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The insured unit shall apply for insurance benefits for the insured, the beneficiary, or the person who pays the funeral expenses and shall not thereby charge any fees.

Under any of the following circumstances, the insured, the beneficiary, or the person who pays funeral expenses may apply to the insurer for insurance benefits in their capacity:
1. The insured unit is closed, dissolved, revoked, canceled, or becomes bankrupt, etc., and fails to file the application for the insured, beneficiary, or person paying funeral expenses.
2. For workers who meet the provisions of Article 6 of the Act, and their employers have not applied for the insurance by the provisions of Article 12.
3. Apply by the provisions of Paragraph 2 of Article 27 of the Act.

The average monthly insured salary specified in Paragraph 2, Article 28 of the Act shall be calculated by dividing by six the total monthly insured salary of the insured for the last six months from the month in which the insured accident occurs; those who have been insured for less than six months shall be calculated based on the average monthly insured salary during the actual insured period.
When the insured has more than two monthly insured salaries in the same particular month, the highest one shall prevail, which shall then be averaged with the monthly insured salaries of the other months.

The average monthly insured salary of all insureds in the most recent year as specified in Paragraph 4 of Article 28 of the Act shall be based on the average monthly insured salary of the most recent statistical annual report of the insurance announced by the insurer at the time of the occurrence of the insured accident. However, for the period before the first announcement of such insurance statistical annual report, the average monthly insured salary announced in the latest labor insurance statistical annual report shall prevail.

When the insured specified in Paragraph 2 of Article 29 of the Act has any death event insured, the beneficiary or the person who pays the funeral expenses shall also meet the requirements of Articles 49 or 50 of the Act. Only either the stipulated death benefits or other social insurance benefits specified in the following Subparagraphs can be claimed:
1. The death benefit specified in Articles 62, 63, or 63-1 of the Labor Insurance Act.
2. The funeral and interment allowance specified in Article 40 of the Farmer Health Insurance Act.
3. The funeral and interment allowance specified in Article 19 of Guidelines for the Trial Implementation of Farmer Occupational Accident Insurance
4. The lump-sum death benefit or survivor's pension is specified in Article 27 of the Public Servant and Teacher Insurance Act.
5. The death benefit is specified in Article 13 of the Act of Insurance for Military Personnel.
6. The funeral and interment benefit under Article 39 and survivor's pension under Article 40 of the National Pension Act.

If the insured, the beneficiary, or the person who pays funeral expenses applies for insurance benefits after the insurer examines that the insured accident is not caused by occupational injury or disease, the applicant may agree in writing to apply to the same accident by the Labor Insurance Act.

Insurance benefits distributed in cash under the Act shall, after being approved by the insurer, be directly remitted to the personal account at the financial institution designated by the insured, beneficiary, or person paying funeral expenses, and the insured unit shall be notified. However, in the event of the application of insurance benefits as specified in Subparagraph 1 or 3 of Article 39, the insurer may not notify the insured unit.
If the financial institution account mentioned in the preceding Paragraph is located overseas, the handling fee shall be borne by the insured, the beneficiary, or the person who pays the funeral expenses.

The interest to be accrued on the overdue part specified in Paragraph 1 of Article 35 of the Act shall be paid by the insurer's official budget.

If the insured, the beneficiary, or the person who pays the funeral expenses, applies to the insurer for insurance benefits by mail, the date of the original postmark of the post office shall prevail.

To apply for various insurance benefits by the provisions of the Act, the attached documents and materials shall be verified by the following units if such documents and materials are prepared outside the premise of government agencies (institutions) of the Republic of China:
1. Prepared overseas: To be verified by ROC embassies abroad; those prepared at foreign embassies and consulates in Taiwan or authorized institutions shall be re-verified by the Ministry of Foreign Affairs.
2. Prepared in Mainland China: To be verified by the agency established or designated by the Executive Yuan or the non-governmental organization entrusted by it.
3. Prepared in Hong Kong or Macau: To be verified by the agency established or designated by the Executive Yuan or a non-governmental organization entrusted by it in Hong Kong or Macau.
If the documents and materials in the preceding Paragraph are in foreign languages, the Chinese translation certified by the units listed in the preceding Paragraphs or the notary public in China shall be attached. However, if the documents and materials are in English, they may be exempted from being attached unless the insurer considers it necessary.

