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龙岩市工伤保险绿荫工程项目可行性研究报告DOC

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《中华人民共和国社会保险法》(以下简称《社会保险法》)在经过改革开 放以来近 40 年的经济社会发展大环境要求下,于 2010 年 10 月终于出台。这是 随着经济社会深入发展的需要,补足了我们国家社会主义法律系统中社会保障 领域立法确实的短板。在深圳等发达地区首先试经验基础上,《社会保险法》确 立了工伤保险基金先行支付制度的基本,有力地填补了国务院《工伤保险条例》 中规章制度的不足之处,这一社会救济方式的保障功能得到了有效的加强。我 们知道,在现实生活中,存在大量雇主没有依法为雇员缴纳工伤保险费,也有 太多工伤是由第三人侵权而引起,面对这两种情况,甚至两种情况都出现时, 往往工伤职工获得权益保护的过程漫长且不一定能实现权利主张。而《社会保 险法》的出台,无疑是给这类职工的正当合法权益保护带来了保障,由社会保 险经办机构现行支付,而后由社会保险经办机构这一公权力机关进行追偿,既 保障了工伤职工的权益,又让用人单位或侵权第三人的义务无法逃避。 根据《社会保险法》第 41 条、第 42 条的规定,从法律行为的角度来看, 工伤保险基金先行支付制度就是指用人单位未依法为职工缴纳工伤保险而发生 工伤保险事故,或工伤保险事故是由第三人侵权所致,这两种情况下,雇佣单 位或第三人拒绝执行法律规定的各项待遇和费用时,由基金先行垫付赔偿,然 后由国家再以公权力介入向雇佣单位、第三人追偿。这种制度体现了对工伤职 工基本权益的保护,符合现代法治国家公平正义和人道主义社会公共道德的明 显特征。 但是,这种出于保护弱者利益的法律制度却没有得到有效落实。全国只有 少数地方实行了工伤保险基金先行支付制度,从福建省来看,也只有厦门地区 具体地将这种制度真正实施起来,其他八地市均没有执行。事实上,当今社会 往往对工伤保险基金先行支付的需求正在不断增大,龙岩地区作为工业建筑企 业多的发展中新兴城市,对工伤保险基金先行支付的需求也更为迫切。因此, 笔者结合龙岩地区的实际和工伤保险基金先行支付制度的漏洞,提出在龙岩市 社会保险中有关工伤保险领域实施绿荫工程项目的想法,力图对龙岩市社会保 障事业中的重要一环节之工伤保险基金先行支付制度的真正执行的推动进行探 索尝试。本文即是这一想法的成果,希望对理论研究或项目实施都能起到一些II 有利作用。 关键字:工伤保险 绿荫工程项目 基金运行 可行性III Abstract The law of the People's Republic of China social insurance law (hereinafter referred to as the social insurance law ) conform to the needs of social reality, play the social security function of social security law, in the form of law to establish the fund of inductrial injury insurance ahead of the payment system, which enhanced the relief function of work-related injury insurance in our country, complements our existing industrial injury insurance law. In practice, there are a large number of non insured workers, when they encounter an accident, it is to the employer or third people request compensation process long and hard. Social insurance law provisions of the uninsured workers and due to the third person tort caused by the injured worker apply for work-related injury fund advance payment related to the treatment of the right, given the social security agencies after the advance payment of the right of recourse against the. Industrial injury insurance fund to pay the first payment system simplifies the procedures and the difficulty of workers seeking relief workers, reflecting the concept of social justice and distributive justice, and enhance the mandatory work injury insurance. According to the provisions of Article 41 and 42 of the social insurance law, and the advance payment of the work injury insurance fund is refers to in industrial accidents, because the employer party not in accordance with the law for the worker pay work-related injury insurance premiums, inductrial injury worker cannot lawfully obtained treatment of inductrial injury insurance, unit of choose and employ persons and not in accordance with the law of workers compensation, or infringement of the third party are not carried out according to the civil compensation, by inductrial injury insurance fund advance payment of compensation, the social insurance agencies to recover from the employer or third party. This system embodies the protection of the basic rights and interests of workers, in line with the modern rule of law in the state of justice and the obvious characteristics of humane social public morality. However, this system has not been effectively implemented for the protection of the interests of the weak legal system. Only a few places in the country to implementIV the work injury insurance fund first payment system, from the perspective of Fujian Province, but only the Xiamen area specifically this system landing, and the rest of the city are not implemented. Actually, society of industrial injury insurance fund payment in advance of demand is increasing, Longyan area as industrial construction enterprises in the development of new city, demand of fund of inductrial injury insurance payment in advance is more and more urgent. Therefore, the author combined with the actual and industrial injury insurance fund in Longyan, the first payment system vulnerability, put forward in Longyan City, the implementation of the first payment of work-related injury insurance fund ideas. This paper is the result of this idea, and hope to have some beneficial effects on the theoretical research and project implementation. Keywords: Employment injury insurance Project shade Fund operation FeasibilityV 目 录 第 1 章 引言...............................................................................................................1 1.1 问题的提出 .................................................................................................................... 1 1.2 背景及意义 .................................................................................................................... 2 1.3 文献综述......................................................................................................................... 2 1.4 研究方法及本文结构 .................................................................................................. 