Page 25 - BLI-Brief Introduction

Chapter Two - Profile of Labor Insurance and Labor Protection Programs

3. Insurance Benefits insured salary during the 6 months before the
The Labor Occupational Accident Insurance and month during which the insured person suffers
Protection Act provides five benefits including the insured incident. If the period is less than
medical care benefits, injury or sickness benefits, 6 months, it shall be calculated based on the
permanent disability benefits, survivor benefits, and average monthly insured salary during the actual
disappearance benefits. In addition to increasing the period of the insurance.
level of benefits and adding benefit items, workers 2. Insurance benefits paid on a daily basis shall be
may still apply for benefits related to occupational based on the average monthly insured salary,
accidents if the employers who are mandated to divided by 30.
join the insurance fail to include the workers in the 3. In the event of an accident, yet an employer
insurance plan.
who is mandatory enrollment unit has failed to
[Qualification] include the employee in the insurance plan, the
Article 27 of Labor Occupational Accident Insurance monthly insured salary of the employee for the
and Protection Act: period that fails to meet the requirement shall

1. When the insured person suffers occupational be determined by the corresponding level in the
injury or occupational disease (hereinafter insured salary category chart. However, the level
referred to as “occupational injury or disease”) shall not be higher than the corresponding rating
and incurs an insured medical, injury or sickness, of the recent annual average monthly insured
permanent disability, death or disappearance salary of the overall insured persons announced
incident after the insurance coverage starts by the BLI. If the insured unit or the insured
and before it ends, the insured person, the person fails to provide relevant salary information
beneficiary or the funeral cost payer may seek for the BLI to review, the insured salary shall be
insurance benefit in accordance with the Act. calculated based on the first level of the insured
salary category chart.
2. When an insured person suffers occupational
injury or disease during the existence of the (1)Medical Care Benefits
insurance coverage, he/she may seek medical 1. In the event of an occupational injury/
care benefits, injury or sickness benefits, disease, the insured person may be
permanent disability benefits or survivor benefits exempted from the co-payment required by
for the same injury or sickness and the disease the national health insurance when being
caused by the injury or sickness within one year treated in a national health insurance
from the day following the end of coverage.
designated hospital or clinic, and the insured
[Calculation of cash benefits payment] person is also entitled to a 30-day subsidy
The benefits payment which is issued by cash is for food expenses when hospitalized for
calculated pursuant to the insured person’s average occupational injury/ disease.
monthly insured salary and benefit payment 2. If an insured person’s disease caused by
standards. The average monthly insured salary is an occupational injury/disease is deemed
calculated below:
by a doctor at an NHI-designated hospital
1. The average monthly insured salary shall be or clinic to require medication that involves
based on the average of the actual monthly usage of partially covered special materials

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