History

This Act is enacted to protect workers' livelihood and promote social security. Matters not provided herein shall be governed by other relevant laws or regulations.

Labor insurance coverage consists of two types as the following:
1.Ordinary injury insurance, which provides seven kinds of benefits, viz. maternity benefit, injury and sickness benefit, medical-care benefit, disability benefit, unemployment benefit, old-age benefit and death benefit; and
2.Occupational injury insurance, which provides four kinds of benefits, viz. injury and sickness benefit, medical-care benefit, disability benefit and death benefit.

All labor insurance books and accounts, documents and operational receipts and payments shall be exempt from taxation.

The labor commission of the central government and the municipal government shall be the competent labor insurance authorities.

The central competent authority shall exercise overall supervision of national labor insurance operations, and shall set up the Bureau of Labor Insurance as the insurer. The Labor Insurance Supervisory Commission shall be set up to supervise labor insurance operations and to settle disputes concerned. In principle, members of this Commission shall be appointed in equal numbers from representatives of relevant government officials, workers, employers, and specialists.
The structure of the Bureau of Labor Insurance and the Labor Insurance Supervisory Commission should be stipulated by other laws.
The Rules for the Settlement of Labor Insurance Disputes shall be prescribed by the competent central authority after due approval of the Executive Yuan.

The following workers above 15 full years and below 60 years of age shall all be insured under this program as insured persons, with their employers, or the organizations or institutes to which they belong reckoned as the insured units:
1.Industrial workers employed by public or private factory, mine, salt field, range, pasturage, forest or tea plantation with more than five employees, as well as workers employed by a communication or transportation enterprise, or by a public utility;
2.Workers employed by a company or firm with more than five employees;
3.Employees in a journalistic, cultural, non-profit organization or cooperative enterprise with more than five persons;
4.Employees of government offices or public or private schools who are not legally entitled to join civil servants' insurance or the insurance of teachers and employees of private schools;
5.Workers employed in fishing production;
6.Persons receiving vocational training in vocational training institutes registered with the government;
7.Members of an occupational union who have no definite employer or who are self-employed; and
8.Fishermen who belong to Class A of Fishermen's Association and are either self-employed or do not have a definite employer.
Preceding provisions also apply to workers under 15 years of age, provided the character and conditions of whose employment have been recognized by the competent authority as not harmful to the physical and moral health of such persons.
The preceding two provisions apply to employed foreign nationals.

If after a labor insurance policy has been taken for workers referred to paragraph 1, subparagraphs (1) to (3) inclusive of the preceding Article, the number of workers employed by the insured unit has decreased to four or less, the insured unit shall continue to carry out the labor insurance project for these workers.

The following persons may apply the provisions of this Act and participate in the labor insurance scheme:
1.Persons employed in occupations outside of those mentioned in paragraph 1 of Article 6;
2.Persons employed in enterprises which have less than five employees in occupations mentioned in paragraph 1 subparagraph (1) to (3). Inclusive of Article 6;
3.Employers concurrently engaged in laboring services;
4.Seamen serving in vessels abroad-who are members of the Chinese Seamen's Union or the Association of Chinese Ship owners.
Persons mentioned in the preceding paragraph who participate in the labor insurance scheme shall not be allowed to suspend the coverage unless they are permitted to do so under of this Act.
Employers mentioned in subparagraph (3) of paragraph l who participate in the labor insurance scheme shall join their employees as the same insured unit.

An insured person who has any of the following conditions may continue in the insurance coverage:
1.under military service;
2.sent abroad for investigation, research, or to provide services;
3.during injury or sick leave without pay, injured or sick for a period of less than one year, or absence from work for a period of less than two years as a result of industrial accident;
4.Employees more than 60 years of age who continue to work;
5.Detained or suspended from work on account of a court case, before the decision of the court is announced.

An insured person who has joined the scheme for a total period of more than 15 years and who has been laid off, may participate in the coverage voluntarily. Under such circumstances, the original insured unit shall take care of ordinary labor insurance procedures until the insured person reaches the age when he is entitled to claim old-age benefit.
Measures concerning the labor insurance procedure and premium of an insured person mentioned in the preceding paragraph shall be promulgated by the competent central authority.

Each insured units shall handle the insuring procedure and other insurance-related affairs for its employees, and prepare a roll list of the employees or members.
The insured units may consign the organization or labor association to which it is affiliated to handle mentioned in the preceding paragraph insuring procedure and other insurance-related affairs.
To verify the number of the insured unit's employees, working conditions and salary, the insurer may check the roll list of employees or members, attendance and work records as well as account books of salary when necessary.
The insured units shall keep the above-mentioned list, records and books for 5 years commencing from the insured person's demission, withdrawal from the organization, or completion (cancellation) of training.

