0 00:00:04.898 --> 00:00:08.614 Let's take a look at the procedures and precautions for handling industrial accident compensation insurance 1 00:00:09.014 --> 00:00:15.065 First of all, in the event of an industrial accident, workers apply for industrial compensation to the Korea Workers' Compensation and Welfare Service 2 00:00:15.258 --> 00:00:18.341 which decides whether to pay medical care benefits 3 00:00:18.446 --> 00:00:21.823 and notifies whether to approve medical care 4 00:00:26.278 --> 00:00:27.887 Let's take a closer look 5 00:00:27.911 --> 00:00:31.195 First of all, an industrial accident should happen to the worker 6 00:00:31.530 --> 00:00:34.130 Emergency measures must be taken and if more than four days of medical care is needed for healing 7 00:00:34.418 --> 00:00:39.477 after medical treatment at the hospital, you can apply for industrial accident 8 00:00:41.178 --> 00:00:47.795 After that, workers submit an application for initial medical care benefits and a doctor's opinion to the Korea Workers' Compensation and Welfare Service 9 00:00:48.156 --> 00:00:52.648 At this time, initial medical care benefits application and doctor's note, and if it is necessary to know the accident 10 00:00:52.802 --> 00:00:57.512 in detail, a statement of reason, the worker's ID 11 00:00:57.666 --> 00:00:59.862 and the supporting data must be submitted 12 00:01:00.215 --> 00:01:04.268 At this time, the accident situation should be described in detail following the 5W1H rule 13 00:01:04.944 --> 00:01:11.349 In general, a medical institution requires an electronic document to fill out the initial medical care benefit application 14 00:01:11.589 --> 00:01:16.985 and the medical institution prepares and submits a medical care benefit application form 15 00:01:18.962 --> 00:01:22.799 Next, the corporation decides whether or not to pay medical care benefits 16 00:01:23.011 --> 00:01:26.882 At this time, in the case of occupational accidents, it is under the jurisdiction of the Industrial Complex Governor's Rehabilitation Insurance Department 17 00:01:27.211 --> 00:01:31.928 and in the case of occupational diseases, it is under the Occupational Disease Judging Committee 18 00:01:32.410 --> 00:01:37.778 Relatively, in the case of occupational diseases, it takes a long time to determine whether there is an industrial accident 19 00:01:38.696 --> 00:01:43.838 Whether or not to pay medical care benefits is determined by checking whether the workplace and worker is covered for industrial accidents 20 00:01:43.862 --> 00:01:47.020 and whether it is an accident due to work reasons 21 00:01:48.147 --> 00:01:49.540 Let's take a closer look 22 00:01:49.796 --> 00:01:54.919 Industrial accident application workplaces are all businesses or workplaces that employ workers 23 00:01:55.150 --> 00:02:01.786 and here, it should be kept in mind that the Industrial Accident Act applies to illegal foreign workers as well 24 00:02:02.265 --> 00:02:08.893 Businesses excluded from the application are those that are compensated for disasters under the Public Officials Accident Compensation Act 25 00:02:09.176 --> 00:02:16.299 he Military Accident Compensation Act, the Seafarers Act, the Fishermen and Fishing Boat Accident Compensation Insurance Act 26 00:02:16.431 --> 00:02:24.196 or the Private School Teachers Pension Act, and business of non-corporate persons with less than 5 full time workers 27 00:02:24.295 --> 00:02:30.239 among employment activities within the family, agriculture, forestry, fishing and hunting 28 00:02:32.124 --> 00:02:34.294 Next, we check whether they are workers or not 29 00:02:34.423 --> 00:02:38.107 Here, the term "worker" means a "worker" under the Labor Standards Act 30 00:02:38.272 --> 00:02:42.532 and under the Labor Standards Act, the term "worker" means a person who provides work 31 00:02:42.694 --> 00:02:48.899 to a business or workplace for the purpose of wages, regardless of the type of occupation 32 00:02:49.742 --> 00:02:52.167 Let's look at the requirements for recognizing worker nature 33 00:02:52.322 --> 00:02:57.302 First of all, since it is not related to the type of job, contract workers, daily workers 34 00:02:57.456 --> 00:02:59.824 and short-time workers are also included 35 00:03:00.014 --> 00:03:04.925 And the purpose must be wages, that