一、給員工買商業保險可替代工傷保險責任嗎
工傷保險是(shi)國家為了保(bao)(bao)(bao)障職(zhi)工合法權益而規定的(de)強制性保(bao)(bao)(bao)險(xian)(xian),用人單(dan)位具有為其員工參加工傷(shang)保(bao)(bao)(bao)險(xian)(xian)并繳納保(bao)(bao)(bao)險(xian)(xian)費(fei)的(de)法定義務;根(gen)據大陸(lu)《工傷(shang)保(bao)(bao)(bao)險(xian)(xian)條(tiao)例》相關規定,應當參加工傷(shang)保(bao)(bao)(bao)險(xian)(xian)而未參加工傷(shang)保(bao)(bao)(bao)險(xian)(xian)的(de)用人單(dan)位職(zhi)工發生工傷(shang)的(de),由該用人單(dan)位按(an)照工傷(shang)保(bao)(bao)(bao)險(xian)(xian)條(tiao)例規定的(de)工傷(shang)保(bao)(bao)(bao)險(xian)(xian)待遇專案和標(biao)準支付(fu)費(fei)用。
而商業(ye)保險(xian)(xian)(xian)(xian)具有(you)自愿性,用人(ren)(ren)單(dan)(dan)(dan)位(wei)為其員(yuan)工(gong)購(gou)買商業(ye)保險(xian)(xian)(xian)(xian),一(yi)般認為屬于用人(ren)(ren)單(dan)(dan)(dan)位(wei)給予員(yuan)工(gong)的(de)(de)福利待遇,并不(bu)能轉移(yi)用人(ren)(ren)單(dan)(dan)(dan)位(wei)承(cheng)(cheng)擔的(de)(de)工(gong)傷保險(xian)(xian)(xian)(xian)責(ze)(ze)任。用人(ren)(ren)單(dan)(dan)(dan)位(wei)如(ru)要想實現分散工(gong)傷風(feng)險(xian)(xian)(xian)(xian)的(de)(de)目的(de)(de),可在理賠(pei)時與勞動者(zhe)達成保險(xian)(xian)(xian)(xian)金(jin)權(quan)益轉讓協議,將(jiang)保險(xian)(xian)(xian)(xian)金(jin)權(quan)益轉讓給用人(ren)(ren)單(dan)(dan)(dan)位(wei)。或投保財(cai)產保險(xian)(xian)(xian)(xian)的(de)(de)責(ze)(ze)任保險(xian)(xian)(xian)(xian)——雇(gu)主(zhu)責(ze)(ze)任險(xian)(xian)(xian)(xian)。雇(gu)主(zhu)責(ze)(ze)任險(xian)(xian)(xian)(xian)的(de)(de)被保險(xian)(xian)(xian)(xian)標的(de)(de)物為企業(ye)對雇(gu)員(yuan)在雇(gu)傭期(qi)間應(ying)承(cheng)(cheng)擔的(de)(de)法(fa)律賠(pei)償(chang)責(ze)(ze)任,受(shou)(shou)益人(ren)(ren)是雇(gu)主(zhu),所以(yi)保險(xian)(xian)(xian)(xian)金(jin)是賠(pei)償(chang)給雇(gu)主(zhu),而且受(shou)(shou)法(fa)律和(he)條款的(de)(de)保護。因此(ci)轉移(yi)法(fa)律賠(pei)償(chang)責(ze)(ze)任應(ying)購(gou)買雇(gu)主(zhu)責(ze)(ze)任險(xian)(xian)(xian)(xian)。
二、工傷保險和商險能否兼得
工(gong)傷(shang)保險(xian)是(shi)社(she)會保險(xian)制(zhi)度(du)的(de)重(zhong)要(yao)組(zu)成部分,是(shi)國(guo)家和(he)(he)社(she)會為在生產、工(gong)作中遭(zao)受事故傷(shang)害和(he)(he)患職業(ye)性疾病的(de)勞動者及親屬提供醫(yi)療(liao)救治、生活保障(zhang)、經濟補償(chang)、醫(yi)療(liao)和(he)(he)職業(ye)康復等物質幫(bang)助的(de)一種社(she)會保障(zhang)制(zhi)度(du)。意外傷(shang)害險(xian)是(shi)指(zhi)人的(de)身體和(he)(he)生命受到外來和(he)(he)不可抗拒(ju)因素的(de)意外傷(shang)害后(hou),根據投(tou)保對雙方合同的(de)約(yue)定和(he)(he)投(tou)保額,從(cong)保險(xian)公司獲取相應的(de)賠(pei)償(chang),二者并不相同。