For workers mentioned in Article 6, all insured units shall compile a list and notify the insurer on the same day when the insured persons join the enterprise, or the association, start training courses, separate from the enterprise, withdraw from the association, or end the training courses. The beginning or the ending of such insurance coverage shall start from the day on which the lists were sent out by the insured unit. In case the insured unit fails to send out the list on the same day when the insured persons report for work, join the association, or begin training courses, the day following the day on which such a list is actually sent out to the insurer shall be counted as the day on which the coverage takes effect. In such a case. The insured units shall be fined according to the provisions of Article 72 of this Act.

In case an insured person rejoins the labor insurance scheme after separation from the coverage, his accumulated years of insurance coverage shall be recognized.
The insured person retired after December 9, 1999, and had suspended over 2 years before 21 February, 1979, or suspended over 6 years before 5 February, 1988; all of the coverage years prior to suspension should be computed.
The insured person had received old-age benefits, should claim the shortage payment according to the proceeding paragraph in two years after last amended on December 19, 2001.

The ordinary accident insurance premium rate of labor insurance shall be studied out by the competent central authority within 6.5%~11% of the insured person's monthly insurance salary, and subject to the approval of the Executive Yuan.
The occupational injury insurance premium rate shall be determined according to the insured person's monthly insurance salary as well as the "Table of categories of Occupations and Premium Rates Applicable for Occupational Injury Insurance". For the insured units that employ a certain number of employees, where the percentage of the total amount of occupational injury insurance paid in the former three years exceeds 80% of the total payable amount of occupational injury insurance, 5% of the applicable premium rate of occupational injury insurance will be additionally charged for every 10% increased; where the foresaid percentage is lower than 70%, 5% of the applicable premium rate of occupational injury insurance will be reduced for every 10% reduced. The premium rate of occupational injury insurance shall be calculated and adjusted once every year, and the Actual Rate Regulations shall be promulgated by the competent central authority.
The "Table of categories of Occupations and Premium Rates Applicable for Occupational Injury Insurance" shall be prescribed by the competent central authority, reported to the Executive Yuan for review and approval, and sent to the Legislative Yuan for reference; and shall be adjusted at least once every three years.
The insurer shall separately handle the accounting of occupational injury insurance.

The term "monthly insurance salary" referred to in the preceding Article shall mean the salary reported by an insured unit pursuant to the "Table of Grades of Insured Salary" and on the basis of the insured person's total monthly salary. In case an insured person's wage is calculated on piecework basis, the monthly insurance salary shall be pro rata to that of a worker of the same grade in the Table reported by the insured unit. The monthly insurance salaries of workers referred to in paragraph 1 subparagraph (7) or (8) of Article 6 or paragraph 1 subparagraph (4) of Article 8 shall be assessed by the insurer pursuant to the Table subject to the approval of the competent central authority.
In case the reassessment of an insured person's monthly insurance wage was made between February to July of the current year, the insured unit shall notify the insurer of the same before the end of August of the current year; in case the reassessment was made between August of the current year to January of the following year, notification shall be made by the insured unit to the insurer before the end of February of the following year. The reassessed monthly insurance salary shall be effective on the first day of the month following the notification .
The "Table of Grades of Insurance Salary" referred to in paragraph 1 of this Article shall be prescribed by the competent central authority subject to the approval of the Executive Yuan.

Where the insured person's insurance salary declared by the insured unit is not true, the insurer may directly make adjustment according to the insurance salary of an equivalent grade of the same occupation, and notify the insured unit about the adjustment. In case the insurance salary after being adjusted is not in conformity with the actual salary, the latter shall apply.
The insurance salary directly adjusted under the above paragraph shall take effect on the first day of the next month after adjustment is made.

In case of additional insurance under Subparagraph 3, Paragraph 1, Article 8, whose income is lower than the top grade of the "Table of Grades of Insurance Salary", the insured unit may quote and declare the insurance salary by itself. But the declared salary may not be lower than that of the grade applicable for the highest insurance salary as declared by the affiliated employees.

Labor insurance premiums shall be calculated and paid in accordance with the following measures:
1.In case an insured person is a worker referred to in paragraph 1, subparagraph (1) to (6) inclusive, of Article 6 or paragraph 1, subparagraphs (1) to (3) inclusive of Article 8, twenty percent of the premium on ordinary injury shall be paid by the insured person, seventy percent by his employer, and the remaining ten percent shall be paid by central government in provincial area, but equal paid by municipal and central government in municipal area. The premium of occupational injury shall be paid by the employer entirely.
2.In case an insured person is a worker referred to in paragraph 1, subparagraphs(7) of Article 6,sixty percent of ordinary injury and occupational accident insurance premiums shall be paid by the insured person, and the remaining forty percent, subsidized by the central government in provincial area, but subsidized by municipal government in municipal area.
3.In case an insured person is a worker referred to paragraph 1, subparagraph (8) of Article 6, twenty percent of ordinary injury and occupational accident insurance premium shall be paid by the insured person, and the remaining eighty shall be subsidized by the central government in provincial area, but subsidized by municipal government in municipal area.
4.In case an insured person is a worker referred to in paragraph 1, subparagraph 4 of Article 8, eighty percent of ordinary injury and occupational accident insurance premiums shall be paid by the insured person, and the remaining twenty percent shall be subsidized by the central government in provincial area, but subsidized by municipal government in municipal area.
5.In case an insured person is a worker referred to in Article 9-1, eighty percent of the insurance premium shall be borne by the insured person, and the remaining twenty percent shall be subsidized by the central government in provincial area, but subsidized by municipal government in municipal area.

