The delivery rider is injured during delivery, and both occupational injury protection and commercial accident insurance can be 'double compensated'!
2024-11-07
Some new forms of employment workers have both occupational injury protection and commercial accident insurance, and under this premise, they have the right to receive dual protection when they suffer occupational injuries. This is the verdict of a case recently released by the Guangzhou Intermediate People's Court. Wu is a delivery platform rider, and the delivery platform site purchased crowdsourced rider accident insurance from a certain insurance company for Wu. Wu pays a 2.5 yuan insurance premium every day when receiving orders. The scope of insurance liability stipulated in the insurance policy involved in the case includes accidental injury insurance liability, with an insurance amount of 600000 yuan; Accidental medical insurance liability, insurance amount of 50000 yuan, etc. In addition, the insurance policy also stipulates that if the insured meets the occupational injury situation stipulated in the "Measures for the Protection of Occupational Injuries to New Forms of Employment", the insurance company shall not be liable for insurance. During the insurance period, Wu was unfortunately injured in a traffic accident while delivering food, and was assessed as a level 8 disability. After the accident, the social security department approved the occupational injury protection and disability benefits for Wu and issued a one-time disability subsidy of 84000 yuan. Later, Wu applied to the insurance company for compensation of over 180000 yuan, including accidental disability insurance and accidental medical insurance. The insurance company refused to compensate Wu on the grounds that he meets the occupational injury situation stipulated in the "Measures for Occupational Injury Protection of New Forms of Employment" and has obtained occupational injury protection benefits for new forms of employment from the social security department, and meets the deductible conditions stipulated in the policy. Wu then sued the insurance company to the court. The Guangzhou Intermediate People's Court ruled in the second instance that the insurance company paid a total of over 180000 yuan in insurance benefits to Mr. Wu in accordance with the insurance contract. The judge of Guangzhou Intermediate People's Court stated that in this case, Wu's receipt of occupational injury protection benefits from the social security department cannot be a reason for the insurance company to exempt itself from insurance liability. Firstly, both parties agree that "Wu shall be exempt from compensation in the event of an accident that meets the requirements of occupational injury in the new employment form". According to Article 17 (2) of the Insurance Law of the People's Republic of China, the insurance company shall provide notice and clear explanation to Wu regarding the aforementioned insurance exemption clauses. However, the insurance company has not provided sufficient evidence to prove that it has fulfilled its corresponding obligations, and the corresponding exemption clauses have no legal effect on Wu. Secondly, the exemption clause in the case regards obtaining occupational injury protection from the human resources and social security department as a situation of exempting oneself from compensation responsibility, which improperly excludes the legitimate rights of workers in new forms of employment, violates the principle of fairness, and does not conform to the original design intention of the occupational injury protection system in new forms of employment. The purpose of the national pilot program for occupational injury protection for new forms of employment is to broaden the scope of protection for this group of workers, allowing them to receive corresponding economic compensation when they suffer occupational injuries, reducing the economic pressure on practitioners, and enhancing their ability to resist occupational injury risks. The judge reminds that there is no conflict between occupational injury protection and commercial insurance. Workers in new forms of employment who suffer from occupational injuries have the right to apply for occupational injury protection benefits, as well as the right to claim accidental injury insurance compensation based on the commercial insurance they have purchased. (New Society)
Edit:Rina Responsible editor:Lily
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