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)(bao)(bao)障職(zhi)工(gong)(gong)合法權益而規(gui)定的強制性保(bao)(bao)(bao)險(xian)(xian),用(yong)(yong)人(ren)單(dan)位具有為其員工(gong)(gong)參加工(gong)(gong)傷(shang)(shang)保(bao)(bao)(bao)險(xian)(xian)并繳納保(bao)(bao)(bao)險(xian)(xian)費的法定義(yi)務(wu);根據(ju)大(da)陸(lu)《工(gong)(gong)傷(shang)(shang)保(bao)(bao)(bao)險(xian)(xian)條例》相(xiang)關規(gui)定,應當參加工(gong)(gong)傷(shang)(shang)保(bao)(bao)(bao)險(xian)(xian)而未參加工(gong)(gong)傷(shang)(shang)保(bao)(bao)(bao)險(xian)(xian)的用(yong)(yong)人(ren)單(dan)位職(zhi)工(gong)(gong)發生工(gong)(gong)傷(shang)(shang)的,由該用(yong)(yong)人(ren)單(dan)位按照工(gong)(gong)傷(shang)(shang)保(bao)(bao)(bao)險(xian)(xian)條例規(gui)定的工(gong)(gong)傷(shang)(shang)保(bao)(bao)(bao)險(xian)(xian)待(dai)遇專案和標準支付費用(yong)(yong)。
而商(shang)(shang)業(ye)保(bao)險(xian)(xian)(xian)(xian)具有自(zi)愿(yuan)性,用人(ren)單(dan)位(wei)(wei)為其員(yuan)(yuan)工(gong)(gong)購買(mai)商(shang)(shang)業(ye)保(bao)險(xian)(xian)(xian)(xian),一般認為屬于用人(ren)單(dan)位(wei)(wei)給予員(yuan)(yuan)工(gong)(gong)的(de)(de)(de)福利待遇,并不能轉(zhuan)(zhuan)移用人(ren)單(dan)位(wei)(wei)承(cheng)擔(dan)的(de)(de)(de)工(gong)(gong)傷保(bao)險(xian)(xian)(xian)(xian)責(ze)任(ren)(ren)。用人(ren)單(dan)位(wei)(wei)如要想實現分散工(gong)(gong)傷風(feng)險(xian)(xian)(xian)(xian)的(de)(de)(de)目(mu)的(de)(de)(de),可在理賠(pei)時與勞動(dong)者(zhe)達成保(bao)險(xian)(xian)(xian)(xian)金權(quan)(quan)益轉(zhuan)(zhuan)讓協(xie)議,將保(bao)險(xian)(xian)(xian)(xian)金權(quan)(quan)益轉(zhuan)(zhuan)讓給用人(ren)單(dan)位(wei)(wei)。或投保(bao)財產保(bao)險(xian)(xian)(xian)(xian)的(de)(de)(de)責(ze)任(ren)(ren)保(bao)險(xian)(xian)(xian)(xian)——雇(gu)主責(ze)任(ren)(ren)險(xian)(xian)(xian)(xian)。雇(gu)主責(ze)任(ren)(ren)險(xian)(xian)(xian)(xian)的(de)(de)(de)被保(bao)險(xian)(xian)(xian)(xian)標的(de)(de)(de)物為企業(ye)對雇(gu)員(yuan)(yuan)在雇(gu)傭期間應承(cheng)擔(dan)的(de)(de)(de)法律賠(pei)償責(ze)任(ren)(ren),受益人(ren)是雇(gu)主,所以(yi)保(bao)險(xian)(xian)(xian)(xian)金是賠(pei)償給雇(gu)主,而且受法律和條(tiao)款的(de)(de)(de)保(bao)護。因此轉(zhuan)(zhuan)移法律賠(pei)償責(ze)任(ren)(ren)應購買(mai)雇(gu)主責(ze)任(ren)(ren)險(xian)(xian)(xian)(xian)。
二、工傷保險和商險能否兼得
工傷(shang)保(bao)(bao)險是(shi)社會保(bao)(bao)險制度(du)的重要組(zu)成部(bu)分(fen),是(shi)國(guo)家和(he)社會為(wei)在生(sheng)產、工作中(zhong)遭受(shou)事故傷(shang)害和(he)患職業(ye)性疾(ji)病的勞動者(zhe)及親屬提供(gong)醫療救治、生(sheng)活保(bao)(bao)障、經濟補償、醫療和(he)職業(ye)康(kang)復等物質(zhi)幫助的一種社會保(bao)(bao)障制度(du)。意(yi)外(wai)(wai)傷(shang)害險是(shi)指人的身體和(he)生(sheng)命受(shou)到外(wai)(wai)來(lai)和(he)不可抗拒因素的意(yi)外(wai)(wai)傷(shang)害后,根(gen)據投(tou)保(bao)(bao)對雙方合同(tong)的約定和(he)投(tou)保(bao)(bao)額(e),從保(bao)(bao)險公司(si)獲(huo)取相(xiang)(xiang)應的賠償,二者(zhe)并不相(xiang)(xiang)同(tong)。