The labor insurance premiums shall be paid monthly according to the following regulations:
1.For an insured person on referred to in paragraph 1, subparagraphs (1) to (6) of Article 6, or paragraph 1, subparagraphs (1) to (3) inclusive of Article 8, the portion of the premium to be borne by him shall be deducted by the insured unit which shall be paid together with the employer's portion to the insurer before the end of the following month.
2.For an insured person referred to in paragraph 1, subparagraphs (7) or (8) of Article 6, or paragraph 1, subparagraph 4 of Article 8, the portion of the premium to be borne by him shall be paid in the current month to the insured unit to which he belongs, and the insured unit shall forward the accumulated premiums to the insurer before the end of the following month.
3.For an insured person referred to in Article 9-1, the premium due shall be paid by him in the current month to the insured unit or labor organization to which he belongs, and the insured unit or labor organization concerned shall forward the accumulated premiums to the insurer before the end of the following month.
All labor insurance premiums paid to the insurer shall not be refundable except for the consequence of cases which are neither attributable to the insured unit, nor to the insured person.

In case an insured unit has not paid the premiums due before the date indicated in paragraph 1 of the preceding Article, they may be paid within a fifteen-day grace period. In case the premiums remain unpaid to the insurer within the grace period, an additional overdue penalty at the rate of 0.2 percent shall be paid for each day beginning from the expiration day of the grace period to one day before the premiums are paid in full, provided that the overdue penalty shall not be more than double the amount of the premiums.
In case the premiums have not been paid fifteen days after the penalty is due, the insurer shall take legal action for the premiums and penalties payable. In case the insured unit has no property to be attached or has property that is not sufficient to pay the debt, the chief executive officer or responsible pen on shall be liable to pay compensation if deemed responsible for the default.
The insurer temporarily suspends benefit payments to an insured person from the day legal action is taken to the day when the premiums and penalties are paid in full, except when the portion of the premium payable by the insured person on has already been deducted or paid to the insured unit.
For an insured person on referred to in paragraph 1 subparagraphs (7) or (8) of Article 6, and paragraph I subparagraph (4) of Article 8, the premiums payable under Article 15 shall be paid to the insured unit periodically. In case it has not been paid after the fifteen-day grace period, the insured unit may charge penalties according to paragraph l and forward the total amount to the insurer. In case it has not been paid fifteen days after the penalties have been charged, benefit payments shall be suspended temporarily.
In case an insured person on referred to in Article 9-1 has not paid insurance premiums for more than two months, it is considered that he has withdrawn from insurance. All benefit payments received by him during the period when he owes premium contributions shall be recovered legally.

In case an insured person temporarily loses his salary because of an injury for which he receives sickness or injury benefits or hospital care benefits, he may be exempted from paying his portion of the premiums so long as his salary is suspended.
The period during which an insured person is exempted from paying his portion of the insurance premiums referred to in the preceding paragraph shall be included in calculating his coverage period.

Upon the occurrence of a contingency covered by the insurance after the beginning and before the end of the effective period of the insurance, an insured person or his beneficiary may claim insurance benefit payments pursuant to the provisions of this Act.
Insurance benefits payable in cash shall be computed on the basis of average monthly insurance salary for the last six months prior to the month in which the insured contingency occurs. In case an insured person is paid on a daily-wage basis, his insurance benefits shall be determined by dividing his average monthly insurance salary by thirty. But the old-age benefits shall be computed on the basis of the average monthly insurance salary for the last three years prior to the month in which the insured person retires, or, in case the insurance period is less than three years, on the basis of his average monthly insurance salary for the actual insurance period.
In case an insured person is a full-time fisherman, aviation or navigation worker, or a mine-worker, and is declared missing as a result of an accident which occurred in the course of fishing, aviation, navigation, or mining as the case may be, in addition to the insurance benefit claims under this Act, a special missing-person allowance equivalent to seventy percent (70%) of his average monthly insurance salary shall be payable at the end of every three-month period from the day the insured person is declared missing in the census registry until the day prior to (1) his return alive, (2) the expiration of one year after he was declared missing, or (3) he is declared dead by law, whichever happens first.
In case an insured person has been missing for one year or has been declared dead by law, a claim for survivors' benefits may be made in pursuance to the provisions of Article 64.

