一、給員工買商業保險可替代工傷保險責任嗎
工傷保險是國家為了保(bao)障(zhang)職工合法(fa)權益而規(gui)定的(de)強制性保(bao)險(xian),用人(ren)單(dan)位具有為其員工參加工傷(shang)(shang)保(bao)險(xian)并繳納保(bao)險(xian)費(fei)的(de)法(fa)定義務;根據大陸(lu)《工傷(shang)(shang)保(bao)險(xian)條例(li)》相關規(gui)定,應(ying)當參加工傷(shang)(shang)保(bao)險(xian)而未參加工傷(shang)(shang)保(bao)險(xian)的(de)用人(ren)單(dan)位職工發生(sheng)工傷(shang)(shang)的(de),由該用人(ren)單(dan)位按照工傷(shang)(shang)保(bao)險(xian)條例(li)規(gui)定的(de)工傷(shang)(shang)保(bao)險(xian)待遇專案(an)和標(biao)準支付費(fei)用。
而(er)商(shang)業(ye)保(bao)(bao)險(xian)(xian)具有自愿性(xing),用(yong)人(ren)(ren)單(dan)位(wei)(wei)(wei)為其員(yuan)工購(gou)買商(shang)業(ye)保(bao)(bao)險(xian)(xian),一(yi)般認為屬于用(yong)人(ren)(ren)單(dan)位(wei)(wei)(wei)給(gei)(gei)予員(yuan)工的福利待(dai)遇,并不能轉(zhuan)移用(yong)人(ren)(ren)單(dan)位(wei)(wei)(wei)承擔的工傷保(bao)(bao)險(xian)(xian)責(ze)任(ren)。用(yong)人(ren)(ren)單(dan)位(wei)(wei)(wei)如要想實現分散工傷風險(xian)(xian)的目的,可在(zai)理(li)賠時與勞動(dong)者達(da)成保(bao)(bao)險(xian)(xian)金權(quan)益(yi)轉(zhuan)讓(rang)協議,將保(bao)(bao)險(xian)(xian)金權(quan)益(yi)轉(zhuan)讓(rang)給(gei)(gei)用(yong)人(ren)(ren)單(dan)位(wei)(wei)(wei)。或投保(bao)(bao)財產保(bao)(bao)險(xian)(xian)的責(ze)任(ren)保(bao)(bao)險(xian)(xian)——雇主責(ze)任(ren)險(xian)(xian)。雇主責(ze)任(ren)險(xian)(xian)的被保(bao)(bao)險(xian)(xian)標的物為企業(ye)對(dui)雇員(yuan)在(zai)雇傭期(qi)間應承擔的法律(lv)賠償(chang)責(ze)任(ren),受(shou)益(yi)人(ren)(ren)是雇主,所以保(bao)(bao)險(xian)(xian)金是賠償(chang)給(gei)(gei)雇主,而(er)且受(shou)法律(lv)和條款的保(bao)(bao)護。因(yin)此(ci)轉(zhuan)移法律(lv)賠償(chang)責(ze)任(ren)應購(gou)買雇主責(ze)任(ren)險(xian)(xian)。
二、工傷保險和商險能否兼得
工傷(shang)(shang)保(bao)險(xian)是(shi)社(she)會(hui)保(bao)險(xian)制(zhi)度的(de)重(zhong)要(yao)組成部分,是(shi)國家(jia)和社(she)會(hui)為在(zai)生(sheng)(sheng)產、工作中遭受(shou)事(shi)故傷(shang)(shang)害(hai)和患職(zhi)業(ye)性(xing)疾病的(de)勞動者及親屬提供醫(yi)療(liao)救治(zhi)、生(sheng)(sheng)活保(bao)障、經濟補償、醫(yi)療(liao)和職(zhi)業(ye)康(kang)復等物質幫(bang)助的(de)一種社(she)會(hui)保(bao)障制(zhi)度。意外傷(shang)(shang)害(hai)險(xian)是(shi)指人的(de)身體和生(sheng)(sheng)命受(shou)到外來和不可(ke)抗拒(ju)因素的(de)意外傷(shang)(shang)害(hai)后,根據投保(bao)對雙方合同的(de)約定和投保(bao)額,從保(bao)險(xian)公(gong)司獲(huo)取相應的(de)賠償,二者并不相同。
