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Measures of Anhui Province on the Execution of Regulations on the Industrial Injury Insurance

release date:2006/07/03 hits:517

Measures of Anhui Province on the Execution of Regulations on the Industrial Injury Insurance 
(Adopted at the Fourteenth Regular Meeting of the People's Government of the Province on June 21st 2004, No. 169 Decree of the People's Government of Anhui Province on June 30th 2004, and became effective as of Aug. 1st 2004)

Chapter One   General Provisions
Article One
The Measures herein are formulated in light of the actual circumstances of the Province for the purpose of executing Regulations on the Industrial Injury Insurance prepared by the State Council (hereinafter referred to as the "Regulations").
Article Two All types of enterprises and individual industrial and commercial entities that have hired workers within the administrative region of the Province (hereinafter referred to as the "Employing Units") shall participate in industrial injury insurances according to the Regulations and the Measures and pay industrial injury insurance premiums for all their employees or hired workers.
Employees in all types of enterprises and hired workers in individual industrial and commercial entities within the administrative region of the Province (hereinafter referred to as the "Employees") shall have the right to enjoy industrial injury insurance treatments according to the Regulations and the Measures.
Article Three The administrative departments for labor insurance of people's governments above the county level shall be responsible for the industrial injury insurances within their respective administrative region.
Social insurance handling institutions set up by administrative departments for labor insurance to handle the industrial injury insurance tasks (hereinafter referred to as the "Handling Institutions") shall undertake to specifically handle industrial injury insurance affairs. Service expenses required by the Handling Institutions shall be borne by the financial department at the same level.
Article Four Other relevant departments for safety production supervision and administration, health, finance and local tax etc. shall, within their respective scope of duties and responsibilities, carry out effectively tasks that are relevant with industrial injury insurances.
Governments and their relevant departments shall develop policies and standards regarding industrial injury insurances, and shall collect opinions from labor unions, relevant departments and Employing Units.
Article Five Employing Units shall establish and perfect the safety production responsibility systems, to prevent the occurrence of industrial injury accidents and avoid and reduce the impairments caused by occupational diseases. Employing Units that have relatively low occurrence rates of occupational diseases in an industry in the overall arrangement areas may be given rewards, and the rewarding measures shall be developed jointly by the administrative department for labor insurance of the Province and the financial department of the Province.

Chapter Two   Industrial Injury Insurance Funds
Article Six Industrial injury insurance funds shall be overall arranged by cities that have districts. Where it is difficult for whole-city overall arrangement, industrial injury insurance funds may be overall arranged by a county (city) subject to the consent of the people's government of the city with districts and subject to the approval of the People's Government of the Province.
Article Seven An industrial injury insurance fund shall consist of the following items:
1.   Industrial injury insurance premiums paid by Employing Units;
2.   Belated payments for industrial injury insurance premiums;
3.   Interests of the industrial injury insurance fund;
4.   Donations from the society;
5.   Other funds which are included into the industrial injury insurance fund in accordance with laws.
Industrial injury insurance funds shall be deposited into the special financial accounts for social insurance funds.
Article Eight Industrial baseline rate standards and rate fluctuation measures of industrial injury insurance premiums shall be fixed according to the principle "to fix receipts in light of expenditures" and the principle of "balanced receipts and expenditures".
Industrial baseline rate standards shall be fixed by the people's government of an overall arrangement area; rate fluctuation measures shall be fixed by the administrative department for labor insurance of an overall arrangement area together with the administrative departments for finance, local tax, health, safety production supervision and administration according to provisions of the state. The Handling Institution of an overall arrangement area shall put forward its opinions regarding the specific payment rate for an Employing Unit according to the unit's uses of industrial injury insurance premiums, occurrence rate of industrial injuries, industrial injury insurance administration (industrial injury salvation and declaration etc. ), safety production administration and occupational health checks, and execute the payment rate after it is approved by the administrative department for labor insurance of the overall arrangement area.
For any Employing Unit whose business scope involves more than one industry, the industrial rate standard shall be fixed according to the industry the owner determines as applicable.
Article Nine Industrial injury insurance funds shall be used for the following items;
1.   Industrial injury insurance treatments paid in accordance with provisions;
2.   Occupational convalescence treatment expenses?
3.   Labor abilities verification expenses;
4.   Industrial injury affirmation and examination expenses;
5.  Rewarding expenses as provided in Article Five of thj Measures;
6.   Other expenses as provided in laws, rules and regulations.
Article Ten Industrial injury insurance reserve funds shall be set up at the province and city levels. Reserve funds shall be drawn and reserved from the industrial injury insurance premiums collected, and reserve funds shall not be increased further once the aggregate amount is equal to 30% of the annual collected amount of industrial injury insurance premiums, and 30% of the reserve funds shall be turned in as the reserve fund at the province level. Where reserve funds are used to pay industrial injury insurance treatments in significant accidents and the reserve funds at the city level becomes insufficient for the payment, the people's government at the same level shall advance payments according to a certain proportion and the reserve funds at the province level shall be paid. The specific measures shall be prepared jointly by the administrative department for labor insurance of the Province and the financial department of the Province.
Article Eleven The administration of the collection and payment of industrial injury insurance premiums shall be executed according to relevant provisions of the state and the Interim Provisions of Anhui Province on the Collection and Payment of Social Insurance Premiums.
Employing Units shall publicize within the unit the names of Employees that participate in industrial injury insurances, paid salaries, paid amounts and other basic information.