For within one year after an insurance policy has been cancelled, an insured person shall remain entitled to injury or sickness benefits or hospital care benefits for an injury or sickness or a risk requiring medical care occurred during the period of his insurance policy. The provisions of Articles 35 and 36 shall limit the period in which an insured person may claim injury or sickness benefits. An insured person receiving medical care at a hospital operated or specially contracted by the insurer shall leave the hospital as soon as he is deemed fit for convalescence elsewhere.
Disability or survivors' benefits may still be claimed in case of disability or death sustained as a result of the same injury or sickness or a contingency arising therefrom during the period in which he Continues to receive insurance benefits in pursuant to the provisions of the preceding paragraph. In case an insured person leaves the hospital not because of recovery but with the consent of the hospital operated or specially contracted by the insurer, within one year after his insurance policy has been cancelled, the same claim may be made when disability or death occurs from the same injury or sickness or a contingency arising therefrom.

Where it is confirmed after an insured person retires and withdraws the insurance that he/she has got a kind of occupational disease during the valid period of the insurance, he/she may claim the occupational disability benefits.
The regulations of the above-mentioned payment, that objects, kinds of occupational diseases, determination procedure, calculation of the amount payable and other related affairs shall be prescribed by the competent central authority.

In case the disability or old-age benefits claimed by an insured person before his death have been confirmed as payable by the insurer, these benefits may be received by the duly entitled survivors of the insured person. In case an insured person has no survivors referred to in Article 65, the person responsible for the funeral service shall be paid the burial subsidy equivalent ten months' insurance salary of the insured person.
In case old-age benefits have been received in pursuant to the provisions of the preceding paragraph, no further claims for burial subsidy or survivors' benefits may be made.

In case an insured person cannot continue to work on account of disability but is entitled at the same time to claim either disability or old-age benefits, he may choose either the one or the other.

No insurance benefits may be claimed repeatedly for same contingency.

An insured person, his beneficiary, or any other interested person shall be entitled to no insurance benefits other than burial subsidy for a covered contingency incurred intentionally for the purpose of receiving insurance benefits.

In case an insured unit intentionally files an application for person ineligible under the provisions of this Act to participate in the insurance program and to receive insurance benefits for or on behalf of such a person, the insurer shall take legal action to recover the insurance benefits paid to the ineligible insured person, but also to nullify his qualifications.

The insurer shall not be responsible for paying insurance benefits either to an insured person who refuses without adequate reason to submit to examination by a specially contracted hospital or clinic, or who refuses to submit, upon request, any required documents. The same applies to the beneficiary of an insured person who refuses to submit the required documents.

No insurance benefits shall be payable for a contingency incurred by war or civil commotion, or by an intentional criminal act committed by the insured person, his father, mother, son, daughter, or spouse.

An adopted son or daughter shall not be entitled to receive insurance benefits in case the adoption registration has been less than six months at the time when the contingency occurs.

Where deemed necessary for the insurer to audit insurance benefit payment or for the Labor Insurance Supervisory Commission to settle disputed cases, the insurer or the Commission may request the insured person, beneficiary, insured unit, hospital, clinic, or the physicians or midwifes who hold the certified license, to submit a report, or check the patient data, salary account books, examination and chemical test records or diagnosis radiographs (Ｘ-ray photos) as well as other related documents, and the insured person, beneficiary, insured unit, hospital, clinic, or the physicians or midwifes may not deny such request or check.

The title of an insured person or his beneficiary to all kinds of insurance benefits may not be assigned, offset, attached or mortgaged. However, an insured person who has not repaid interest on a loan referred to Subparagraph (4), Paragraph 1 of Article 67 shall have the amount deducted from insurance benefits claimed by the insured person or other beneficiaries.
The method of deduction in the above paragraph shall be decided by the competent central authority.

A claim for insurance benefits shall be extinguished if not filed within two years from the day on which the benefits become payable.

In case an insured person has one of the following conditions, she may claim to receive maternity benefits:
1.Childbirth occurring more than 280 days after her insurance coverage;
2.Premature labor occurring more than 181 days after her insurance coverage; or
3.Miscarriage occurring more than 84 days after her insurance coverage.
In case of childbirth, premature labor, or miscarriage of the spouse of an insured person, claims may be made pursuant to the provisions of the preceding paragraph.

Maternity benefits are payable according to the following provisions:
1.In case of childbirth or premature labor of an insured person, or the spouse of an insured person, a lump sum payment of delivery expenses shall be made equivalent to 30 days' salaries computed on the basis of the average monthly insurance salary of the insured person, in case of miscarriage, the payment shall be reduced by fifty percent.
2.In case of childbirth or premature labor of an insured person, she shall receive, in addition to delivery expenses, a lump sum maternity benefit equivalent to 30 days' salaries computed on the basis of her average monthly insurance salary.
3.In case of a plural birth resulting from childbirth or premature labor, delivery expenses shall be increased proportionately.
In case of difficult labor when the insured person has already claimed hospitalization benefits, delivery expenses shall no longer be payable.

In case an insured person is not receiving salary payment on account of an ordinary injury or sickness for which he is hospitalized and under medical treatment, he shall be paid ordinary injury or sickness benefit beginning from the fourth day on which he is incapacitated for work.

In case an insured person is not receiving salary payment on account of injury or occupational disease incurred on duty for which he is receiving medical treatment, he shall be paid occupational injury or disease compensation beginning from the fourth day on which he is incapacitated for work. The List of Occupational Diseases is attached hereto as Exhibit 1.
The Regulations for examining injury or sickness incurred on duty shall be prescribed by the competent central authority.

