co-ordination area; if the insured person's salary is lower than 60% of the average monthly salary of the employees in the previous year in the co-ordination area, it will be calculated according to 60% of the average monthly salary of the employees in the co-ordination area in the previous year in the co-ordination area;
The multiplier of lump-sum injury benefit will be calculated by The insurer shall determine the multiplier of the lump-sum injury benefit in accordance with the relevant provisions of the national industrial injury insurance policy and set it out in the insurance policy.
Article IV Exemption of Liability
The insurer shall not be liable to pay the insurance benefit if the insured person is disabled due to one of the following circumstances or reasons:
I. Intentional killing or injury of the insured person by the policyholder;
II. Intentional crime or violation of public security regulations by the insured person;
III. Battery, intoxication, suicide, intentional self-injury or consumption of drugs, alcohol, drugs and other substances by the insured person, Suicide, intentional self-inflicted injury or taking, smoking, injecting drugs;
4. Accidents caused by the insured person under the influence of alcohol, drugs, controlled substances;
5. Driving under the influence of alcohol, driving without a valid driver's license, or driving a motor vehicle without a valid driver's license;
6. The insured person does not comply with the doctor's advice, and privately takes, applies, or injects drugs;
7.
VII. Any occupational disease caused by exposure to or use of asbestos, asbestos products or substances containing asbestos;
VIII. Any period during which the Insured Person is suffering from AIDS or HIV (HIV positive);
IX. Nuclear explosion, nuclear radiation or nuclear contamination;
X. Pre-existing medical condition(s) that the Insured Person has suffered from prior to the date of application;
xi.
Xi. The circumstances listed in Article 15 of the Regulations on Work Injury Insurance (adopted on April 16, 2003) under the Decree of the State Council No. 375, which are regarded as work-related injuries.
Article 5 Insurance Period
The insurance period of this contract shall be as agreed by both parties, but shall not exceed one year, starting from the zero hour of the day following the day when the insurer agrees to underwrite, collects the premiums and issues the insurance policy, and ending at the twenty-fourth hour of the day when the insurance period expires.
Article 6 Delivery of Premiums and Suspension of Contract Effect
The premiums shall be paid in four ways, namely, wholesale, semi-annual, quarterly and monthly, which shall be chosen by the policyholder at the time of application. The date of delivery of the single premium shall be the effective date of this contract; the date of delivery of the semi-annual premium shall be the effective date of this contract; the date of delivery of the quarterly premium shall be the effective date of this contract; the date of delivery of the monthly premium shall be the effective date of this contract; the validity of the contract shall be terminated if the policyholder fails to deliver the premium in accordance with the above mentioned dates.
Article 7: Truthful Information
When concluding this contract, the insurer shall explain to the policyholder the contents of the insurance terms and conditions, clearly state the exemption of liability clauses, and have the right to make inquiries about the relevant circumstances of the policyholder and the insured, and the policyholder and the insured shall truthfully inform the policyholder and the insured of the contents of the insurance terms and conditions.
If the policyholder intentionally conceals the facts and fails to fulfill the obligation of truthful notification, or fails to fulfill the obligation of truthful notification due to negligence, which is sufficient to affect the insurer's decision on whether to agree to underwrite the insurance or to increase the premium rate, the insurer has the right to terminate the insurance contract.?
If the policyholder intentionally fails to fulfill the obligation of truthful notification, the insurer shall not be liable to pay the insurance premiums and shall not refund the insurance premiums in respect of the insurance accidents that occurred before the termination of the insurance contract.
If the policyholder fails to fulfill the obligation of truthful disclosure due to negligence, which has a serious impact on the occurrence of the insurance accident, the insurer shall not be liable to pay the insurance premiums for the insurance accident which occurred before the termination of the insurance contract.
Article 8 Designation and Change of Beneficiary
The beneficiary of the lump-sum injury benefit under this contract shall be the insured person himself, and the insurer shall not accept any other designation or change.
Article 9 Notification of Insurance Accident
The policyholder, the insured or the beneficiary shall notify the insurer in writing within ten days from the date when the policyholder, the insured or the beneficiary knew or should have known of the occurrence of the insurance accident, or the policyholder, the insured or the beneficiary shall be responsible for the increase of the cost of investigation and inspection caused by the insurer due to the delay in notification, except for the delay caused by force majeure.
Article 10: Application for Insurance Benefits
If the insured person is disabled due to work injury, the insured person, as the applicant, shall fill in the application form for insurance benefits and apply to the insurer for insurance benefits with the following certificates and information:
l. Certificate of insurance and the most recent certificate of payment of premium;
2. Certificate of the insured person's domicile and identity;
3. Certificate of labor insurance;
4. certificate of the insured person's employment; and
5. certificate of the insured person's employment.