is, they must be paid in exchange for labor 36 00:03:05.272 --> 00:03:08.506 and the person who provides work in the business/workplace 37 00:03:08.619 --> 00:03:13.795 that is, they must be in a "subordinate relationship of use" under the labor contract 38 00:03:14.654 --> 00:03:18.121 In sum, it refers to a person who receives a command from a business owner 39 00:03:18.221 --> 00:03:22.813 and provides labor under a de facto subordinate relationship 40 00:03:23.122 --> 00:03:26.283 In other words, it is protecting workers who have suffered 41 00:03:26.437 --> 00:03:29.985 occupational accidents while under "business owner control" 42 00:03:32.949 --> 00:03:36.576 According to precedents, the worker nature shall be determined by the employer 43 00:03:36.600 --> 00:03:39.859 subject to employment rules or service regulations 44 00:03:40.027 --> 00:03:44.108 and shall be determined by combining various economic and social conditions 45 00:03:44.345 --> 00:03:49.636 such as whether the employer conducts considerable command and supervision in the course of performing the workers' duties 46 00:03:49.909 --> 00:03:55.261 whether the employer designates the working hours and places and whether the worker is bound by it 47 00:03:55.349 --> 00:03:58.177 whether the labor provider can independently conduct the business on his/her own 48 00:03:58.315 --> 00:04:01.620 such as owning equipment, raw materials, work tools 49 00:04:01.873 --> 00:04:07.576 or hiring a third party to act on behalf of the business 50 00:04:07.821 --> 00:04:14.975 whether he/she carries risks such as generating profits and causing losses through the provision of labor themselves 51 00:04:15.300 --> 00:04:19.596 whether the nature of the remuneration is subject to the work itself, whether the basic or fixed salary is set 52 00:04:19.909 --> 00:04:25.878 matters concerning remuneration, such as whether earned income tax is withheld 53 00:04:26.159 --> 00:04:31.601 the presence or absence and the degree of the continuity of the labor provision relationship and the exclusivity to the employer 54 00:04:31.665 --> 00:04:36.587 and whether the status as a worker is recognized in the laws and regulations on the social security system 55 00:04:38.205 --> 00:04:42.977 In some cases, those who cannot be viewed as workers are exceptionally covered by industrial accident insurance 56 00:04:43.047 --> 00:04:49.311 It is a labor provider. The existing Industrial Accident Insurance Act had a "exclusive requirement" 57 00:04:49.335 --> 00:04:53.664 that labor should be provided only to a specific company 58 00:04:53.715 --> 00:04:59.727 and as a result, there were limits to protection for special types of workers and platform workers 59 00:04:59.905 --> 00:05:02.687 However, due to the revision of the Industrial Accident Insurance Act 60 00:05:02.713 --> 00:05:08.427 this exclusive requirement was completely abolished on July 1, 2023 61 00:05:08.902 --> 00:05:13.283 Specifically, if you look at the changes in the Industrial Accident Insurance Act 62 00:05:13.649 --> 00:05:16.652 the subjects covered by industrial accident insurance has been expanded 63 00:05:17.485 --> 00:05:21.756 Under the Industrial Accident Insurance Act, the requirements for special exclusive use were abolished 64 00:05:21.925 --> 00:05:27.010 and 'special use' and 'platform workers' were redefined as 'labor providers' 65 00:05:27.484 --> 00:05:31.807 As a result, the blind spot of industrial accident insurance for 66 00:05:31.907 --> 00:05:35.689 labor providers working at various companies is expected to be resolved 67 00:05:36.624 --> 00:05:41.007 Here, a labor provider refers to a person who provides labor for 68 00:05:41.127 --> 00:05:45.487 the business of someone other than himself or herself 69 00:05:45.511 --> 00:05:51.463 that is, if requested to provide labor directly by the business owner 70 00:05:51.591 --> 00:05:56.801 or through an electronic information processing system 71 00:05:56.975 --> 00:06:01.816 to mediate and arrange labor for workers, and receive wages 72 00:06:02.023 --> 00:06:06.932 and they are persons engaged in occupations prescribed by 73 00:06:07.007 --> 00:06:11.198 Presidential Decree in consideration of the need for protection from occupational accidents, types of labor provision, etc. 74 00:06:13.393 --> 00:06:20.782 The occupations of labor providers are insurance planners, construction machinery pilots, visiting instructors, golf course caddies 75 00:06:20.985 --> 00:06:28.590 delivery drivers, quick service drivers, loan recruiters, credit card members recruiters, proxy drivers 76 00:06:28.787 --> 00:06:37.158 visiting salespeople, rental product door-to-door inspector, home appliance installation and repair workers, construction site cargo owners 77 00:06:37.382 --> 00:06:45.030 cargo owners, software technicians, after-school instructors, tour interpreters 78 00:06:45.204 --> 00:06:47.664 and school bus drivers for children 79 00:06:48.205 --> 00:06:56.124 In particular, in the case of cargo owners, all specific items and industries classifications will be abolished from July 2023, 80 00:06:56.224 --> 00:07:04.433 and all cargo owners will be fully covered under the Trucking Transportation Business Act 81 00:07:05.909 --> 00:07:09.613 In general, the employer bears the full amount of industrial accident insurance premiums 82 00:07:09.637 --> 00:07:11.621 and the workers do not bear them 83 00:07:11.908 --> 00:07:14.414 However, the labor provider and the business owner will 84 00:07:14.526 --> 00:07:18.667 pay half of the industrial accident insurance premiums each 85 00:07:19.556 --> 00:07:22.675 And we check whether there is a disaster due to business reasons 86 00:07:23.111 --> 00:07:29.869 It determines whether a work-related disaster has occurred under the control of the employer 87 00:07:32.840 --> 00:07:37.682 If you have confirmed the approval of medical treatment, the Corporation must notify you of the approval of medical treatment 88 00:07:37.984 --> 00:07:40.920 If it is clear that there is a disaster due to business reasons 89 00:07:41.051 --> 00:07:44.397 the decision to approve medical treatment will be notified within 7 days 90 00:07:44.835 --> 00:07:50.159 It may take a long time to confirm if it is necessary to confirm the specific facts about the details of the work 91 00:07:50.183 --> 00:07:54.854 or the circumstances of the accident, and in the case of occupational diseases 92 00:07:54.878 --> 00:07:56.949 to check the causal relationship with the work 93 00:07:57.459 --> 00:08:00.640 If there is an objection to the disposition of disapproval of medical treatment 94 00:08:00.901 --> 00:08:06.602 you may request an examination to the industrial complex's industrial accident examination office 95 00:08:06.626 --> 00:08:10.313 through a disposition order within 90 days from the date of knowing that there is a disposition 96 00:08:10.395 --> 00:08:14.033 or file an administrative lawsuit with the competent administrative court 97 00:08:14.691 --> 00:08:20.167 However, if the decision is disapproved after deliberation by the Occupational Disease Judgment Committee 98 00:08:20.378 --> 00:08:24.368 it can be re-examined by the Industrial Accident Insurance Review Committee 99 00:08:24.542 --> 00:08:29.918 of the Ministry of Employment and Labor through the disposition branch without a review request procedure 100 00:08:30.227 --> 00:08:34.385 or an administrative lawsuit may be filed with the competent administrative court 101 00:08:38.113 --> 00:08:42.247 Upon approval, you can receive insurance benefits by 102 00:08:42.412 --> 00:08:44.914 submitting a medical care bill and a vacation benefit bill 103 00:08:46.331 --> 00:08:52.065 Let me tell you the precautions related to industrial accident compensation, first of all, duplicate compensation is prohibited 104 00:08:52.524 --> 00:08:57.377 Korea developed through the legislative process according to the transition process 105 00:08:57.401 --> 00:09:00.090 of the general industrial accident worker protection system 106 00:09:00.599 --> 00:09:07.536 There are compensation for damages under civil law, accident compensation under the Labor Standards Act, and industrial accident compensation under the Industrial Accident Insurance Act 107 00:09:08.077 --> 00:09:12.698 Accordingly, in the event of an industrial accident under the current law in Korea 108 00:09:12.931 --> 00:09:19.046 the workers in the accident acquire the right to claim damages under the Civil Act, the right to claim accident compensation under the Labor Standards Act 109 00:09:19.201 --> 00:09:23.909 and the right to