Ordinary injury or sickness benefits shall be payable at the rate of fifty percent of the average monthly insurance salary of an insured person, and payable once every half month for the maximum period of six months, provided that such benefits shall be payable for an additional six months in case the insured person has at least one full year of insurance coverage prior to the occurrence of the injury or sickness.

Occupational injury or disease compensation shall be payable at the rate of seventy percent of the average monthly insurance salary of an insured person, and payable every half month for the maximum period of six months. In case the insured person has not recovered from the injury or disease after one full year, the compensation shall be reduced to fifty percent of the average monthly insurance salary for the maximum period of one year.

In case an insured person has received all payments of such insurance benefits provided in the preceding two Articles during the period of injury or sickness, and continues to participate in the insurance scheme after recovery, he shall be entitled to claim injury or sickness benefits according to the regulations in case the contingency arises.

In case an insured person has received all payments of such insurance benefits provided in Articles 35 and 36, and has not recovered It the end of the prescribed period, he may either apply for continued medical care or claim for disability benefits in case the hospital operated or specially contracted by the insurer confirms that it will not be possible for him to recover from the injury or disease.

Medical care benefits consist of outpatient medical care benefits and inpatient hospitalization benefits.

with a view to protect the health of the insured persons, the insurer shall set up regulations to prevent the occurrence of occupational diseases.
The regulations referred to in the preceding paragraph shall be presented to the competent central authority for approval.

An insured person who has been injured or sick may apply for medical care by a hospital or clinic operated or specially contracted by the insurer.

The sphere of outpatient medical care benefits consists of the following:
1.Diagnostic services (including laboratory examination and medical consultation);
2.Pharmaceutical services and the supply of therapeutic materials; and
3.Treatment, operation or medical care.
Ten percent of the preceding expenses shall be paid by the insured person, provided that they do not exceed the maximum amount allowed by the competent central authority.

In case the diagnosis given by the hospital or clinic operated or specially contracted by the insurer decides that the insured person who conforms to one of the following conditions shall be hospitalized, his insured unit shall make such an application on his behalf, except when an insured person is already hospitalized on account of emergent injury or sickness:
1.Where an occupational injury has been sustained;
2.Where an occupational disease has been afflicted;
3.Where an ordinary injury has been inflicted; or
4.Where the insured person has accumulated insurance coverage for more than 45 days before he applies for hospitalization treatment on account of an ordinary sickness.

Where the insured person gets an occupational injury or disease, the insured unit shall fill in a clinic note of occupational disease or a letter of application for hospitalization (hereinafter referred to as "the Clinic Note or Application Letter for Occupational Disease") to apply for diagnosis and treatment; in case the insured unit doesn't produce the note or letter, the insured person may request the insurer to issue, and the insurer shall grant the note or letter after the case is confirmed.
Where the insured person has not the above-mentioned Clinic Note or Application Letter for Occupational Disease and is diagnosed to have got an occupational disease, the doctor may produce a clinic note of occupational disease. The acquisition and loss of the qualification to produce such note as well as the application and use of the clinic note shall be prescribed out by the insurer, and reported to the competent central authority for approval and issue.

Hospitalization care benefits shall include the following:
1.Diagnostic services (including laboratory examination and medical consultation);
2.Pharmaceutical services and the supply of therapeutic materials;
3.Treatment, operation or medical care;
4.Fifty percent of food expenses within 30 days; and
5.Hospital bed belonging to the same category as the Government Employees' Insurance Scheme.
The insured person shall be responsible to pay for five percent of the expenses referred to in subparagraphs (1) to (3) inclusive and subparagraph (5) of the preceding paragraph, provided that they do not exceed the maximum amount allowed by the competent central authority.
In case an insured person personally wishes to stay in a hospital bedroom of a higher category, he shall be responsible to pay for such additional expenses, besides the expenses referred to in the preceding paragraph.
The enforcement day and regulations of paragraph two of this Article and paragraph two of Article 41 shall be decided after they have been approved by the Legislative Yuan.

Medical care benefits shall not include legally declared epidemics, leprosy, narcotic addictions, child delivery, miscarriage, plastic surgery, artificial teeth, artificial eye, eyeglasses or accessories, patient transportation, special nurses, blood transfusion, registration fees, charges for documents, treatments for which facilities are not available at the hospital or clinic, or other subparagraphs which are not referred to in Articles 41 or 43, except in the case of blood transfusion in an emergency treatment of an insured person deemed by the hospital operated or specially contracted by the insurer to be strictly necessary.

In case an insured person has been receiving inpatient hospitalization care for an injury or sickness for more than one month, the hospital concerned shall file an application for further hospitalization of the insured person once every month.
In case an insured person receiving inpatient hospitalization care in a hospital operated or specially contracted by the insurer is recommended after due diagnosis to leave the hospital for convalescence elsewhere, he shall do so as soon as possible, or be responsible to pay for the cost of further hospitalization care himself.