Chapter Three   Industrial Injury Affirmation
Article Twelve Where any industrial injury accident occurs in an Employing Unit, it shall report to the administrative department for labor insurance of the overall arrangement area within 48 hours at maximum.
Article Thirteen Where any special circumstance exists in the Employing Unit, the industrial injury affirmation application period can be protracted to 30 days subject to the consent of the administrative department for labor insurance of the overall arrangement area.
Article Fourteen The administrative department for labor insurance of the overall arrangement area shall be responsible for the industrial injury affirmation of any Employ that works in an enterprise that produces or operates in more than one overall arrangement areas, and the administrative department for labor insurance local to the place where the accident has occurred shall assist the investigation; alternatively, the administrative department for labor insurance of the overall arrangement area may assign the administrative department for labor insurance local to the place where the accident has occurred to carry out the investigation and evidence collection tasks, and the affirmation conclusion shall be issued by the assigning party.
Article Fifteen The following materials shall be submitted for an application of industrial injury affirmation:
1. Industrial injury affirmation application form;
2. Materials proving the existence of the labor relationship (including the factual labor relationship) with the Employing Unit;
3. Medical diagnosis certificate or occupational disease diagnosis certificate (or occupational disease diagnosis verification);
4. Materials proving the infliction of injury because of any special reason;
(1) Testimonials or legal documents issued by a public security authority or people's court for an injury inflicted by violence;
(2) Testimonials issued by a traffic accident handling department for a traffic accident;
(3) Testimonials- issued by a civil administration department or any other relevant department for an injury resulted from emergency relief and disaster salvation acts and other acts that protect the interests of the state and the public;
(4) Testimonials issued by a labor ability verification committee for the recurrence of an old injury;
(5) Accidental injury testimonials provided by other relevant units or individuals.
Article Sixteen Where an Employing Unit does not think an industrial injury affirmation applied by an Employ or his/her direct relative is an industrial injury, the Employing Unit shall provide evidence materials within 15 days after the date it receives the notification from the administrative department for labor insurance, and the time for evidence provision shall not be included into the period for industrial injury affirmation.

Chapter Four   Labor Ability Verification
Article Seventeen The Province and cities that have districts shall set up a labor ability verification committee that consist of representatives from administrative departments for labor insurance, personnel and health, labor unions, Handling Institutions, and representatives from Employing Units. The number of staff of a labor ability verification committee shall be a singular.
Article Eighteen The labor ability verification committee of a city shall shoulder the following tasks:
1.   Preliminary verification and recheck verification of the seriousness of labor parafunction;
2.   Preliminary verification and recheck verification of the seriousness of life self-ma nagement paraf unction;
3.   Confirmation of the period for position reservation with salaries;
4.   Confirmation of the necessity for continued treatment after the period for position reservation with salaries expires;
5.   Confirmation of any illness caused directly by an industrial injury;
6.   Confirmation of convalescence treatments;
7.   Confirmation of the recurrence of an old injury;
8.   Confirmation of the provision of auxiliary devices;
9.   Verification of the labor abilities of the supported relatives;
10.   Other verification and confirmation items as provided in laws, rules and regulations. The labor ability verification committee of a city shall organize experts to verify the
cases mentioned in Item (C) to Item (H) that require expert verifications.
Article Nineteen The labor ability verification committee of the Province shall undertake to carry out a re-verification and other verifications provided in laws, rules and regulations, where any unit or individual refuses to accept the verification conclusions on the seriousness of labor parafunction and the life self-management parafunction made by the labor ability verification committee of a city.
Article Twenty The standards for verification expenses of labor ability verification committees shall be proposed by the administrative department for labor insurance of the Province, and shall be examined and approved jointly by the pricing department of the Province and the financial department of the Province.
Article Twenty-one When an Employee recovers from his/her industrial injury after treatments or his/her situations become relatively stable, the medical institution shall give medical conclusions, and the unit or individual shall apply for labor ability verification in a timely manner.