首先,工(gong)傷(shang)保(bao)險是一(yi)種(zhong)政(zheng)府行為,而人(ren)身意外傷(shang)害(hai)險是一(yi)種(zhong)商業行為。工(gong)傷(shang)保(bao)險所提供(gong)的(de)保(bao)障水(shui)平一(yi)般僅(jin)滿足于(yu)被保(bao)險人(ren)的(de)基本生活需要,高于(yu)社會貧困線,低于(yu)勞動(dong)期間的(de)工(gong)資標準;人(ren)身意外傷(shang)害(hai)險所提供(gong)的(de)保(bao)障水(shui)平的(de)高低完全取決保(bao)險雙方當事人(ren)的(de)約(yue)定和投(tou)(tou)保(bao)人(ren)交(jiao)費的(de)多少(shao)而決定,投(tou)(tou)保(bao)人(ren)只要有繳(jiao)費能力、身體(ti)健康狀(zhuang)況符合(he)合(he)同規定的(de)要求(qiu),投(tou)(tou)保(bao)金額不論多少(shao)都(dou)是可(ke)以(yi)的(de)。
其次,從性質上說,工傷保險屬于法定的社會保險,由政府的勞動和社會保(bao)(bao)(bao)障部門(社會保(bao)(bao)(bao)險(xian)機構(gou))管理,具有(you)強制性,如果(guo)用人單(dan)位違反規定不為職工(gong)購買工(gong)傷(shang)(shang)保(bao)(bao)(bao)險(xian),將承擔一定的社會責任。依照《工(gong)傷(shang)(shang)保(bao)(bao)(bao)險(xian)條例》第六十二條規定,工(gong)傷(shang)(shang)保(bao)(bao)(bao)險(xian)具有(you)社會強制性而(er)意外(wai)傷(shang)(shang)害(hai)保(bao)(bao)(bao)險(xian)則屬于(yu)商業保(bao)(bao)(bao)險(xian),其規范調整屬于(yu)商法部門,不具有(you)強制性,保(bao)(bao)(bao)險(xian)的賠償(chang)金額可根據投(tou)保(bao)(bao)(bao)金額大小而(er)不同,體現(xian)締約自(zi)由性。
再次(ci),從繳費標(biao)準(zhun)看(kan),工(gong)傷(shang)保(bao)(bao)險(xian)(xian)待遇(yu)是根據(ju)社會經濟發展(zhan)水(shui)平和(he)(he)承受(shou)能力,由政(zheng)府制定統一(yi)的(de)(de)(de)(de)(de)繳費標(biao)準(zhun)。在支付工(gong)傷(shang)保(bao)(bao)險(xian)(xian)待遇(yu)時,要考慮工(gong)傷(shang)職工(gong)和(he)(he)供(gong)養(yang)親屬的(de)(de)(de)(de)(de)基本生活需要。人(ren)身意外傷(shang)害險(xian)(xian)的(de)(de)(de)(de)(de)保(bao)(bao)險(xian)(xian)金額(e)則是保(bao)(bao)險(xian)(xian)人(ren)和(he)(he)投保(bao)(bao)人(ren)雙方約定的(de)(de)(de)(de)(de),當發生保(bao)(bao)險(xian)(xian)事故時,保(bao)(bao)險(xian)(xian)人(ren)按合同(tong)規定的(de)(de)(de)(de)(de)金額(e)一(yi)次(ci)性賠付保(bao)(bao)險(xian)(xian)金,其保(bao)(bao)障水(shui)平是依據(ju)合同(tong)和(he)(he)投保(bao)(bao)人(ren)交納的(de)(de)(de)(de)(de)保(bao)(bao)險(xian)(xian)費多少而定的(de)(de)(de)(de)(de),多投多保(bao)(bao),少投少保(bao)(bao),不(bu)投不(bu)保(bao)(bao)。