An insured person shall have the option to receive medical care at any hospital or clinic operated or specially contracted by the insurer, unless otherwise specially provided.

An insured person who becomes disabled as a result of injury or sickness and has received disability benefits shall not be entitled to claim for inpatient hospitalization care for the same injury or sickness.

An insured person who has received medical care benefits during an effective coverage period shall remain entitled to insurance benefits of other categories.

All medical expenses incurred by an insured person shall be payable by the insurer directly to the hospital or clinic operated or specially contracted by the insurer, and shall not be payable to an insured person in cash.

All public hospitals or clinics located in an area in which this Act is applicable shall be recognized as hospitals or clinics specially contracted by the insurer for medical treatment under the labor insurance scheme, provided they are above the required standards. Hospitals or clinics operated by an insured unit or a private agency may apply to the insurer to become specially contracted for medical treatment of insured persons under the labor insurance scheme, provided they are above the required standards.
Regulations for the special contracting with and operation of hospitals or clinics specially contracted by the insurer for the labor insurance scheme referred to in the preceding paragraph shall be prescribed by the competent central authority in consultation with the competent central health authority.

A specially contracted hospital or clinic offering out-patient or inpatient hospitalization services shall charge an insured person for medical expenses due in accordance with the Schedule for the Payment of Medical Expenses in Labor Insurance, and the Schedule of sable Medicines and Their Prices.
The Schedule for the Payment of Medical Expenses in Labor Insurance, and the Schedule of Usable Medicines and Their Prices referred to in the preceding paragraph shall be prescribed by the competent central authority.
The medical expenses referred to in preceding paragraph 1 shall be subject to review by a screening committee consisting of various categories of doctors and pharmacists appointed by the insurer. The regulations concerning such a review shall be prescribed by the competent central authority.

In case an application for outpatient or inpatient hospitalization services filed by an insured unit is deemed not to have conformed with the provisions governing insurance benefits, medical care benefits, or hospitalization care benefits, or in case of misrepresentations in the application forms, or in case the application forms are given to noninsured persons for use, the insured unit shall be responsible for paying all the medical expenses incurred.
In case the medical care given by a specially contracted hospital or clinic does not fail within the sphere of medical care benefits, the medical expenses so incurred shall be borne by the hospital or clinic concerned or by the insured person himself.

In case an insured person suffers any residual physical handicap in the wake of a medical treatment of ordinary injury or sickness, and such disability conforms to the provisions of the Disability Benefits Payment Schedule, and the diagnosis by a hospital operated or specially contracted by the insurer confirms that the insured person will be disabled for the rest of his life, he may claim the payment of disability benefits in one lump sum calculated on the basis of his average monthly insurance salary pursuant to the same category of disability in the Disability Benefits Payment Schedule, a sample of which is attached as Exhibit 2.
The provisions referred to in the preceding paragraph may also apply to an insured person who, on the expiration of the period when he received ordinary injury or sickness benefits or at least one year after receiving medical treatment, has not recovered or suffers any residual physical handicap which conforms to the provisions of the Disability Benefits Payment Schedule, and the diagnosis by a hospital operated or specially contracted by the insurer confirms that the insured person's injury or sickness is incurable.

An insured person shall be paid an additional fifty percent of disability benefits calculated on the same category and payment schedule of disability benefits in case he suffers, in the wake of I medical treatment for occupational injury or disease, any residual physical handicap which conforms to the provisions of the Disability Benefits Payment Schedule, and the diagnosis by a hospital operated or specially contracted by the insurer confirms that the insured person will be disabled for the rest of his life. Such disability benefits shall be payable on a lump sum basis.
The provisions referred to in the preceding paragraph shall also apply to an insured who, on the expiration of the period when he received occupational injury or sickness benefits, has not recovered and his residual physical handicap conforms to the provisions of the Disability Benefits Payment Schedule, and the diagnosis by a hospital operated or specially contracted by the insurer confirms that his occupational injury or sickness will be incurable.