When an insurer entrusts an NHI insurer (hereinafter referred to as the “NHI insurer”) to handle medical benefits by the provisions of Paragraph 2 of Article 38 of the Act, the contract of entrustment shall be prepared by the insurer with the NHI insurer, which shall be submitted to the central competent authority for approval with the central competent health and welfare authority.
When the insured attends the NHI hospital or clinic for medical treatment, the procedures for medical treatment, consultancy, the method of providing medical treatment, and other necessary matters for medical treatment shall be handled mutatis mutandis by the relevant provisions of the National Health Insurance, unless otherwise provided for in the Act and these Rules.

When the insured applies for outpatient or inpatient treatment for occupational injuries and diseases, the insured shall submit the occupational injury and disease outpatient clinic or inpatient application form issued by the insured unit or the insurer, and submit the following documents for inspection:
1. Certificate of National Health Insurance (hereinafter referred to as the NHI card).
2. National Identity Card or other documents sufficient to prove the identity. However, if the NHI card is sufficient to identify the identity, the submission of the National Identity Card may be waived.
Those who fail to present the documents specified in the provisions of the preceding Paragraph shall be rejected to register for medical treatment as the insured of the insurance at the NHI hospital or clinic.

If the insured fails to timely submit the occupational injury and disease outpatient application form, the application form for hospitalization, or the NHI card for inspection, the insured shall present the identification document to declare that he is the insured under the insurance and handle the registration for medical treatment; the NHI hospitals or clinics shall first provide medical treatment, and then collect medical treatment fees, and issue receipts based on the Enforcement Rules of the Medical Care Act.
If the insured receives medical treatment by the provisions of the preceding Paragraph, within 10 days from the date of the medical treatment (excluding holidays) or before discharge, if the insured submits additional documents, the NHI hospital or clinic shall refund the medical treatment fees collected.

If due to reasons not attributable to the insured, which causes him to fail to submit additional documents within 10 days from the date of receiving medical treatment or before discharge by the provisions of the preceding Article, the insured may within six months from the date of receiving outpatient medical treatment or the date of discharge apply to the insurer for reimbursement of medical expenses.
Those applying for reimbursement of medical expenses by Paragraph 1 of Article 40 of the Act shall submit the following documents:
1. Occupational accident medical treatment fees reimbursement application form and the payment receipt.
2. Diagnosis certificate or supporting documents.
3. Receipts of medical expenses and details of the fees collected.

After receiving the occupational injury and disease outpatient application form or the application form for hospitalization, the NHI hospital or clinic shall fill in the insured’s medical treatment information in detail, and attach the occupational injury and disease outpatient application form or the application form for hospitalization to the insured's medical record, and archive these documents at least seven years for future review.
The second copy of the occupational injury and disease outpatient application form in the preceding Paragraph shall be returned to the insured for reference after the diagnosis and treatment; the second copy of the application form for hospitalization shall be submitted to the insurer for review within ten days.
The insurer shall notify the NHI insurer, the NHI hospital or clinic, the insured unit, and the insured if the application form for hospitalization or outpatient treatment in the Preceding paragraph is verified as not conforming to definitions of occupational injury or disease.

The inability to work as specified in Article 42 of the Act shall be comprehensively determined by the insurer based on the following items:
1. Reasonable treatment and rehabilitation period and working capacity required for the insured's injury or illness diagnosed by the certified physician.
2. The inability of the insured to work during the period of reasonable treatment and rehabilitation.
For the matters in Paragraph 1 of the preceding Paragraph, the insurer may when necessary, entrust the relevant specialist physicians to provide medical opinions and make determinations accordingly.
The determination of the work capacity in Subparagraph 1 of Paragraph 1 shall not be limited to the original work the insured engages in.

Those who apply for injury or illness benefit by the provisions of Article 42 of the Act shall submit the following documents:
1. Injury or illness benefit application form and benefit payment receipt.
2. Injury or illness diagnosis certificate.
The diagnosis certificate of injury or illness specified in Subparagraph 2 of the preceding Paragraph may be replaced by a certificate issued by the hospital or clinic that contains the name of the injury or illness, the duration of medical treatment, and the course of treatment.

For the insured claiming the injury and illness benefit, he may make the claim, by having every 15 days as an installment, from the day following the end of the installment; if such installment is less than 15 days, the claim will start on the day following the termination of the treatment for injury and illness.