最后,從承擔(dan)責任的主體看,建立(li)工傷保(bao)險的目的是為(wei)了(le)分(fen)散用(yong)(yong)人(ren)單位(wei)承擔(dan)責任的風(feng)險,調動社會力量(liang)以保(bao)證用(yong)(yong)人(ren)單位(wei)損(sun)失減少,因此,用(yong)(yong)人(ren)單位(wei)在(zai)繳納一(yi)定(ding)數額保(bao)險金后,最后由(you)國家統一(yi)管(guan)理的社會基金支付賠償金。而(er)人(ren)身意外傷害保(bao)險其賠償是由(you)保(bao)險公司從收取的保(bao)費中支付。
根據勞(lao)動(dong)和(he)社(she)(she)會(hui)保(bao)(bao)(bao)(bao)障部辦公廳(ting)《關于參加商(shang)業(ye)保(bao)(bao)(bao)(bao)險(xian)(xian)中的(de)人身(shen)意(yi)(yi)外傷(shang)(shang)(shang)(shang)害險(xian)(xian)后是(shi)否還(huan)應當參加工(gong)(gong)傷(shang)(shang)(shang)(shang)保(bao)(bao)(bao)(bao)險(xian)(xian)問題(ti)的(de)復函》的(de)有關規(gui)定(ding),工(gong)(gong)傷(shang)(shang)(shang)(shang)保(bao)(bao)(bao)(bao)險(xian)(xian)是(shi)社(she)(she)會(hui)保(bao)(bao)(bao)(bao)險(xian)(xian)的(de)一(yi)個(ge)重要組成部分,是(shi)國家(jia)強制實(shi)施的(de)一(yi)項(xiang)社(she)(she)會(hui)保(bao)(bao)(bao)(bao)障制度。按照(zhao)勞(lao)動(dong)法第七(qi)十二(er)條“用人單位(wei)(wei)和(he)勞(lao)動(dong)者必(bi)須依(yi)法參加社(she)(she)會(hui)保(bao)(bao)(bao)(bao)險(xian)(xian),繳納社(she)(she)會(hui)保(bao)(bao)(bao)(bao)險(xian)(xian)費”的(de)規(gui)定(ding),中國境內的(de)企(qi)(qi)業(ye)無(wu)(wu)論是(shi)否參加了商(shang)業(ye)保(bao)(bao)(bao)(bao)險(xian)(xian)中的(de)人身(shen)意(yi)(yi)外傷(shang)(shang)(shang)(shang)害險(xian)(xian),都(dou)必(bi)須按照(zhao)國家(jia)規(gui)定(ding)參加工(gong)(gong)傷(shang)(shang)(shang)(shang)保(bao)(bao)(bao)(bao)險(xian)(xian)。人身(shen)意(yi)(yi)外傷(shang)(shang)(shang)(shang)害險(xian)(xian)不能(neng)代替(ti)工(gong)(gong)傷(shang)(shang)(shang)(shang)保(bao)(bao)(bao)(bao)險(xian)(xian)。企(qi)(qi)業(ye)在參加工(gong)(gong)傷(shang)(shang)(shang)(shang)保(bao)(bao)(bao)(bao)險(xian)(xian)的(de)同時,可以根據本(ben)單位(wei)(wei)的(de)實(shi)際情況(kuang),為職工(gong)(gong)辦理人身(shen)意(yi)(yi)外傷(shang)(shang)(shang)(shang)害險(xian)(xian)。用人單位(wei)(wei)的(de)投保(bao)(bao)(bao)(bao)行(xing)為純粹屬于給(gei)員工(gong)(gong)的(de)額外福利(li),無(wu)(wu)法起到替(ti)代工(gong)(gong)傷(shang)(shang)(shang)(shang)保(bao)(bao)(bao)(bao)險(xian)(xian)的(de)功(gong)能(neng)。
綜上,職工在獲得人(ren)身意外傷害(hai)險(xian)賠(pei)償后,仍(reng)可以(yi)(yi)主(zhu)張工傷保險(xian)賠(pei)償。用人(ren)單位不能以(yi)(yi)職工已(yi)獲得人(ren)身意外傷害(hai)賠(pei)償為由(you)進行抗辯(bian),職工可以(yi)(yi)同時得到(dao)該兩種(zhong)賠(pei)償。