3. Certificate of work injury from the labor security administrative department;
4. Certificate of the degree of disability of the insured person's work injury issued by the labor capacity appraisal institution recognized by the insurer;
5. Other certificates and information provided by the insured person to confirm the nature of the insurance accident, the cause of the accident, and the degree of injury, etc.
6.
2. If the insured person entrusts another person to claim the insurance benefit on his/her behalf, he/she is required to provide a letter of authorization and the identity proof of the entrusted person; if the insured person is incapable of civil conduct or is a person with limited civil capacity, his/her guardian will claim the insurance benefit on his/her behalf and is required to provide the identity proof of the guardian.
Third, after the insurer receives the applicant's application for insurance benefit payment and the above proofs and information, the insurer shall fulfill its obligation to pay the insurance benefit within ten days after reaching an agreement with the applicant on the amount of insurance benefit to be paid if it is determined to be an insurance responsibility; if it is not an insurance responsibility, it shall issue a notice of refusal to pay the insurance benefit to the applicant; and if it is an insurance responsibility and the amount of insurance benefit to be paid can not be determined. According to the existing proofs and information, the minimum amount that can be determined will be paid first, and after the insurer finally determines the amount of insurance benefits to be paid, the corresponding difference will be paid.
Article 11 Changes of the Insured
If the policyholder needs to increase the number of insured persons due to changes in the number of employees, he/she shall notify the insurer in writing, and the insurer shall start to bear the insurance responsibility after reviewing and agreeing to and charging the corresponding insurance premiums. The expiration date of the insurance period of the newly added insured is the same as the expiration date of the insurance period of this contract.
II. If the insured person leaves his/her job, the insurance liability of the insurer for him/her shall be terminated from the date of his/her leaving his/her job, and the unexpired premium shall not be refunded.
Third, the insurer has the right to terminate this contract if the insured's active staff is less than the eight persons stipulated in this contract, and will follow the relevant provisions on the termination of the contract by the insured.
Article XII Change of Address
The policyholder shall promptly notify the insurer in writing of any change of residence or correspondence address. If the policyholder fails to notify the insurer in writing, the insurer will send the relevant notice to the insurer at the last domicile or correspondence address stated in this contract.
Article 13: Changes in the Contents of the Contract
During the validity period of this contract, the policyholder and the insurer may change the contents of this contract by mutual agreement. In case of change of this contract, the insurer shall endorse the original insurance policy or attach an endorsement, or the policyholder and the insurer shall enter into a written agreement on the change.
Article 14 Handling of Cancellation of this Contract by the Policyholder
I. After the establishment of this Contract, the policyholder may request for the cancellation of this Contract, but the policyholder shall not request for the cancellation of this Contract if the insurance benefit payment has already occurred. When the policyholder requests to terminate this contract, he/she shall fill in the application form for termination of this contract and submit the insurance contract, the latest premium payment certificate and the insured person's certificate of domicile and identity document.
2. This contract shall be terminated on the date the insurer receives the application for termination of the contract. Within thirty days from the date of receipt of the above certificates and information, the insurer shall refund the outstanding premiums for annual, semi-annual and quarterly premiums, and shall not refund any premiums for monthly premiums.
Article 15 Dispute Settlement
The dispute settlement method of this contract shall be agreed by the parties in the contract to choose one of the following two methods:
I. Disputes arising from the fulfillment of this contract shall be settled by the parties through consultation, and if the consultation fails, it shall be submitted to arbitration of the arbitration institution as stated in the insurance policy;
II. If the negotiation fails, the parties concerned shall bring a lawsuit to the people's court with jurisdiction in the place where the insurance policy is issued in accordance with the law.
Article 16 Interpretation
Work Injury: Work Injury is recognized on the basis of Article 14 of the State Council's Decree No. 375, Regulations on Work Injury Insurance (adopted on April 16, 2003). An insured person shall be recognized as injured at work in one of the following circumstances:
1. Injured by an accident during working hours and in the workplace due to work-related reasons;
2. Injured by an accident in the workplace before or after working hours, while engaged in preparatory or finishing work related to work;
3. Injured by an accident in the performance of work-related duties during working hours and in the workplace due to violence or other accidental injuries. Injuries caused by violence or other accidents during working hours and in the workplace in the performance of work duties;
4. Occupational diseases;
5. Injuries caused by work or accidents while away from home on work;
6. Injuries caused by motor vehicle accidents while traveling to and from work;
7. Other cases stipulated by the laws and administrative regulations to be regarded as work-related injuries.
Occupational Disease: refers to diseases caused by exposure to factors such as dust, radioactive substances and other poisonous and harmful substances during the occupational activities of workers in enterprises, institutions and individual economic organizations. The classification and catalog of occupational diseases are stipulated, adjusted and announced by the health administrative department of the State Council in conjunction with the labor security administrative department of the State Council. Occupational disease disability rating appraisal by the State Council administrative department of labor security, in conjunction with the State Council administrative department of health to develop.