Those who apply for permanent disability benefit by the provisions of Article 43 of the Act shall submit the following documents:
1. Permanent disability benefits application form and benefit payment receipt.
2. Permanent disability diagnosis certificate.
3. Those who have undergone medical examination shall submit the examination report and relevant images.
In reviewing permanent disability benefits, the insurer may, in addition to designating an NHI hospital or physician for re-examination by the provisions of Article 47 of the Act, may also notify the hospital or clinic that issued the permanent disability diagnosis certificate to review relevant examination records or medical records.

For those who apply for permanent disability benefits by the provisions of Article 43 of the Act, the day when the actual permanent disability is diagnosed by the NHI hospital or clinic, the day of the occurrence of the insurance accident, and the day on which the application can be made as specified in Article 37 of the Act.
If the insured suffers an injury or illness during the effective period of the insurance, after the insurance validity is terminated the insured still meets the treatment period stipulated in the permanent disability benefit standard of labor occupational accident insurance and is diagnosed as a permanent disability by a specialist, and the degree of disability is consistent with the validity of the insurance, and the degree of disability one year after the termination of the insurance, the symptoms are fixed, and the disability compensation may be claimed by the provisions of Paragraph 2 of Article 27 of the Act, and the date of the expiration of one-year period after the termination of the insurance validity is considered as the date allowing making the claim.
If the date of the diagnosis of permanent disability in the preceding two Paragraphs is unknown or there is any apparent doubt, the insurer may confirm it based on the medical records or relevant information.
If the insured requests a permanent disability diagnosis certificate, the NHI hospital or clinic shall deliver it to the insurer within five days after such certificate is issued.

If the marriage relationship specified in Subparagraphs 1 and 2 of Paragraph 1 of Article 44 of the Act has been existing for more than one year, it shall be calculated continuously from the date of application.

The term “schooled” as mentioned in Subparagraph 3, Paragraph 1, Article 44 of the Act refers to those who have a formal student identity and are enrolled in public schools, private schools approved and registered by the competent educational administration at all levels or foreign schools that meet the requirements of the Ministry of Education.

Those who apply for additional allowances for dependents by Paragraph 1 of Article 44 of the Act shall provide the following documents:
1. The application form and a payment receipt for the additional allowance of permanent disability benefit for the dependents.
2. Transcripts of the complete household registration of the insured; if the family members and the insured are not recorded in the same household registration, the transcript of each household registration shall be submitted at the same time, and the following items shall be stated:
(1) When dependents are spouses, the date of marriage shall be stated.
(2) When dependents are foster children, the date of adoption and registration shall be stated.
3. If the children are schooled, it is required to additionally attach the photocopy of the tuition receipt or proof of school attendance. The applicant shall re-submit the relevant certificates before the end of September each year and send them to the insurer for verification. Those who meet the conditions after verification shall continue to be distributed with the allowance until the end of August of the following year.
4. For spouses and children who are unable to make a living, certificates of physical and mental disabilities, or certificates of guardianship declaration shall also be attached.

After approving the permanent disability annuity benefit of the insured, the insurer shall provide the approving documents and materials to the competent authority for use in assisting workers with occupational accidents inappropriate medical rehabilitation, social rehabilitation, functional rehabilitation, occupational rehabilitation, and other rehabilitation services.
When the insurer assesses the degree of disability of the insured by the provisions of Paragraph 1 of Article 45 of the Act, the functional rehabilitation in the preceding Paragraph shall be included in the assessment.

The same part referred to in Paragraphs 1 and 4 of Article 46 of the Act refers to the same part as the disability category specified in the labor insurance disability benefit criteria.

If the insured is directly withdrawn by the insurer by the provisions of Article 48 of the Act, the date of withdrawal shall be the date of the diagnosis of actual permanent disability in the NHI hospital or clinic.

For those who apply for survivor's pension by Subparagraph 1, Paragraph 2, Article 49 of the Act, the marriage relationship for more than one year shall be calculated continuously from the date of death of the insured.
For the determination of whether “schooled” or not, Article 59 shall apply mutatis mutandis to those who apply for survivor's pension by the provisions of Subparagraphs 2 and 4 of Paragraph 2 of Article 49 of the Act.

