In early February 2023, Kong joined Company A and suffered a work-related injury the next day. He received treatment in the hospital until the end of June. After appraisal, Kong is classified as a Level 10 disability. In early June 2023, the human resources and social security department issued a "Decision on the Recognition of Work Injury" to Kong.
Subsequently, Kong initiated labor arbitration and requested the employer to pay a one-time disability allowance. The arbitration holds that the employer has already purchased work-related injury insurance for the employee, and the employee's request for a one-time disability allowance should be applied to the Social Security Fund Management Bureau. Therefore, the arbitration will not be processed. Kong refused to accept the arbitration and filed a lawsuit with the court.
Company A argued that Kong had already purchased work-related injury insurance for him when he joined, and Kong's arbitration request for a one-time disability allowance should be applied to the Social Security Fund Management Bureau and should not be borne by the company. After investigation and evidence collection by the court, it was found that Company A only processed the work-related injury insurance enrollment procedures for Kong in April 2023. The Shenzhen Social Insurance Fund Management Bureau issued a notice of non payment of work-related injury insurance benefits, stating that Kong falls under the category of insured after injury and does not meet the payment conditions of the work-related injury insurance fund. Therefore, the one-time disability allowance will not be paid.
Both parties have signed a written labor contract, and the labor relationship is clear. Both parties should fulfill their respective obligations in accordance with the law.
Company A only processed the work-related injury insurance enrollment procedures for Kong after his work-related injury, which resulted in Kong being unable to enjoy work-related injury insurance benefits after being injured. According to the relevant provisions of the Work Injury Insurance Regulations, employers have a legal obligation to pay work-related injury insurance premiums for their employees. If the employer fails to fulfill this obligation, the relevant expenses incurred by the employee due to work-related injuries shall be borne by the employer.
In summary, the court ruled in accordance with the law that Company A shall pay Kong a total of approximately 90000 yuan for medical expenses, wage differences during the suspension period, one-time employment subsidies, and one-time disability subsidies. The judgment has come into effect.
Work injury insurance covers "just in case" situations, not "after the fact". According to the Regulations on Work Injury Insurance, if an employee of an employer who should have participated in work injury insurance but did not, suffers a work-related injury, the employer shall pay the expenses in accordance with the work injury insurance benefits and standards stipulated in this Regulation. This means that failure to timely participate in insurance will result in workers being unable to receive benefits from the work-related injury insurance fund, and the compensation liability will be borne by the employer, including one-time disability benefits, medical expenses, etc. that should have been paid by the fund.
For employers, paying work-related injury insurance for workers in accordance with the law is a mandatory obligation and there is no room for bargaining. The 'retroactive processing' does not have the legal effect of exempting compensation liability. It is recommended that employers complete social security registration as soon as possible within the statutory period after the employee joins the company. For workers, after a work-related accident occurs, they should pay attention to retaining evidence such as labor relations, accident history, and medical records, and apply for work-related injury recognition in a timely manner. If the employer fails to pay work-related injury insurance in accordance with the law, resulting in the inability of the employee to enjoy social security fund benefits, the corresponding expenses shall be borne by the employer in accordance with the law. Workers can claim their legitimate rights through negotiation, mediation, labor arbitration, litigation, and other means.
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