首先,工(gong)傷(shang)(shang)保(bao)(bao)險(xian)是一(yi)種政府行為(wei),而(er)人(ren)(ren)身意外傷(shang)(shang)害險(xian)是一(yi)種商業行為(wei)。工(gong)傷(shang)(shang)保(bao)(bao)險(xian)所提(ti)供的(de)(de)(de)保(bao)(bao)障水平一(yi)般僅滿足于被保(bao)(bao)險(xian)人(ren)(ren)的(de)(de)(de)基(ji)本生活(huo)需要(yao),高于社會貧困線,低(di)于勞動期間的(de)(de)(de)工(gong)資(zi)標準(zhun);人(ren)(ren)身意外傷(shang)(shang)害險(xian)所提(ti)供的(de)(de)(de)保(bao)(bao)障水平的(de)(de)(de)高低(di)完全取決保(bao)(bao)險(xian)雙方當(dang)事人(ren)(ren)的(de)(de)(de)約定(ding)(ding)和投(tou)保(bao)(bao)人(ren)(ren)交費的(de)(de)(de)多(duo)少而(er)決定(ding)(ding),投(tou)保(bao)(bao)人(ren)(ren)只要(yao)有(you)繳費能力、身體健康(kang)狀況符合合同(tong)規(gui)定(ding)(ding)的(de)(de)(de)要(yao)求(qiu),投(tou)保(bao)(bao)金(jin)額不論多(duo)少都是可(ke)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(zheng)府的(de)勞動和社(she)會(hui)保(bao)障部門(社(she)會(hui)保(bao)險(xian)(xian)(xian)機構)管理,具有(you)強(qiang)制(zhi)(zhi)性(xing),如(ru)果用(yong)人(ren)單(dan)位違反規(gui)定(ding)不(bu)(bu)為職(zhi)工(gong)(gong)購買工(gong)(gong)傷保(bao)險(xian)(xian)(xian),將承擔一定(ding)的(de)社(she)會(hui)責任。依照《工(gong)(gong)傷保(bao)險(xian)(xian)(xian)條(tiao)例(li)》第六十二條(tiao)規(gui)定(ding),工(gong)(gong)傷保(bao)險(xian)(xian)(xian)具有(you)社(she)會(hui)強(qiang)制(zhi)(zhi)性(xing)而意外傷害(hai)保(bao)險(xian)(xian)(xian)則屬于商業保(bao)險(xian)(xian)(xian),其規(gui)范(fan)調整屬于商法部門,不(bu)(bu)具有(you)強(qiang)制(zhi)(zhi)性(xing),保(bao)險(xian)(xian)(xian)的(de)賠償金額可根據投保(bao)金額大小而不(bu)(bu)同,體現締約自(zi)由性(xing)。
再次,從(cong)繳(jiao)費(fei)標(biao)準(zhun)看,工傷(shang)保(bao)(bao)(bao)(bao)險(xian)(xian)待(dai)遇是(shi)根(gen)據(ju)社(she)會經濟發(fa)展水平和(he)承受能力,由(you)政(zheng)府制定(ding)統(tong)一的(de)(de)繳(jiao)費(fei)標(biao)準(zhun)。在支付工傷(shang)保(bao)(bao)(bao)(bao)險(xian)(xian)待(dai)遇時(shi),要考慮工傷(shang)職工和(he)供養親屬的(de)(de)基(ji)本生(sheng)(sheng)活需要。人(ren)身意外傷(shang)害險(xian)(xian)的(de)(de)保(bao)(bao)(bao)(bao)險(xian)(xian)金額則是(shi)保(bao)(bao)(bao)(bao)險(xian)(xian)人(ren)和(he)投(tou)保(bao)(bao)(bao)(bao)人(ren)雙(shuang)方(fang)約定(ding)的(de)(de),當發(fa)生(sheng)(sheng)保(bao)(bao)(bao)(bao)險(xian)(xian)事故時(shi),保(bao)(bao)(bao)(bao)險(xian)(xian)人(ren)按合同(tong)(tong)規定(ding)的(de)(de)金額一次性賠付保(bao)(bao)(bao)(bao)險(xian)(xian)金,其保(bao)(bao)(bao)(bao)障水平是(shi)依據(ju)合同(tong)(tong)和(he)投(tou)保(bao)(bao)(bao)(bao)人(ren)交納的(de)(de)保(bao)(bao)(bao)(bao)險(xian)(xian)費(fei)多(duo)少而(er)定(ding)的(de)(de),多(duo)投(tou)多(duo)保(bao)(bao)(bao)(bao),少投(tou)少保(bao)(bao)(bao)(bao),不(bu)(bu)投(tou)不(bu)(bu)保(bao)(bao)(bao)(bao)。