A claims for disability benefits shall be subject to screening and approval according to the following principles:
1.An insured person who suffers from any residual physical handicap conforming to any of the categories specified in the Disability Benefits Payment Schedule shall be entitled to claim disability benefits according the category of his disability.
2.In case an insured person suffers from a residual physical handicap which simultaneously meets more than two categories specified in the Disability Benefits Payment Schedule, his claim for disability Benefits shall be dealt with in accordance with the provisions of subparagraphs (3) to (6) inclusive of this Article, and, in addition, he shall be entitled to receive benefits according to the category which ranks the highest in the categories.
3.In case an insured person suffers any residual physical handicap which simultaneously conforms to more than two categories between categories 14 and 1 as set forth in the Disability Benefits Payment Schedule, insurance benefits shall be payable according to the category which ranks one category above the highest of them. However, in case the highest category happens to be category 1, benefits payable shall be rated at category 1.
4.In case an insured person suffers any residual physical handicap which simultaneously conforms to more than two categories between categories 8 and 1 as set forth in the Disability Benefits Payment Schedule, insurance benefits shall be payable according to the category which is two categories above the highest of them. But in case the highest category is category 2 or above, benefits shall be payable on the 'oasis of category 1.
5.In case an insured person suffers a residual physical handicap which simultaneously conforms to more than two categories between categories 5 and 1 as set forth in the Disability Benefits Payment Schedule, insurance benefits shall be payable according to the category which is three categories above the highest of them. But in case the highest category is category 3 or above, benefits shall be paid on the basis of category 1,
6.In case an insured person suffers I residual physical handicap which does not conform to any of the categories as set forth in the Disability Benefits Payment Schedule, the physical handicap as set forth in the Schedule shall also apply in determining the category of disability in the light of the degree of such a disability.
7.In case the amount of disability benefits determined pursuant to subparagraphs (3) to (6) inclusive of this Article exceeds the total amount of benefits under each one of the applicable category, insurance benefits shall be payable according to the total amount of benefits under each applicable category.
8.In case an insured person was originally partially-disabled and a new injury or sickness has aggravated his disability on the same part, disability benefits shall be payable for the number of days during which he sustained aggravated disability in the amount determined according to the Disability Benefits Payment Schedule, provided that the amount of disability benefits for the original disability as determined in accordance with the Schedule shall be deductible.
9.In case an insured person was originally partially-disabled and a new injury or sickness not only has aggravated his disability on the same part, but also has caused disability to another part of his body, disability benefits shall be payable for the number of days during which he sustained the disability prescribed under subparagraphs (1) to (6) inclusive of this Article, in an amount determined according to the Disability Benefits Payment Schedule, provided that the amount of benefits for the original disability determined pursuant to the Schedule shall be deductible.
10.In case an insured person's aggravated disability as specified in subparagraphs (8) and (9) is caused by an occupational injury or disease, the insured person shall be paid disability benefits for the number of days during which he suffers disability, in an amount which is fifty percent higher than that determined according to each applicable category.

If, in reviewing a claim for disability benefits, the insurer deems it necessary to conduct a re-examination, another hospital or doctor may be appointed for the re-examination.

In case an insured person is unable to continue his original work after receiving disability benefits, the effect of his insurance shall be terminated immediately.

An insured person who has any of the following conditions may claim to receive old-age benefits:
1.An insured person at least sixty years of age or a female insured person at lease fifty-five years of age who has been insured for at one year and resigns;
2.An insured person whose insurance coverage reached over fifteen , who is at least fifty-five years of age and resigns;
3.An insured person who has hen insured in the same insured unit for over twenty-five years and resigns; or
4.An insured person whose insurance coverage reached over twenty-five years, who is at least fifty years of age and resigns;
5.An insured person who has been employed for more than five in physical hard labor, work of special character, certified by the competent central authority as dangerous, who is at least fifty-five years of age and resigns.
An insured person who has received old-age benefits may no longer participate in the labor insurance.

An insured person who claims old-age benefits payment in accordance with the provisions of paragraph 1 of the preceding Article shall receive one-month's old-age benefits for each one of his coverage years computed on the basis of his average monthly insurance salary. In case his coverage exceeds fifteen years, the insured person shall receive two-months' old-age benefits for each one of the excess years, provided that the maximum amount of old-age benefits payment shall not exceed forty-five months of insurance salaries, and the period exceeding half a year may be reckoned as one year.

(Deleted)

In case an insured person continues to work after attaining sixty years of age, his insurance coverage above that age shall not exceed five years. On resignation, he may claim old-age benefits payment according to the provisions of Article 59, provided that the maximum amount shall not exceed fifty months' insurance salaries including the old-age benefits receivable before he attained sixty years of age.

In the event of death of the father, mother, spouse, or child of an insured person, he may claim burial subsidy pursuant to the following provisions:
1.Three-months' salaries on the basis of his average monthly insurance in the event of the death of his father, mother, or spouse;
2.Two-and-a-half months' salaries on the basis of his average monthly salary in the event of the death of his child It least twelve years of age, or
3.One-and-a-half months' salaries on the basis of his average monthly salary in the event of the death of his child less than twelve years of age.

In the event of the death of an insured person, five months of burial subsidy is payable. In case he is survived by his spouse, child, father, mother, grandfather, or a dependent grandchild, brother(s) or sister(s), survivors' benefits may also be paid according to the following provisions:
1.Ten-months survivors' benefits shall be payable in one lump sum on the basis of his average monthly insurance salary in case his insurance coverage is less than one full year;
2.Twenty-months survivors' benefits shall be payable in one lump sum on the basis of his average monthly insurance salary in case his insurance coverage is more than one full year but less than two full years; or
3.Thirty-months survivors' benefits shall be payable in one lump sum on the basis of his average monthly insurance salary in case his insurance coverage is more than two full years.

In case an insured person dies from an occupational injury or disease, not only shall a five-month burial subsidy be payable on the basis of his average monthly insurance salary, but forty-month survivors' benefits shall also be payable to his survivor, in case he is survived by his grandfather, father, mother, spouse, child, grandchild, brother or sister, irrespective of the length of his insurance coverage period.