Unexpired premium: it is the premium X0.75X(1- number of months elapsed/n), and the number of days less than a month is calculated as 1 month. Annual n=12; half-yearly n=6; quarterly n=3.
Labor security administrative department: is the local administrative department responsible for social insurance.
Monthly salary of the person: refers to the average monthly contribution salary of the insured person (work-injured employee) for the 12 months before he/she suffered accidental injury at work or suffered from occupational disease, according to the Regulations on Work Injury Insurance adopted by the State Council on April 16, 2003.
AIDS: refers to Acquired Immune Deficiency Syndrome (AIDS).
AIDS: means Human Immunodeficiency Virus (HIV). A person is recognized as being infected with HIV or having AIDS if he or she is positive for HIV antibodies in a serological test. The definition of acquired immunodeficiency syndrome shall be as established by the World Health Organization.
Force majeure: an objective circumstance that cannot be foreseen, avoided and overcome.
Monthly (Quarterly, Semi-Annual, Annual) Effective Correspondence Date: means the monthly (quarterly, semi-annual, annual) correspondence date of the effective date.
Insurer: means China Pacific Property Insurance Company Limited.
Schedule 1: Industrial Risk Classification of Workers' Compensation Insurance Industry
Grade
Industry Nature Classification
1
Banking, Securities, Insurance, Other Financial Activities, Residential Services, Other Services, Leasing, Business Services, Accommodation, Food and Beverage, Wholesale, Retail, Warehousing, Postal Service, Telecommunications and Other Transmission Services, Computer Services, Software, Health, Social Security, Social Welfare, News Publishing, Radio, Television, Film and Audiovisual, Culture and Arts, Education, Research and Experimental Development, Professional and Technical, Scientific and Technological Exchange and Promotion Services, Urban Public **** Transportation
2
Real Estate, Sports, Recreation, Water Conservancy Management, Environment management industry, public *** facilities management industry, agricultural and food processing industry, food manufacturing, beverage manufacturing, tobacco products industry, textile industry, textile clothing, shoes, hats manufacturing, leather, fur, down and its products, forestry, agriculture, animal husbandry, fisheries, agriculture, forestry, animal husbandry, fishery services, timber processing and wood, bamboo, rattan and grass products industry, furniture manufacturing, paper and paper products industry, printing industry and record Media reproduction, education and sporting goods manufacturing, chemical fiber manufacturing, pharmaceutical manufacturing, general machinery manufacturing, special machinery manufacturing, transportation equipment manufacturing, electrical machinery and equipment manufacturing, instrumentation and culture, office machinery manufacturing, non-metallic mineral products, metal products, rubber products, plastic products, communications equipment, computers and other electronic equipment manufacturing. Crafts and other manufacturing industries, waste resources and waste materials recycling and processing industry, electricity, heat production and supply industry, gas production and supply industry, water production and supply industry, housing and civil engineering construction industry, construction and installation industry, building decoration industry, other construction industry, geological survey industry, railroad transportation, road transportation, water transportation, air transportation, pipeline transportation, loading and unloading and other transport Services
3
Petroleum Processing, Coking and Core Fuel Processing, Chemical Materials and Chemical Products Manufacturing, Ferrous Metals Smelting and Rolling Processing, Nonferrous Metals Smelting and Rolling Processing, Petroleum and Natural Gas Mining, Ferrous Metals Mining and Processing, Nonferrous Metals Mining and Processing, Non-Metallic Minerals Mining and Processing, Coal Mining and Washing, and Other Mining
Schedule 2: Premium Rates
Currency: RMB Yuan
Industry Nature
Stage 1
Stage 2
Stage 3
Monthly Premium Rates
11
19
26
Note: The premiums of annual payment, semi-annual payment and quarterly payment are twelve times and six times of the monthly premiums respectively. premiums are twelve, six and three times the monthly premiums, respectively.
The insurer reserves the right to suspend, discontinue or increase the premiums for units with higher risks, frequent accidents and higher claim rates, regardless of the above industry rate standards.
Schedule 3: Lump-sum injury benefits
Injury class
5
6
7
8
9
10
Multiples of benefits
60
48
31
19
10
5
Attachment :
China Pacific Property and Casualty Insurance Company Limited's branches may determine the premiums and lump-sum injury benefits according to the local work injury insurance and market conditions.