Chapter Five   Industrial Injury Insurance Treatments
Article Twenty-two
Where an Employee is disabled because of an industrial injury and his/her disability is verified as a Grade One to Grade Four disability, his/her labor relationship shall be kept and he/she shall resign from his/her work post and enjoy relevant treatments in accordance with provisions in Article Thirty-three of the Regulations.
During the period that he/she receives disability subsidies, the Employing Unit and the individual Employee shall pay basic medical insurance premiums in accordance with provisions, with the disability subsidy serving as the base number. Where the actual amount of the disability subsidy, after the deduction of the basic medical insurance premiums paid by the individual, is lower than the local lowest salary standard, the difference shall be filled from the industrial injury insurance funds.
Article Twenty-three Where an Employee is disabled because of an industrial injury and his/her disability is verified as a Grade Five or Grade Six disability, he/she shall enjoy relevant treatments in accordance with the provisions in Article Thirty-four of the Regulations, his/her labor relationship shall be kept, and the Employing Unit shall arrange for him/her a proper job. Where it is difficult to arrange any job, the Employing Unit shall extend disability subsidies according to the provisions in the Regulations. During the period that he/she receives disability subsidies, the Employing Unit and the individual Employee shall pay various social insurance premiums in accordance with provisions, with the disability subsidy serving as .the base number. Where the actual amount of the disability subsidy, after the deduction of various social insurance premiums paid by the individual, is lower than the local lowest salary standard, the difference shall be filled by the Employing Unit.
Where an Employee is disabled because of an industrial injury and his/her disability is verified as a Grade Five or Grade Six disability, the labor relationship between him/her and the Employing Unit may be canceled or terminated if so required by him/herself, and the Employing Unit shall pay a one-time industrial injury medical subsidy and disability employment subsidy and shall stop extending the disability subsidy. The standard of the one-time industrial injury medical insurance; for a Grade Five disability, it shall be 20 months average monthly salary of Employees in the overall arrangement area in the previous year; for a Grade Six disability, it shall be 15 months salary. The standard of the one-time disability employment subsidy: for a Grade Five disability, it shall be 35 months average monthly salary of Employees in the overall arrangement area in the previous year; and for a Grade Six disability it shall be 30 months salary.
Article Twenty-four Where an Employee is disabled because of an industrial injury and his/her disability is verified as a Grade Seven to Grade Ten disability, and his/her labor contract expires or he/she requires to cancel the labor contract, the Employing Unit shall pay a one-time industrial injury medical subsidy and disability employment subsidy. The standard of the one-time industrial injury medical insurance: for a Grade Seven disability it is 10 months average monthly salary of Employees in the overall arrangement area in the previous year, for a Grade Eight disability it is 8 months salary, for a Grade Nine disability it is 6 months salary, and for a Grade Ten disability it is 4 months salary; the standard of the onetime disability employment subsidy: for a Grade Seven disability it is 20 months average monthly salary of Employees in the overall arrangement area in the previous year, for a Grade Eight disability it is 15 months salary, for a Grade Nine disability it is 10 months salary, and for a Grade Ten disability it is 5 months salary.
Article Twenty-five According to the provisions in Article Twenty-three and Article Twenty-four of the Measures, the one-time disability employment subsidy for Employees that enjoy the one-time disability employment subsidy and are less than five years away from the legal retirement age shall be executed according to the following standards:
1.   Where it is less than two years, 60% of the full amount shall be paid;
2.   Where it is less than three years, 70% of the full amount shall be paid;
3.   Where it is less than four years, 80% of the full amount shall be paid;
4.   Where it is less than five years, 90% of the full amount shall be paid.
Article Twenty-six Where any disabled Employee undergoes retirement procedures in accordance with provisions, the one-time industrial injury medical subsidy and disability employment subsidy shall not be paid.
Article Twenty-seven The following industrial injury treatments for Employees shall be paid from the industrial injury insurance funds:
1.   Expenses for industrial injury medical treatments;
2. Expenses for disability auxiliary devices;
3.   Expenses for life nursing;
4.   One-time industrial death subsidy;
5.   One-time disability subsidy;
6.   Disability subsidy for Employees having a Grade One to Grade Four disability;
7.   Burial subsidy;
8.   Pension for supported relatives;
9.   Other expenses as provided in laws, rules and regulations.
Article Twenty-eight The following industrial injury treatments for Employees shall be paid by Employing Units;
1.   Nursing expenses for the period of position reservation with salaries;
2.   Salaries and welfares treatments for the period of position reservation with salaries;
3.   Inpatient meal subsidies during the period of inpatient treatments in the overall arrangement area;
4.   Expenses for medical arrangement,  transportation and accommodation outside the overall arrangement area;
5.   Difference of the inpatient medical treatments expenses and nursing expenses after the period of position reservation with salaries expires;
6.   Disability subsidy for employees having a Grade Five or Grade Six disability;
7.   One-time industrial injury medical subsidy and disability employment subsidy;
8.   Other expenses as provided in laws, rules and regulations.
Article Twenty-nine Where any Employee is missing during the time he/she is out to perform his/her duties or during the period of emergency relief and disaster salvation, and reappears later or his/her death conclusion is repealed by a people's court, his/her relatives shall refund the industrial injury treatments that they have received.
Article Thirty Where an Employee is inflicted injury in any industrial injury accident during the time he/she is exported for service provision by the unit that has a labor relationship with him/her, the unit that has the labor relationship with him/her shall bear the industrial injury insurance responsibilities, and it shall negotiate with the unit using the labor to agree on the industrial injury insurance compensations.
Where an Employee that has bought industrial injury insurances in the state suffers any industrial injury and receives compensations in a foreign country during the period he/she is dispatched to work in that foreign country, the industrial injury insurance treatments within the state shall not be paid; however, if the compensations he/she gets in the foreign country are lower than the industrial injury insurance treatments in the overall arrangement area, the different part shall be filled.
Article Thirty-one Where the disability grade of any Employee that has suffered an industrial injury changes after recheck verification, the industrial injury insurance treatments relevant with the new verification conclusion shall be paid starting from the next month the recheck verification conclusion is issued; where the disability grade becomes higher, the different part of the one-time disability subsidy shall be filled.
Article Thirty-two Where a unit or Employ that has suffered an industrial injury refuses to accept the verification conclusion made by the labor ability verification committee of a city and applies for re-verification by the labor ability verification committee of the Province, during the period of the re-verification, the industrial injury insurance treatments for the injured Employee shall be calculated and paid according to the verification conclusion made by the labor ability verification committee of the city, and shall be calculated according to the verification conclusion made by the labor ability verification committee of the Province after the verification conclusion of the labor ability verification committee of the Province is issued.
Article Thirty-three The measures for the readjustments of disability subsidies, pensions for supported relatives and life nursing expenses shall be developed jointly by the administrative department for labor insurance of the Province and the financial department of the Province.

