摘要
强制性是工伤保险作为社会保险和责任保险的内在要求,是贯穿整个工伤保险制度的一项基本原则。我国工伤医疗待遇的给付应当始终在强制性原则的要求下展开,既要强制用人单位参保,又要强制保护被保险人。然而,目前相关法规和实践中对工伤医疗待遇给付的规定实则违背了强制性原则,主要表现为以工伤发生之日作为开始给付的时间点较为模糊、以缴纳保费作为给付条件不合理、超出给付范围的合理医疗费用分担主体不明确等问题。基于此,有必要从总结我国工伤医疗待遇给付问题的现状入手,分析其对工伤保险强制性原则的偏离,并进一步指出强制性要求下工伤医疗待遇给付的应然状态,即明确工伤保险关系建立的时间点和工伤医疗待遇开始给付的时间点、不以缴纳保费作为工伤医疗待遇给付的条件及治疗工伤所需的合理必要的自费医疗费用由用人单位承担。
Compulsory is an inherent requirement of industrial injury insurance as social insurance and liability insurance,and it is a basic principle throughout the entire industrial injury insurance system.The payment of medical treatment for work-related injuries in our country should always be carried out under the requirements of the mandatory principle.It is necessary to compel the employer to participate in the insurance and to compulsorily protect the insured.However,the current regulations and practices regarding the payment of work-related injury medical benefits actually violate the mandatory principle.The main manifestation is that the date of the work-related injury occurs as the time point for the start of payment is rather vague,and the payment of insurance premiums as a payment condition is unreasonable and exceeds the scope of payment.Problems such as the unclear subject of reasonable medical expenses sharing.Based on this,it is necessary to start by summarizing the status quo of work-related injury medical benefits in my country,analyze its deviation from the compulsory principles of work-related injury insurance,and further point out the expected status of work-related injury medical benefits under compulsory requirements,that is,to clarify the establishment of work-related injury insurance relationships.The employer shall bear the reasonable and necessary self-financed medical expenses required for the treatment of work-related injuries as well as the conditions for non-payment of insurance premiums as the payment of the work-related injury medical benefits and the time when the work-related injury medical benefits start to be paid.
出处
《光华法学》
2021年第1期158-172,共15页
Guanghua Law Review
关键词
工伤医疗待遇给付
强制性
给付开始的时间
给付条件
给付范围
Work Injury Medical Treatment Benefits
Compulsory
Payment Start Time
Payment Conditions
Payment Scope
