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(guo)家(jia)為(wei)了(le)保(bao)(bao)障職工(gong)(gong)(gong)合法(fa)權益而規定的強制性保(bao)(bao)險(xian),用(yong)人單位(wei)(wei)具有為(wei)其員工(gong)(gong)(gong)參加工(gong)(gong)(gong)傷(shang)保(bao)(bao)險(xian)并繳納保(bao)(bao)險(xian)費(fei)的法(fa)定義務(wu);根據大陸《工(gong)(gong)(gong)傷(shang)保(bao)(bao)險(xian)條(tiao)例》相關規定,應當參加工(gong)(gong)(gong)傷(shang)保(bao)(bao)險(xian)而未參加工(gong)(gong)(gong)傷(shang)保(bao)(bao)險(xian)的用(yong)人單位(wei)(wei)職工(gong)(gong)(gong)發生工(gong)(gong)(gong)傷(shang)的,由(you)該用(yong)人單位(wei)(wei)按照工(gong)(gong)(gong)傷(shang)保(bao)(bao)險(xian)條(tiao)例規定的工(gong)(gong)(gong)傷(shang)保(bao)(bao)險(xian)待遇專(zhuan)案和(he)標準(zhun)支付費(fei)用(yong)。
而商(shang)業保(bao)險(xian)具有(you)自愿(yuan)性,用(yong)人(ren)(ren)單(dan)位(wei)(wei)為其員(yuan)工(gong)購買商(shang)業保(bao)險(xian),一般(ban)認為屬于用(yong)人(ren)(ren)單(dan)位(wei)(wei)給予員(yuan)工(gong)的(de)福(fu)利待遇,并不能轉(zhuan)移用(yong)人(ren)(ren)單(dan)位(wei)(wei)承(cheng)擔的(de)工(gong)傷保(bao)險(xian)責任(ren)。用(yong)人(ren)(ren)單(dan)位(wei)(wei)如(ru)要想實現分散工(gong)傷風險(xian)的(de)目的(de),可(ke)在理賠(pei)時與(yu)勞動者達(da)成保(bao)險(xian)金(jin)權益(yi)轉(zhuan)讓(rang)協議,將(jiang)保(bao)險(xian)金(jin)權益(yi)轉(zhuan)讓(rang)給用(yong)人(ren)(ren)單(dan)位(wei)(wei)。或投保(bao)財產保(bao)險(xian)的(de)責任(ren)保(bao)險(xian)——雇主(zhu)責任(ren)險(xian)。雇主(zhu)責任(ren)險(xian)的(de)被保(bao)險(xian)標的(de)物為企業對雇員(yuan)在雇傭期間應(ying)承(cheng)擔的(de)法律賠(pei)償(chang)(chang)(chang)責任(ren),受(shou)益(yi)人(ren)(ren)是(shi)(shi)雇主(zhu),所以保(bao)險(xian)金(jin)是(shi)(shi)賠(pei)償(chang)(chang)(chang)給雇主(zhu),而且受(shou)法律和條款的(de)保(bao)護。因此(ci)轉(zhuan)移法律賠(pei)償(chang)(chang)(chang)責任(ren)應(ying)購買雇主(zhu)責任(ren)險(xian)。
二、工傷保險和商險能否兼得
工傷保(bao)(bao)(bao)險(xian)(xian)是社(she)會保(bao)(bao)(bao)險(xian)(xian)制度的(de)重要組成部分,是國家和(he)社(she)會為在生產、工作(zuo)中遭受事故傷害(hai)和(he)患職(zhi)業性疾病(bing)的(de)勞(lao)動者(zhe)及(ji)親屬提(ti)供(gong)醫(yi)療(liao)救治、生活保(bao)(bao)(bao)障(zhang)、經(jing)濟補償、醫(yi)療(liao)和(he)職(zhi)業康復等物質幫(bang)助的(de)一(yi)種社(she)會保(bao)(bao)(bao)障(zhang)制度。意外傷害(hai)險(xian)(xian)是指(zhi)人的(de)身體和(he)生命受到外來和(he)不可抗拒因素的(de)意外傷害(hai)后,根據投(tou)(tou)保(bao)(bao)(bao)對雙方合同的(de)約定和(he)投(tou)(tou)保(bao)(bao)(bao)額,從保(bao)(bao)(bao)險(xian)(xian)公司獲取相(xiang)應的(de)賠償,二者(zhe)并不相(xiang)同。