首先,工傷(shang)(shang)保(bao)(bao)(bao)險(xian)(xian)是一(yi)種政府(fu)行(xing)為,而人(ren)身(shen)意外(wai)傷(shang)(shang)害險(xian)(xian)是一(yi)種商業行(xing)為。工傷(shang)(shang)保(bao)(bao)(bao)險(xian)(xian)所提供(gong)的(de)保(bao)(bao)(bao)障水平一(yi)般僅(jin)滿足于被保(bao)(bao)(bao)險(xian)(xian)人(ren)的(de)基本生活需要,高(gao)于社會貧困線,低于勞動期間(jian)的(de)工資(zi)標準;人(ren)身(shen)意外(wai)傷(shang)(shang)害險(xian)(xian)所提供(gong)的(de)保(bao)(bao)(bao)障水平的(de)高(gao)低完全取決保(bao)(bao)(bao)險(xian)(xian)雙(shuang)方當事人(ren)的(de)約定和投保(bao)(bao)(bao)人(ren)交(jiao)費的(de)多(duo)少而決定,投保(bao)(bao)(bao)人(ren)只(zhi)要有繳費能力(li)、身(shen)體健(jian)康狀況符合合同規(gui)定的(de)要求,投保(bao)(bao)(bao)金額(e)不(bu)論多(duo)少都是可以(yi)的(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)的勞動和(he)社(she)會(hui)保(bao)障(zhang)部(bu)門(社(she)會(hui)保(bao)險(xian)機構)管理,具有(you)強(qiang)制性(xing),如果(guo)用人單位違(wei)反規定(ding)不為職工(gong)購買(mai)工(gong)傷(shang)(shang)保(bao)險(xian),將承擔一(yi)定(ding)的社(she)會(hui)責任(ren)。依(yi)照《工(gong)傷(shang)(shang)保(bao)險(xian)條(tiao)例》第六十(shi)二條(tiao)規定(ding),工(gong)傷(shang)(shang)保(bao)險(xian)具有(you)社(she)會(hui)強(qiang)制性(xing)而意外(wai)傷(shang)(shang)害(hai)保(bao)險(xian)則屬(shu)于(yu)商(shang)業保(bao)險(xian),其規范調(diao)整屬(shu)于(yu)商(shang)法部(bu)門,不具有(you)強(qiang)制性(xing),保(bao)險(xian)的賠償(chang)金額可根據投保(bao)金額大(da)小而不同,體現締約(yue)自由性(xing)。
再(zai)次(ci)(ci),從繳(jiao)費(fei)標準看,工(gong)(gong)傷(shang)保(bao)(bao)險(xian)(xian)(xian)(xian)(xian)待遇(yu)是(shi)(shi)根據社會經濟(ji)發(fa)展水平(ping)和承受能力(li),由政府(fu)制定統一的繳(jiao)費(fei)標準。在支(zhi)付工(gong)(gong)傷(shang)保(bao)(bao)險(xian)(xian)(xian)(xian)(xian)待遇(yu)時,要考慮工(gong)(gong)傷(shang)職工(gong)(gong)和供(gong)養(yang)親(qin)屬的基本生活(huo)需要。人(ren)(ren)身意(yi)外傷(shang)害險(xian)(xian)(xian)(xian)(xian)的保(bao)(bao)險(xian)(xian)(xian)(xian)(xian)金額則(ze)是(shi)(shi)保(bao)(bao)險(xian)(xian)(xian)(xian)(xian)人(ren)(ren)和投(tou)(tou)保(bao)(bao)人(ren)(ren)雙方約(yue)定的,當發(fa)生保(bao)(bao)險(xian)(xian)(xian)(xian)(xian)事故時,保(bao)(bao)險(xian)(xian)(xian)(xian)(xian)人(ren)(ren)按(an)合同規定的金額一次(ci)(ci)性賠付保(bao)(bao)險(xian)(xian)(xian)(xian)(xian)金,其保(bao)(bao)障水平(ping)是(shi)(shi)依據合同和投(tou)(tou)保(bao)(bao)人(ren)(ren)交(jiao)納的保(bao)(bao)險(xian)(xian)(xian)(xian)(xian)費(fei)多少而(er)定的,多投(tou)(tou)多保(bao)(bao),少投(tou)(tou)少保(bao)(bao),不(bu)投(tou)(tou)不(bu)保(bao)(bao)。
