If the employer fails to pay the basic medical insurance for the employee, who will pay for the basic medical insurance treatment that the employee can enjoy after illness, that is, the part of the expenses that can be reimbursed by the medical insurance?Recently, the Jieyang Intermediate People's Court upheld the final judgment of the first instance in a labor dispute case, and a company in Jieyang paid Wu 20 basic medical insurance benefits50,000 yuan.
In March 2018, Wu joined a company in Jieyang. The company paid pension insurance, work-related injury insurance, and unemployment insurance for Mr. Wu. In May 2022, Wu suddenly fell into a coma at home due to his own illness and was immediately sent to the hospital. In December of the same year, Wu was discharged from the hospital and spent 21 medical expensesMore than 80,000 yuan, and the reimbursable amount of basic medical insurance is 2050,000 yuan. Later, Mr. Wu applied for labor arbitration and demanded that the company pay all medical expenses. After the labor arbitration commission made the ruling, both parties were dissatisfied and sued the court.
The court of first instance held that the first paragraph of Article 23 of the Social Insurance Law stipulates that "employees shall participate in the basic medical insurance for employees, and the employer and the employee shall jointly pay the basic medical insurance premiums in accordance with the provisions of the state." "As Wu's employer, a company in Jieyang has the obligation to pay the basic medical insurance for Wu during his employment, and because the company has not paid the insurance, Wu cannot enjoy the basic medical insurance benefits during his hospitalization due to illness, and should pay Wu the loss of medical insurance benefits.
After the first-instance judgment, a company in Jieyang was dissatisfied and appealed.
After trial, the Jieyang Intermediate People's Court held that the facts found in the first-instance judgment were clear, the law was correctly applied, and should be upheld, so it made the above judgment in accordance with law.
The judge reminded that the employer should pay the "five insurances" for the employee on time and in full. The judge said that social insurance is referred to as social insurance, including endowment insurance, medical insurance, unemployment insurance, work-related injury insurance and maternity insurance, which is commonly referred to as the "five insurances", which protects the right of workers to receive help and compensation in the case of old age, illness, work-related injury, unemployment, childbirth, etc., and is also a compulsory social security system in China. According to the Labor Law, the Labor Contract Law, the Social Insurance Law and other relevant laws, the employer must register the employee for social security within 30 days after the employee joins the company. If the employer fails to pay social insurance for the employee in full and on time, the employee may report to the labor department or the social insurance premium collection agency. If the rights and interests of the employee are damaged due to the employer's failure to pay social insurance, the employer shall bear the corresponding responsibility and compensate the employee for the loss as appropriate.
Text |Reporter Dong Liu, correspondent Li Jie, Zhong Zhubin.