Those applying for the funeral and interment allowance by Paragraph 1 of Article 49 of the Act shall provide the following documents:
1. Death benefit application and payment receipt.
2. Death certificate, public prosecutor's autopsy certificate, or death declaration ruling.
3. Transcript of the overall household registration with the date of death.
4. Proof of payment of funeral expenses. However, if the person who pays the funeral expenses has the priority to receive the survivor's pension, the lump sum survivor benefit, or survivor allowance, the letter of the affidavit may be adopted instead.

Those applying for the survivor's pension by Paragraph 2 of Article 49 of the Act shall provide the following documents:
1. Death benefit application and payment receipt.
2. Death certificate, public prosecutor's autopsy certificate, or death declaration ruling.
3. Transcript of the overall household registration with the date of death. If the beneficiary is a spouse, the date of marriage shall be stated; if the beneficiary is a foster child, the date of adoption and registration shall be stated. If the beneficiary and the deceased are not in the same household registration, the transcripts of each household registration shall be submitted altogether.
4. If the children or grandchildren are schooled, it is required to additionally attach the photocopy of the tuition receipt or proof of school attendance. The applicant shall re-submit the relevant certificates before the end of September each year and send them to the insurer for verification. Those who meet the conditions after verification shall continue to be distributed with the allowance until the end of August of the following year.
5. For spouses, children, grandchildren, and siblings who are unable to make a living, certificates of physical and mental disabilities, or certificates of guardianship declaration shall also be attached.
6. If the beneficiary of the Disappearance benefit is the insured's grandchildren or siblings, the relevant supporting documents of the insured shall be attached to the application.

Those applying for the lump-sum survivor benefit by Paragraph 3 of Article 49 of the Act shall provide the following documents:
1. Death benefit application and payment receipt.
2. Death certificate, public prosecutor's autopsy certificate, or death declaration ruling.
3. A transcript of the overall household registration with the date of death. If the beneficiary is a foster child, the date of adoption and registration shall be stated; if the beneficiary and the deceased are not in the same household registration, each household registration transcript shall be submitted altogether.
4. If the beneficiary of the Disappearance benefit is the insured's grandchildren or siblings, the relevant supporting documents of the insured shall be attached to the application.
5. If the insured passes away, all relevant documents that do not meet the requirements for the distribution of the survivor's pension.

Those applying for the survivor allowance by Paragraph 5 of Article 49 of the Act shall provide the following documents:
1. Death benefit application and payment receipt.
2. Death certificate, public prosecutor's autopsy certificate, or death declaration ruling.
3. A transcript of the overall household registration with the date of death. If the beneficiary is a foster child, the date of adoption and registration shall be stated; if the beneficiary and the deceased are not in the same household registration, each household registration transcript shall be submitted altogether.
4. If the beneficiary of the Disappearance benefit is the insured's grandchildren or siblings, the relevant supporting documents of the insured shall be attached to the application.

In the event before the insured passes away and a lump-sum payment for a permanent disability benefit is requested by the provisions of Paragraphs 1 or 3 of Article 43 of the Act, if the insurer approves the payment but fails to pay it, the surviving family member may accept such benefit.
The beneficiaries of the permanent disability benefit, the priority of claiming and the method of distribution shall apply mutatis mutandis to Paragraph 2 of Article 49, Paragraphs 1 and 2 of Article 52, and Article 53 of the Act.

If the insured withdraws the insurance and passes away during the period of receiving the permanent or severe disability benefit, and the surviving family members choose to claim the survivor’s pension by Paragraph 1 of Article 50 of the Act, the pension for survivors will be paid from the month following the death of the insured.
If the surviving family members specified in the preceding Paragraph choose to apply for distribution of the amount of difference between permanent disability benefit and the total amount of pension already collected by Paragraph 2 of Article 50 of the Act, they shall meet the criteria of difference between permanent disability benefit and the total amount of pension already collected by the time the insured is diagnosed with a permanent disability to be distributed.

By the provisions of Paragraph 2 of Article 50 of the Act, a person who chooses to apply for the amount of difference between permanent disability benefit and the total amount of pension already collected shall provide the following documents:
1. Permanent disability benefit difference application form and benefit payment receipt.
2. Documents specified in Subparagraphs 2 to 4 of Article 68.

Failure to reach an agreement as specified in Paragraph 1 of Article 53 of the Act means that each applicant fails to complete the agreement within 30 days as specified in the written notice from the insurer and submit a certificate of agreement.

