Question from Nguyen Quang Vinh (Quang Ninh province) and others: If an employee has an accident outside the workplace and he/she has accident insurance (commercial insurance), who is obliged to cover his/her expenses, compensation and other benefits? If he/she does not have social insurance or health insurance, who is obliged to cover those payments?
The answer to your question is provided in Article 5 of Circular No. 04/2015/TT-BLDTBXH, dated February 2, 2015, that guides compensation, benefits and medical expenses paid to employees as victims of occupational accidents and diseases. The circular took effect on March 20, 2015.
It stipulates as follows:
1. If employees meet with accidents caused by others while on duty or complying with the employer’s legitimate work assignment outside of the domain of agencies, enterprises, organizations and cooperatives or without any clear cause identified, employers shall compensate the employees according to the provisions set out in Article 3 hereof.
2. If employees have accidents caused by others while travelling on a regular route between their working place and home at a legitimate time, or without any clear cause for the accident identified, employers shall pay benefits to such employees according to the provisions set out in Article 4 hereof.
3. In case an employee is covered by an accident insurance bought by employer, the employee shall be entitled to compensation and benefits under the contract signed with the insurer for an accident at work. If the sum of money paid by the insurer to the victim is lower than the limit as laid down in Articles 3, 4 hereof, the employer shall pay at least the remainder of the total amount as compensation or benefits that the victim (or relatives) are entitled to according to the provisions set out in Articles 3, 4 hereof.
4. If an employer fails to pay social insurance contribution for an employee who is a policy-holder under the Law on Social Insurance, in addition to the compensation and benefits as defined in Articles 3, 4 hereof, employers in the place of the insurer must pay social benefits to the insured employees who have occupational accidents or diseases as follows:
a) For employees losing work capability from 5 percent to 30 percent, employers shall make a lump sum payment equal to the limit as defined by the Law on Social Insurance;
b) For employees losing work capability from 31 percent and over, employers shall make monthly payments as equal to the limit as defined by the Law on Social Insurance. Payment may be made once or on a monthly basis depending on an agreement between the parties.
Sickness
Work Injury and Occupational Disease
Survivor’s
Old-age
Maternity
Unemployment
Medical (Health Insurance)
Certificate of coverage
VSS - ISSA Guidelines on Social Security