首先(xian),工傷(shang)(shang)保(bao)(bao)(bao)險(xian)是一種(zhong)政(zheng)府行(xing)為,而人(ren)身(shen)意外(wai)傷(shang)(shang)害(hai)險(xian)是一種(zhong)商業行(xing)為。工傷(shang)(shang)保(bao)(bao)(bao)險(xian)所(suo)提(ti)供的(de)(de)(de)保(bao)(bao)(bao)障水平一般僅滿足于(yu)(yu)被保(bao)(bao)(bao)險(xian)人(ren)的(de)(de)(de)基本生活需(xu)要(yao)(yao),高于(yu)(yu)社會貧困線,低于(yu)(yu)勞(lao)動期間的(de)(de)(de)工資(zi)標準;人(ren)身(shen)意外(wai)傷(shang)(shang)害(hai)險(xian)所(suo)提(ti)供的(de)(de)(de)保(bao)(bao)(bao)障水平的(de)(de)(de)高低完全取決保(bao)(bao)(bao)險(xian)雙(shuang)方(fang)當事人(ren)的(de)(de)(de)約定(ding)和投保(bao)(bao)(bao)人(ren)交費(fei)的(de)(de)(de)多(duo)(duo)少(shao)而決定(ding),投保(bao)(bao)(bao)人(ren)只要(yao)(yao)有繳費(fei)能(neng)力(li)、身(shen)體健康狀(zhuang)況符(fu)合(he)合(he)同規定(ding)的(de)(de)(de)要(yao)(yao)求(qiu),投保(bao)(bao)(bao)金額不論多(duo)(duo)少(shao)都是可以的(de)(de)(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(de)勞動和社(she)會保(bao)障部門(社(she)會保(bao)險(xian)(xian)(xian)機構)管理,具有強制(zhi)性,如果用人單(dan)位違(wei)反規(gui)定(ding)不為(wei)職工(gong)購買工(gong)傷(shang)保(bao)險(xian)(xian)(xian),將承擔一定(ding)的(de)社(she)會責(ze)任。依(yi)照《工(gong)傷(shang)保(bao)險(xian)(xian)(xian)條(tiao)例(li)》第六十二條(tiao)規(gui)定(ding),工(gong)傷(shang)保(bao)險(xian)(xian)(xian)具有社(she)會強制(zhi)性而(er)意外傷(shang)害(hai)保(bao)險(xian)(xian)(xian)則屬(shu)于(yu)商業保(bao)險(xian)(xian)(xian),其(qi)規(gui)范調整屬(shu)于(yu)商法部門,不具有強制(zhi)性,保(bao)險(xian)(xian)(xian)的(de)賠償(chang)金(jin)額可根據投(tou)保(bao)金(jin)額大小而(er)不同,體現締約自由性。
再(zai)次(ci),從繳費(fei)標準(zhun)看,工傷保(bao)(bao)(bao)(bao)險(xian)待(dai)遇是根據(ju)社會經濟發展水平和(he)(he)承受能力(li),由(you)政府制定(ding)統一的(de)(de)繳費(fei)標準(zhun)。在支付工傷保(bao)(bao)(bao)(bao)險(xian)待(dai)遇時(shi),要考慮工傷職(zhi)工和(he)(he)供養親屬的(de)(de)基本(ben)生活需要。人(ren)(ren)身(shen)意外傷害險(xian)的(de)(de)保(bao)(bao)(bao)(bao)險(xian)金額(e)(e)則是保(bao)(bao)(bao)(bao)險(xian)人(ren)(ren)和(he)(he)投保(bao)(bao)(bao)(bao)人(ren)(ren)雙方約定(ding)的(de)(de),當發生保(bao)(bao)(bao)(bao)險(xian)事故時(shi),保(bao)(bao)(bao)(bao)險(xian)人(ren)(ren)按合(he)同(tong)規定(ding)的(de)(de)金額(e)(e)一次(ci)性賠付保(bao)(bao)(bao)(bao)險(xian)金,其保(bao)(bao)(bao)(bao)障水平是依據(ju)合(he)同(tong)和(he)(he)投保(bao)(bao)(bao)(bao)人(ren)(ren)交納(na)的(de)(de)保(bao)(bao)(bao)(bao)險(xian)費(fei)多(duo)(duo)少(shao)而定(ding)的(de)(de),多(duo)(duo)投多(duo)(duo)保(bao)(bao)(bao)(bao),少(shao)投少(shao)保(bao)(bao)(bao)(bao),不投不保(bao)(bao)(bao)(bao)。