When there are two or more surviving family members with the same priority and an agreement is reached by the proviso of Paragraph 2 of Article 53 of the Act, the insurer may notify the applicant in writing to complete the agreement within 30 days, and the representative applicant shall submit such agreement. If the applicant fails to submit it within the time limit, the insurer may issue an annuity to the surviving family member by Paragraph 2 of Article 53 of the Act, and the surviving family members may not request the change.

If there are two or more surviving family members with the same priority and they apply for a lump sum benefit for the surviving family members by the provisions of Paragraph 3 of Article 49 of the Act, they cannot jointly claim it, the insurer may notify the other unnamed surviving family members (who have the same priority) in writing using the registered address to reach an agreement for joint claiming within 30 days; if they fail to apply within the time limit, except for complying with the age requirements, it will be deemed that they fail to meet the requirements for surviving family annuity benefit.

If the insured passes away and the minor beneficiary is unable to claim the survivor's annuity, the lump sum benefit, or the survivor allowance, the insured unit to which the insured affiliates shall immediately notify the insurer to keep the benefit and accumulate the interest until such beneficiary can claim it.

When the beneficiary or the person paying the funeral expenses applies for the death benefit, if the insured unit to which the insured affiliates has not proceeded with the withdrawal procedures, the insurer will withdraw the insurance directly.

Those who apply for disappearance benefit by the provisions of Paragraph1 of Article 55 of the Act shall submit the following documents:
1. Disappearance benefit application form and benefit payment receipt.
2. Transcripts of the overall household registration of the insured; if the beneficiary and the insured are not in the same household registration, each household registration transcript shall be submitted altogether.
3. Accident report or emergency report of disappearing person and other relevant accident certificates.
4. Evidence of the occurrence of an accident in the performance of duties.
The beneficiaries of the disappearance benefit, the priority of claiming and the method of distribution shall apply mutatis mutandis to Paragraph 2 of Article 49, Paragraphs 1 and 2 of Article 52, and Paragraphs 1 and 3 of Article 53 of the Act.
If the beneficiary of the Disappearance benefit is the insured's grandchildren or siblings, the relevant supporting documents of the insured shall be attached to the application.

The month of the application specified in Paragraph 2 of Article 56 of the Act shall be based on the postmark of the original post office or the date of delivery to the insurer.

Those who apply for annuity benefit by the provisions of the Act and do not have household registration in ROC shall submit their identity or residence-related documents verified by the units listed in Paragraph 1 of Article 47, which shall be submitted to the insurer for re-examination every year.

Where the distribution of annuity benefit is suspended by Subparagraphs 1 and 2 of Paragraph 2 of Article 44 and Subparagraphs 1 and 2 of Article 54 of the Act, upon the reasons for the suspension no longer exist, the applicant may re-apply to the insurer, and the insurer will distribute the benefit by the provisions of Paragraph 2 of Article 56 of the Act; the survivor's annuity shall be distributed by the provisions of Paragraph 3 of Article 56 of the Act. However, this does not apply to the circumstance in which the spouse specified in Paragraph 1 of Article 54 of the Act remarries.
If the distribution of annuity benefit is suspended by the provisions of Subparagraphs 3 and 4 of Paragraph 2 of Article 44 and Subparagraph 3 of Article 54 of the Act, the distribution of annuity benefit shall be suspended from the month when the altered materials at the government agency’s media are sent to the insurer.
Upon the reasons for the suspension of distribution as specified in the preceding Paragraph no longer exist, the applicant may apply to the insurer with a document proving that the reasons for the suspension of distribution no longer exist, and the insurer will issue the distribution by the provisions of Paragraph 2 of Article 56 of the Act; the survivor's pension will be distributed by the provisions of Paragraph 3 of Article 56 of the Act.
If the applicant fails to submit the supporting documents to the insurer by the provisions of the preceding Paragraph, the distribution of the insurer shall be resumed from the month when the altered materials are sent by the government agency’s media to the insurer.

The supporting documents to be attached by Paragraph 3 of Article 57 of the Act are as follows:
1. Transcript of the household registration with the date of death of the recipient of annuity benefits.
2. Transcript of the household registration of the legal heir.
The transcript of the household registration in the preceding Paragraph may be replaced by a photocopy of the household registration.