Article Content

  Chapter 2 Occupational Accident Insurance

   Section 4 Insurance Benefit

     Subparagraph 4 Permanent Disability Benefit

Article 43
When an insured person suffers occupational injury or disease, if the symptoms are fixed following treatment, further treatment will not improve the result of treatment. The person is diagnosed with permanent disability by a contracted hospital or clinic of national health insurance, meeting the conditions for permanent disability benefit under the Insurance. He/she may seek an lump sum payment of permanent disability benefit based on his/her average monthly insured salary and the prescribed benefit standards.
When the level of Permanent disability of the insured person under the previous paragraph meets one of the following conditions following evaluation, Permanent disability pension may be claimed.
1.Full Permanent disability: Issuance based on 70% of average monthly insured salary.
2.Serious Permanent disability: Issuance based on 50% of the average monthly insured salary.
3.Partial Permanent disability: Issuance based on 20% of the average monthly insured salary.
If the insured person has accrued seniority under labor insurance before the implementation of the labor insurance pension system on 1 January 2009 and meets the conditions for permanent disability pension payment following evaluation, in addition to the permanent disability pension already collected, the insured person may still choose to collect a permanent disability lump sum benefit, which shall not be changed after approved payment by the insurer.
During the period when the insured person collects permanent disability pension, he/she shall not collect Injury or sickness benefit for the same Injury or sickness.
The types, status, and level of permanent disability under the first and second paragraphs, the amount of benefit, the level of medical institution for the issuance of diagnosis, the review and approval standards, the evaluation standards for the level of permanent disability and the standards for other compliance matters shall be prescribed by the central competent authority.
Article 44
When permanent disability pension is collected, any family member who meets one of the following conditions shall also be issued a family allowance equivalent to 10% of the amount calculated under the second paragraph of the previous paragraph per person. Such additional issuance shall not exceed a maximum of 20%.
1.The spouse is aged 55 or more and the marriage has continued for one year or longer, except if there are any of the following events:
(1)No capacity to earn a living.
(2)Child in care under subparagraph 3.
2.The spouse is aged 45 or more, the marriage has continued for one year or longer and the monthly work income does not exceed level 1 of the Insured Salary Category Chart.
3.The child must meet one of the following conditions. In case of a foster child, the foster relationship must have continued for 6 months or longer.
(1)Minor.
(2)No capacity to earn a living.
(3)Aged 25 or less, schooled, with monthly work income below level 1 of the Insured Salary Category Chart.
The issuance of additional family allowance shall end if the family member under any subparagraph of the previous paragraph has any of the following events:
1.Divorced spouse or inconsistency with the conditions for collection under subparagraphs 1 and 2 of the previous paragraph.
2.Child inconsistent with the conditions for collection under subparagraph 3 of the previous paragraph.
3.Serving prison sentence, under seizure or detention.
4.Disappearance.
“Detention” referred to under subparagraph 3 of the previous paragraph means a declaration of detention, custody, observation for rehabilitation, forceful rehabilitation or security sanction, enforced in a specific location where the physical freedom is deprived or restricted. It does not include protective measures, release from detention for medical care or probation.
Article 45
After the insured person collects the permanent disability pension, the insurer shall review the level of permanent disability at least every 5 years, except if the insurer deems that there is no need for such review.
When the insurer reviews the collection of permanent disability pension in accordance with the previous paragraph, if it deems that the level of permanent disability has reduced but the conditions for collecting permanent disability pension are still satisfied, permanent disability pension shall be issued based on the reduced level of permanent disability. If the level of permanent disability has been reduced to below the conditions for issuance of permanent disability pension, the issuance of Permanent disability pension shall end and a permanent disability lump sum benefit shall be issued.
The review under the first paragraph shall be performed by the insurer together with functional rehabilitation measures.
Article 46
If the insured person’s body previously suffered from a part of permanent disability and if the occupational injury or disease further aggravates the level of permanent disability of the same body part or causes permanent disability in a different body part, the insurer shall issue permanent disability benefit based on the aggravated level of permanent disability calculated in accordance with the permanent disability benefit standards. However, the total amount of permanent disability lump sum benefit shall not exceed the level 1 payment standard.
If the insured person under the previous paragraph meets the conditions for permanent disability pension and seeks collection of ermanent disability pension, the insurer shall pay 80% of the amount of permanent disability pension on a monthly basis until half of the amount of lump sum ermanent disability benefit calculated based on the previous level of permanent disability and in accordance with the permanent disability benefit standards is fully deducted.
When the insured person under the previous two paragraphs suffers occupational injury or disease during the insurance period and did not collect permanent disability benefit for the previous partial permanent disability, the insurer shall issue permanent disability benefit in accordance with Article 43 based on the aggravated level of permanent disability. However, the total amount of permanent disability lump sum benefit shall not exceed the level 1 payment standard.
If an insured person who collects permanent disability pension suffers an aggravated level of permanent disability in the same body part or permanent disability in a different body part due to the same occupational injury or disease or further suffering of occupational injury or disease, the insurer shall issue permanent disability pension in accordance with the second paragraph of Article 43 based on the level of ermanent disability following evaluation. However, if the level of permanent disability still meets the conditions for the previous pension collected, the previous pension shall continue to be issued.
The central competent authority shall prescribe the manner of benefit issuance under the previous four paragraphs and the standards for other compliance matters.
Article 47
In the review of permanent disability benefit, if the insurer deems it necessary for the insured person to have a repeat examination, it may designate a hospital or physician to perform such repeat examination.
Article 48
When an insured person is evaluated to be without working capability for life and collects Permanent disability benefit under the Insurance or labor insurance, the insurer shall withdraw the insured person from the Insurance.