Chapter Six   Industrial Injury Medical Administration
Article Thirty-four Industrial injury insurances shall be administered under the system of designated medical institutions and designated auxiliary devices provision institutions. The designated medical institutions shall be affirmed and announced by the administrative department for labor insurance of the overall arrangement area, and the designated auxiliary devices provision institutions shall be affirmed and announced by the administrative department for labor insurance of the Province.
Article Thirty-five Industrial injuries of Employees shall be treated in medical institutions that have the qualification and that have entered the service agreement, and may be treated in the nearest institution under emergent circumstances and be transferred for treatment to a medical institution that has entered the agreement after the status of the Employee becomes stable. After the treatments of an Employee are over he/she shall complete the leave procedures in a timely manner.
In case of medical treatments carried out in the nearest institution, the Employing Unit shall report it to the Handling Institution of the overall arrangement area within 5 days after the injury occurs and complete relevant procedures.
Article Thirty-six Expenses required for the treatments received by an Employee for the injury shall be advanced by the unit of the injured Employee, and the Employing Unit shall apply for settlement to the Handling Institution after the administrative department for labor insurance affirms the industrial injury and the participation in the industrial injury insurance; the medical expenses incurred later shall be settled directly between the medical institution that has entered the agreement and the Handling Institution.
Article Thirty-seven When an injured Employee or his/her Employing Unit settles the medical expenses with the Handling Institution, the following materials must be provided:
1.   Materials proving the industrial injury;
2.   Diagnosis evidences,  expense vouchers,  expenses list and relevant case materials issued by the medical institution in accordance with provisions.
Where an Employee is transferred out of the Province for medical treatments, approving documents of the Handling Institution shall also be provided.
Article Thirty-eight Where an Employee needs nursing during the period he/she receives inpatient treatments because of an industrial injury, his/her unit shall pay the nursing expense on a monthly basis. The standard of the nursing expense is 80% of the average monthly salary of Employees in the overall arrangement area in the previous year. Where the life nursing expense that has been received is less than the specified standard before the medical institution issues a certificate, the unit shall fill the difference.
Article Thirty-nine Any expense that occurs in any of the following circumstances shall not be paid from the industrial injury insurance funds;
1.   Industrial injury medical treatment expenses that are incurred in a medical institution that has not entered the agreement without approval;
2.   Auxiliary device provision expenses that are incurred in an auxiliary device provision institution that has not entered the agreement;
3.   Expenses that are not included in industrial injury insurance diagnosis and treatment items index, industrial injury insurance medicines index, or the industrial injury insurance inpatient service standard scope;
4.   Medical expenses that are irrelevant with the treatments for the industrial injury;
5.   Other expenses which are prohibited for payment in laws, rules and regulations.