最后,從(cong)承擔責任(ren)的(de)(de)主體看,建立工傷(shang)保(bao)(bao)險(xian)(xian)(xian)的(de)(de)目的(de)(de)是為了分散用人單位承擔責任(ren)的(de)(de)風險(xian)(xian)(xian),調(diao)動社(she)會(hui)力量(liang)以保(bao)(bao)證用人單位損失減(jian)少,因此,用人單位在(zai)繳(jiao)納一定數額保(bao)(bao)險(xian)(xian)(xian)金后,最后由國家統一管理的(de)(de)社(she)會(hui)基金支(zhi)(zhi)付賠償(chang)金。而人身(shen)意外(wai)傷(shang)害保(bao)(bao)險(xian)(xian)(xian)其賠償(chang)是由保(bao)(bao)險(xian)(xian)(xian)公司從(cong)收(shou)取的(de)(de)保(bao)(bao)費中支(zhi)(zhi)付。
根(gen)據勞(lao)(lao)(lao)動(dong)和社會(hui)保(bao)(bao)(bao)障部辦公廳《關于參(can)(can)加商業(ye)保(bao)(bao)(bao)險(xian)中(zhong)(zhong)的(de)(de)人(ren)(ren)身(shen)意外(wai)傷(shang)害險(xian)后是否(fou)還應當參(can)(can)加工(gong)(gong)(gong)(gong)傷(shang)保(bao)(bao)(bao)險(xian)問題的(de)(de)復(fu)函》的(de)(de)有(you)關規(gui)定,工(gong)(gong)(gong)(gong)傷(shang)保(bao)(bao)(bao)險(xian)是社會(hui)保(bao)(bao)(bao)險(xian)的(de)(de)一個重要組成部分,是國(guo)家(jia)強制實施(shi)的(de)(de)一項(xiang)社會(hui)保(bao)(bao)(bao)障制度。按(an)照勞(lao)(lao)(lao)動(dong)法第七十(shi)二條“用人(ren)(ren)單位(wei)和勞(lao)(lao)(lao)動(dong)者必(bi)須依法參(can)(can)加社會(hui)保(bao)(bao)(bao)險(xian),繳納社會(hui)保(bao)(bao)(bao)險(xian)費”的(de)(de)規(gui)定,中(zhong)(zhong)國(guo)境內的(de)(de)企業(ye)無論是否(fou)參(can)(can)加了(le)商業(ye)保(bao)(bao)(bao)險(xian)中(zhong)(zhong)的(de)(de)人(ren)(ren)身(shen)意外(wai)傷(shang)害險(xian),都(dou)必(bi)須按(an)照國(guo)家(jia)規(gui)定參(can)(can)加工(gong)(gong)(gong)(gong)傷(shang)保(bao)(bao)(bao)險(xian)。人(ren)(ren)身(shen)意外(wai)傷(shang)害險(xian)不能(neng)(neng)代替工(gong)(gong)(gong)(gong)傷(shang)保(bao)(bao)(bao)險(xian)。企業(ye)在參(can)(can)加工(gong)(gong)(gong)(gong)傷(shang)保(bao)(bao)(bao)險(xian)的(de)(de)同時,可以根(gen)據本單位(wei)的(de)(de)實際(ji)情(qing)況,為職工(gong)(gong)(gong)(gong)辦理人(ren)(ren)身(shen)意外(wai)傷(shang)害險(xian)。用人(ren)(ren)單位(wei)的(de)(de)投保(bao)(bao)(bao)行為純粹屬(shu)于給(gei)員工(gong)(gong)(gong)(gong)的(de)(de)額外(wai)福利(li),無法起到替代工(gong)(gong)(gong)(gong)傷(shang)保(bao)(bao)(bao)險(xian)的(de)(de)功(gong)能(neng)(neng)。
綜上,職工(gong)在獲得人(ren)身意(yi)外傷害險(xian)賠(pei)償后(hou),仍可(ke)以(yi)主張(zhang)工(gong)傷保險(xian)賠(pei)償。用人(ren)單(dan)位(wei)不能以(yi)職工(gong)已獲得人(ren)身意(yi)外傷害賠(pei)償為由進行抗辯(bian),職工(gong)可(ke)以(yi)同時得到該兩種賠(pei)償。