Survivors' benefits referred to in the preceding two Articles shall be payable to the entitled survivor(s) according to the order prescribed below:
1.Spouse, son and/or daughter;
2.Father and/or mother;
3.Grandfather and/or grandmother;
4.Grandson and/or granddaughter;
5.Brother and/or sister(s).

The labor insurance fund shall be derived from the following sources:
1.The monies earmarked in one lump sum by the government when the Fund is established;
2.The current-year premiums and the interest income in addition to the balance after due payment of insurance benefits;
3.Penalties on overdue premiums;
4.Income from investment of the Fund.

With due approval of the Labor Insurance Supervisory Commission, the labor insurance Fund may be used in the following manner:
1.Invested in government bonds, treasury bills or corporate bonds;
2.Deposited with government-run banks or other financial institutions designated by the competent central authority.
3.Invested in labor insurance hospital(s) operated by the insurer, or used as loans to public hospitals specially contracted by the insurer to finance the repair or maintenance of labor insurance beds, in a manner to be prescribed by the competent central authority
4.Put towards loans for insured persons; or
5.Invested in any other government-authorized projects which may inure to the benefit of their Fund.
The labor insurance Fund may be applied or disposed of for no other purposes than the payment of insurance benefits or for the purposes referred to in the preceding paragraph. The regulations on the administration of such Funds shall be prescribed by the competent central authority. A report on the Fund's receipts, a status report on how the Fund is being applied or used, and on the cumulative sum of the Fund shall be submitted by the insurer to the competent central authority for public notice on a yearly basis.
Items of an insured person's loan regarding qualification, use, amount, limit, and repayment method in Paragraph 1, Subparagraph 4, should be publicly declared by the Insurer in a report to the central competent authority.

The insurer shall budget the administrative costs for handling the labor insurance program, to be computed at the rate of five and one half percent of the premiums collectible for the month of June of the current budget year and multiplied by twelve. Such costs shall be disbursed by the labor commission of the central government, after the said budget has been duly reviewed and approved by the Labor Insurance Supervisory Commission.

Before the Central Bureau of Labor Insurance is established, in case of any loss in labor insurance, it shall be approved and made good by the labor commission of the central government.

In case a person receives insurance benefits through fraudulent or other improper act, or makes false certification, report, misrepresentation, or files a claim for medical expenses, he shall not only be fined an amount equivalent to twice the insurance benefits received, but also be liable to the insurer for compensation for damages. If criminally liable, he shall also be referred to the court for indictment. Any medical expenses so received by specially contracted hospital or clinic may be deductible from the expenses claimed or receivable by it.

A worker who, in violation of the provisions of this Act, has not participated in labor insurance and attended to the formalities thereof, shall be fined an amount no less than one hundred and no more than five hundred NT dollars.

Any insured unit that fails to carry out labor insurance formalities according to this Act for any of his employees in pursuance of the provisions hereof will be fined a sum two times the insurance premium amount payable for the period from employment to effecting insurance, and the loss caused by this to the employees shall be compensated by the insured unit pursuant to the payment standard prescribed in this Act.
Any insured unit that infringes this Act and declares the insurance salary more or less than the actual amount will be fined a sum two times the insurance premium amount of the period commencing from occurrence of the action, and the additionally received amount will be taken back. The loss caused by this to the employees shall be compensated by the insured unit.
In case when the insurer performs inspection under Paragraph 3, Article 10, an insured unit rejects to provide the documents or infringes Paragraph 4 of the same article, the insured unit will be fined a sum of 2,000~6,000.
According to Paragraph 1, Article 17, in case the insured unit still doesn't pay the insurance premium payable to the insurer after the overdue fine reaches 1 time the premium amount payable, a sum 3 times the insurance premium amount payable will be fined.

In case a penalty remains unpaid for no cause thirty days after the notice of the fine prescribed herein is served, the case shall be referred to the court for compulsory execution.

The premium rates, the enforcement areas, the date and the measures for setting up unemployment insurance shall be prescribed by the Executive Yuan.

(Deleted)

In case an insured person is transferred to the Armed Forces Insurance, the Government Employees' Insurance, or the Insurance for Teaching and Administrative staff of Private Schools, who, at the time of such transference, is not yet entitled to draw old-age insurance benefits pursuant to the provisions of this program, his seniority qualifications shall be reckoned, and when he legally retires on reaching old age, he shall be entitled to claim old-age insurance benefits according to the provisions of Article 59 of this Act.

The provisions including Article 2, Article 31, Article 32, Article 39-52 should not be applied to the delivery expense of maternity benefits and medical benefits of Ordinary Insurance when the National Health Insurance Program becomes effective.

The Enforcement Regulations of this Act shall be prescribed by the competent central authority subject to the approval of the Executive Yuan.

The enforcement areas of this Act shall be determined by the ordinances of the Executive Yuan.

This Act shall become effective on the day of promulgation.