2 第 2 章 龙岩市工伤保险绿荫工程项目概况...........................................................5 2.1 项目简介......................................................................................................................... 5 2.2 项目运行阶段................................................................................................................ 5 2.2.1 项目探索期 ................................................................................................5 2.2.2 项目磨合期 ................................................................................................5 2.2.3 项目成熟期 ................................................................................................5 2.3 项目依据......................................................................................................................... 6 2.4 项目范围......................................................................................................................... 6 2.4.1 项目地域范围 ............................................................................................6 2.4.2 项目实施对象 ............................................................................................6 2.5 预期效益......................................................................................................................... 8 2.5.1 有利于维护市场经济秩序 ........................................................................8 2.5.2 促进社会公平正义价值实现 ....................................................................8 2.5.3 可以解决劳动保障领域的顽疾 ................................................................8 第 3 章 龙岩市实施工伤保险绿荫工程项目的可行性分析...................................9 3.1 项目运行环境................................................................................................................ 9 3.1.1 龙岩市工伤保险绿荫工程实施环境指标 ...................................................9 3.1.2 龙岩市近四年来工伤保险主要数据情况 ..............................................10 3.2 龙岩市实施工伤保险绿荫工程项目的可行性分析 ..........................................11 3.2.1 绿荫工程项目社会需求分析 ..................................................................12 3.2.2 工伤保险基金尚处在风险可控范围内 ..................................................13 3.2.3 绿荫工程项目实施具有法律和经验基础 ..............................................17 3.2.4 绿荫工程项目实施具有体制优势 ..........................................................18VI 第 4 章 龙岩市工伤保险绿荫工程项目运行方案.................................................20 4.1 项目组织管理.............................................................................................................. 20 4.1.1 项目组织体系 ..........................................................................................20 4.1.2 项目人员配置 ..........................................................................................21 4.1.3 项目硬件软件条件 ..................................................................................21 4.2 项目运行流程.............................................................................................................. 22 4.2.1 职工申请 ....................................................................................................23 4.2.2 受理审查 ....................................................................................................24 4.2.3 公告公示 ....................................................................................................24 4.2.4 先行拨付 ....................................................................................................24 4.2.5 基金追偿 ....................................................................................................25 4.3 项目风险控制................................................................................................................ 26 4.3.1 加强工伤保险基金运行 ............................................................................26 4.3.2 加大先行支付前的督促 ............................................................................27 4.3.3 加大先付基金追偿力度 ............................................................................28 第 5 章 龙岩市工伤保险绿荫工程项目保障措施.................................................29 5.1 明确法律法规中未明确的几个问题 ....................................................................... 29 5.1.1 明确项目支付前置条件 ............................................................................29 5.1.2 明确项目支付支付范围 ............................................................................30 5.1.3 进一步明确用人单位或第三人不支付举证责任 ....................................30 5.2 需要建立健全三种机制 ........................................................................................... 31 5.2.1 建立常态化宣传机制 ................................................................................31 5.2.2 建立待遇支付信息互通机制 ....................................................................32 5.2.3 建立有效的人员队伍管理机制 ................................................................34 5.3 行政及司法强制追偿措施保障 ................................................................................ 35 第 6 章 结论.............................................................................................................36 6.1 结论................................................................................................................................ 36 6.2 建议................................................................................................................................ 37