最(zui)后(hou),從承(cheng)擔責任的(de)主體看,建立工傷保險(xian)的(de)目的(de)是(shi)(shi)為了(le)分(fen)散用(yong)人(ren)單位承(cheng)擔責任的(de)風(feng)險(xian),調動社(she)會力量以保證(zheng)用(yong)人(ren)單位損(sun)失減少(shao),因此,用(yong)人(ren)單位在繳納一定數額保險(xian)金(jin)后(hou),最(zui)后(hou)由(you)國家統一管理的(de)社(she)會基金(jin)支(zhi)付賠償金(jin)。而人(ren)身意外傷害保險(xian)其賠償是(shi)(shi)由(you)保險(xian)公司(si)從收取(qu)的(de)保費中支(zhi)付。
根據(ju)勞(lao)動和社會保(bao)障(zhang)部辦公廳《關于(yu)參(can)(can)加(jia)(jia)(jia)商(shang)業(ye)保(bao)險(xian)中的(de)(de)人(ren)身(shen)(shen)意外(wai)傷(shang)害(hai)(hai)險(xian)后是(shi)否還(huan)應(ying)當參(can)(can)加(jia)(jia)(jia)工(gong)(gong)(gong)傷(shang)保(bao)險(xian)問題的(de)(de)復函(han)》的(de)(de)有關規(gui)定(ding),工(gong)(gong)(gong)傷(shang)保(bao)險(xian)是(shi)社會保(bao)險(xian)的(de)(de)一個重要組成部分,是(shi)國(guo)家強制實施(shi)的(de)(de)一項社會保(bao)障(zhang)制度。按(an)照勞(lao)動法(fa)第七(qi)十二條(tiao)“用人(ren)單(dan)位和勞(lao)動者必須依法(fa)參(can)(can)加(jia)(jia)(jia)社會保(bao)險(xian),繳納社會保(bao)險(xian)費”的(de)(de)規(gui)定(ding),中國(guo)境內的(de)(de)企(qi)業(ye)無論是(shi)否參(can)(can)加(jia)(jia)(jia)了商(shang)業(ye)保(bao)險(xian)中的(de)(de)人(ren)身(shen)(shen)意外(wai)傷(shang)害(hai)(hai)險(xian),都必須按(an)照國(guo)家規(gui)定(ding)參(can)(can)加(jia)(jia)(jia)工(gong)(gong)(gong)傷(shang)保(bao)險(xian)。人(ren)身(shen)(shen)意外(wai)傷(shang)害(hai)(hai)險(xian)不(bu)能代(dai)替工(gong)(gong)(gong)傷(shang)保(bao)險(xian)。企(qi)業(ye)在參(can)(can)加(jia)(jia)(jia)工(gong)(gong)(gong)傷(shang)保(bao)險(xian)的(de)(de)同時,可以根據(ju)本(ben)單(dan)位的(de)(de)實際情況(kuang),為職工(gong)(gong)(gong)辦理(li)人(ren)身(shen)(shen)意外(wai)傷(shang)害(hai)(hai)險(xian)。用人(ren)單(dan)位的(de)(de)投保(bao)行(xing)為純(chun)粹屬于(yu)給員工(gong)(gong)(gong)的(de)(de)額外(wai)福利,無法(fa)起到替代(dai)工(gong)(gong)(gong)傷(shang)保(bao)險(xian)的(de)(de)功能。
綜上,職工(gong)(gong)(gong)在獲得(de)(de)人身(shen)意外傷(shang)害險(xian)賠(pei)償(chang)后,仍可以(yi)(yi)主張工(gong)(gong)(gong)傷(shang)保(bao)險(xian)賠(pei)償(chang)。用人單(dan)位不能以(yi)(yi)職工(gong)(gong)(gong)已(yi)獲得(de)(de)人身(shen)意外傷(shang)害賠(pei)償(chang)為由進行抗辯(bian),職工(gong)(gong)(gong)可以(yi)(yi)同時得(de)(de)到該(gai)兩種(zhong)賠(pei)償(chang)。