最后,從承擔責(ze)任(ren)的(de)主體(ti)看,建立工傷(shang)保(bao)(bao)(bao)險的(de)目的(de)是為了(le)分(fen)散用(yong)人(ren)(ren)單(dan)位承擔責(ze)任(ren)的(de)風險,調動社會力量以保(bao)(bao)(bao)證用(yong)人(ren)(ren)單(dan)位損(sun)失減少,因(yin)此,用(yong)人(ren)(ren)單(dan)位在(zai)繳納一定數額保(bao)(bao)(bao)險金(jin)后,最后由國家統一管(guan)理的(de)社會基(ji)金(jin)支付(fu)賠償(chang)金(jin)。而人(ren)(ren)身意(yi)外傷(shang)害保(bao)(bao)(bao)險其賠償(chang)是由保(bao)(bao)(bao)險公司(si)從收(shou)取的(de)保(bao)(bao)(bao)費中支付(fu)。
根據勞動(dong)和社(she)會保障(zhang)部(bu)辦公(gong)廳《關于參(can)(can)加(jia)(jia)(jia)商(shang)業保險(xian)中(zhong)的(de)(de)(de)(de)人身意(yi)外(wai)(wai)傷害(hai)險(xian)后是(shi)否(fou)(fou)還應當參(can)(can)加(jia)(jia)(jia)工(gong)傷保險(xian)問題的(de)(de)(de)(de)復函》的(de)(de)(de)(de)有關規定,工(gong)傷保險(xian)是(shi)社(she)會保險(xian)的(de)(de)(de)(de)一個(ge)重要(yao)組(zu)成部(bu)分,是(shi)國(guo)家強制(zhi)(zhi)實施的(de)(de)(de)(de)一項社(she)會保障(zhang)制(zhi)(zhi)度(du)。按照勞動(dong)法第七十(shi)二(er)條“用(yong)人單(dan)(dan)位(wei)(wei)和勞動(dong)者必須依法參(can)(can)加(jia)(jia)(jia)社(she)會保險(xian),繳(jiao)納(na)社(she)會保險(xian)費(fei)”的(de)(de)(de)(de)規定,中(zhong)國(guo)境內的(de)(de)(de)(de)企業無論是(shi)否(fou)(fou)參(can)(can)加(jia)(jia)(jia)了商(shang)業保險(xian)中(zhong)的(de)(de)(de)(de)人身意(yi)外(wai)(wai)傷害(hai)險(xian),都必須按照國(guo)家規定參(can)(can)加(jia)(jia)(jia)工(gong)傷保險(xian)。人身意(yi)外(wai)(wai)傷害(hai)險(xian)不能代替工(gong)傷保險(xian)。企業在參(can)(can)加(jia)(jia)(jia)工(gong)傷保險(xian)的(de)(de)(de)(de)同時,可(ke)以根據本(ben)單(dan)(dan)位(wei)(wei)的(de)(de)(de)(de)實際(ji)情況,為職工(gong)辦理人身意(yi)外(wai)(wai)傷害(hai)險(xian)。用(yong)人單(dan)(dan)位(wei)(wei)的(de)(de)(de)(de)投保行為純粹屬于給員工(gong)的(de)(de)(de)(de)額(e)外(wai)(wai)福利,無法起到替代工(gong)傷保險(xian)的(de)(de)(de)(de)功能。
綜上,職工在獲得(de)人(ren)身意外(wai)傷(shang)害險賠(pei)(pei)償后,仍可以主張工傷(shang)保(bao)險賠(pei)(pei)償。用人(ren)單位不能(neng)以職工已獲得(de)人(ren)身意外(wai)傷(shang)害賠(pei)(pei)償為由(you)進行抗(kang)辯,職工可以同時(shi)得(de)到該兩種(zhong)賠(pei)(pei)償。