claim insurance benefits under the Industrial Accident Insurance Act, respectively 110 00:09:27.834 --> 00:09:30.960 The claimant may exercise each of the three rights 111 00:09:30.984 --> 00:09:34.449 Therefore, whether to claim accident compensation under the Labor Standards Act 112 00:09:34.562 --> 00:09:37.357 insurance benefits under the Industrial Accident Insurance Act 113 00:09:37.457 --> 00:09:43.569 or even civil damages depends on the intention of the worker is up to the workers' decision 114 00:09:44.109 --> 00:09:47.057 However, no matter which one they choose 115 00:09:47.173 --> 00:09:50.622 they cannot exercise more than one claim at the same time for the same reason 116 00:09:50.780 --> 00:09:53.835 and they cannot claim accident compensation under the Labor Standards Act 117 00:09:54.120 --> 00:09:57.830 at workplaces where industrial accident insurance is compulsory 118 00:09:58.716 --> 00:10:01.776 Most workplaces are covered by industrial accident insurance 119 00:10:01.879 --> 00:10:06.358 So, how is it different between industrial accident insurance and civil damages? 120 00:10:08.227 --> 00:10:11.888 The civil damage compensation system refers to a system that 121 00:10:11.912 --> 00:10:15.876 compensates for the damage of a person whose rights have been violated by the misconduct of another person 122 00:10:17.396 --> 00:10:22.166 Article 90 of the Labor Standards Act stipulates that "If a person who will receive compensation receives 123 00:10:22.190 --> 00:10:28.155 substantial money or goods for accident compensation under the Civil Act or other laws for the same reason 124 00:10:28.312 --> 00:10:33.593 the employer shall be exempted from the liability for compensation within the limit of the amount," 125 00:10:33.872 --> 00:10:38.713 and Article 48 of the Industrial Accident Insurance Act also stipulates that "If the beneficiary has received or 126 00:10:38.737 --> 00:10:43.170 is able to receive insurance benefits under this Act for the same reason 127 00:10:43.256 --> 00:10:49.479 the insured is exempted from the liability for damages under 128 00:10:49.503 --> 00:10:56.172 the Civil Act or other laws within the limit of the amount." 129 00:10:59.159 --> 00:11:03.161 Therefore, from the perspective of workers, it is generally the most advantageous way to 130 00:11:03.185 --> 00:11:07.684 first receive insurance benefits through industrial accident applications under the Industrial Accident Insurance Act 131 00:11:07.708 --> 00:11:12.133 and to file a civil lawsuit if there is a difference from civil compensation 132 00:11:12.744 --> 00:11:18.513 In the case of a serious accident that leaves death or disability, it is difficult to solve it only by compensation for industrial accidents 133 00:11:18.541 --> 00:11:22.597 so it is common to claim separate civil damages 134 00:11:23.648 --> 00:11:25.862 The amount of damages is as follows 135 00:11:26.578 --> 00:11:31.950 Active damage is considered treatment cost, passive damage is lost income according to the labor loss rate 136 00:11:32.179 --> 00:11:37.735 and solatium is mental damage, considering the labor loss rate and negligence ratio 137 00:11:38.276 --> 00:11:42.814 The amount of damage is the sum of active damage, passive damage, and solatium 138 00:11:43.074 --> 00:11:46.702 and industrial accident insurance benefits are deducted from the total amount of damage 139 00:11:47.536 --> 00:11:54.297 In addition, when calculating the amount of damages, details on the circumstances of the accident, the victim's birth date, average wage 140 00:11:54.415 --> 00:12:01.192 disability level, labor loss rate, negligence offset, and the employer's safety management responsibility 141 00:12:01.264 --> 00:12:03.533 are required 142 00:12:06.062 --> 00:12:11.535 Therefore, a worker who has suffered an occupational accident due to the intention or negligence of the employer, etc. 143 00:12:11.699 --> 00:12:17.290 may claim compensation for the occupational accident against the employer, etc. 144 00:12:18.160 --> 00:12:20.156 However, compensation for damages under the Civil Act 145 00:12:20.180 --> 00:12:23.771 requires workers to prove the intention or negligence of the employer, etc. 146 00:12:23.900 --> 00:12:29.653 and a relatively long period of time before a civil trial is confirmed