Chapter Seven   Legal Liabilities
Article Forty Where any functionary in an administrative department for labor insurance is involved in any of the following acts, he/she shall be given administrative sanctions; where the misconduct is serious and a crime is constituted, he/she shall be prosecuted the criminal liabilities in accordance with laws:
1.   Not accepting to handle an industrial injury affirmation application without a proper reason, or practicing fraud to affirm a person that does not meet industrial injury conditions as an industrially injured Employee;
2.  Not keeping effectively the evidences and materials for the application of industrial injury affirmation so that any relevant evidence is lost;
3.   Accepting any property bestowed by a party concerned.
Article Forty-one Where any Handling Institution is involved in any of the following acts, the administrative department for labor insurance shall require rectification, and impose disciplinary punishments to the immediately responsible person in charge and other immediately responsible personnel; where the misconduct is serious and a crime is constituted, they shall be prosecuted the criminal liabilities in accordance with laws; where any economic loss is caused to the party concerned, the Handling Institution shall bear the responsibility for compensation in accordance with laws:
1. Failing to keep in accordance with provisions records regarding units' premium payments and Employees' enjoyment of industrial injury insurance ''itmenfs;
2.   Failing to verifying industrial injury insurance treatments in accordance with provisions ;
3.   Accepting any property from a party concerned.
Article Forty-two Where any Employing Unit, industrially injured Employ or his/her direct relative, medical institution, or auxiliary devices provision institution breaches the Measures, it shall be sanctioned according to provisions in Article Fifty-eight and Article Fifty-nine of the Regulations.
Article Forty-three Where any unit or individual breaches any provision in the Measures, or breaches any provision in the regulations on public security management by being deliberately provocative or by assembling a crowd for affray, he/she shall be sanctioned by the public security authority according to the provisions in Regulations on Punishments in Respect to the Management of Public Security; where a crime is constituted, he/she shall be prosecuted the criminal liabilities in accordance with laws by the judicial authority.
Chapter Eight   Supplementary Provisions
Article Forty-four Life nursing expenses for Employees that have been disabled because of industrial injuries and pensions for supported relatives of Employees that have died because of industrial injuries prior to the execution of the Measures shall be calculated and extended according to the standards of the Regulations starting from Jan. 1st 2004 through the same paying channels. Where the original treatment standards are higher than those provided in the Regulations, the original treatment standards shall continue to be executed; where the standards readjusted according to Article Thirty-three of the Measures are higher than the original standards, the new standards shall be executed.
Article Forty-five For industrial injury accidents that have occurred during the period of non-participation of industrial injury insurances prior to Jan. 1st 2004, the payments of the treatments for disabled Employees and the supported relatives of dead Employees shall be included gradually into uniform administration by various overall arrangements areas. The specific measures shall be developed by the overall arrangements areas respectively.
Article Forty-six Various cities may develop enforcement regulations in light of their respective local circumstances for the participation of industrial injury insurances by individual industrial and commercial entities that have hired workers.
Article Forty-seven The administrative department of labor insurance of the Province shall be responsible for the interpretation of issues arisen during the application of the Measures.
Article Forty-eight The Measures shall become effective as of Aug. Is1 2001 to nullify the Interim Measures of Anhui Province on the Industrial Injury Insurance (No. 82 Decree of the People's Government of the Province) promulgated by the People's Government of the Province on Feb.  20th 1997.

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