History

These Rules are drawn up in accordance with Article 77 of the Labor Insurance Act (hereinafter referred to as the Act).

Pursuant to Article 3 of the Act, the following shall have tax exemption status:
1. Bills and receipts generated from labor insurance transactions between insurer and insured units shall be exempt from the stamp duty.
2. Insurance premium payments, late fee payments, incomes from compulsory enforcement, and other sources of incomes, such as management of foundations and miscellaneous incomes shall be exempt from business and income taxes.
3. Buildings, medical supplies and equipment, emergency response vehicles used by insurer providing labor insurance and benefits received by the insured or others beneficiaries shall be exempt from taxation in accordance with the existing tax law.

The calculation of the duration of the insurance coverage period, unless specified elsewhere in the Statute, shall be in accordance with the Civil Code.
The ages of the insured persons and their dependents shall be calculated according to information contained in the household registry.

Insurer shall compile an annual report at the end of each year, and submit the following documents at monthly intervals to the central competent authority for registration and examination:
1. The statistical records showing insured units, number of insured persons and insurance wages.
2. The statistical records showing all insurance benefits payments.
3. The accounting records showing all transactions involving insurance incomes and expenditures.
4. The insurance fund utilization status.
The above records shall be submitted to the Labor Insurance Supervisory Commission.

The Labor Insurance Supervisory Commission shall compile quarterly supervisory records, examinations of disputes, and financial audit reports, and submit a final report at the end of each year to the central competent authority for registration and examination.

Insurer or members of the Labor Insurance Supervisory Commission, when conducting the labor insurance inspections in accordance with Article 28 of the Statute, shall display their identification documents.

The competent authorities referred to in Paragraph 2 to Article 6 of the statute are the municipalities or county (or city) governments where the workers' worksites are located.

The persons employed outside of the industries mentioned in Item 1 of Paragraph 1 to Article 8 of the Statute, refer to the workers approved and recognized by the central competent authority for insurance coverage from other businesses or civil organizations.

Employed persons with no definite employer or are self-employed and participate in two or more professional labor unions shall select the major union as their basis for insurance coverage.

The insured unit shall establish roll list (card) of employees or members, attendance and work records, payroll, and account book of salary.
The roll list (card) of employees or members shall include the following contents:
1.Name, sex/gender, date of birth, address, and serial number of I.D. Card.
2.Date of accession, enrollment, or attendance in training.
3.Category of work.
4.Working hours and salary.
5.Period of leave without pay caused by injury or sick leave.
The attendance and work records, payroll, and account book of salary mentioned in the first paragraph, as well as Subparagraph 4 and Subparagraph 5 of the above paragraph are not applicable to occupational union, fishermen's association, association of Chinese Ship Owners, and Chinese Seamen's union.

Workers without definite employers referred to in Items 7 to 8 of Paragraph 1 to Article 6 of the Statute are those who are always employed by over two employers that are not belong to the categories of Items 1 to 5 of the same Article of the Statute in the past three months, and whose job opportunities, working times, quantities of work, workplaces and remuneration are not steady.
Self-employed persons referred to in Items 7 to 8 of Paragraph 1 to Article 6 of the Statute are those who perform their job or technique independently and obtain remuneration accordingly, and do not hire persons help them to do the work with payments.

When units apply for coverage of insurance and undertake insurance procedures, they shall fill out application forms for insurance coverage and joining insurance coverage, and submit each of them to the insurer.
The joining application forms referred to in the preceding Paragraph shall be filled out in detail in accordance with household registry or other related information.

When employers, associations or affiliated authorities hiring workers referred to in Article 6 of the Statute apply for coverage of insurance, except for governmental authorities or public schools, they shall submit the Xeroxed copies of the front and back pages of the national identification cards of the persons in charge and the copies of the following related documents issued by other related business competent authorities:
1. Factories shall submit the factory registration certificates.
2. Minefields shall submit the minefield registration certificates, minefield excavating or prospecting certificates.
3. Salt pits, ranges, pastures, forest and tea plantations shall submit registration certificates.
4. Transportation entities shall submit transportation permits or other related documents.
5. Public utilities shall submit business licenses or other related documents.
6. Companies and business entities shall submit company licenses, registration certificates for entities for profit or business registration certificates.
7. Private schools, news media, cultural entities, public-interest entities, cooperative entities, fisheries, occupational training institutions and civil organizations for various businesses shall submit their accredited or registration certificates.

When employers, associations or affiliated authorities hiring personnel referred to in Article 8 of the Statute apply for coverage of insurance, they shall submit the documents in the same manner pursuant to the preceding article.

The insurer shall fill out and make one copy of certificate of insurance in accordance with the application forms for insurance coverage and two copies of insurance card for the insured persons in accordance with the application forms for joining insurance coverage and give them to the insured units. The certificate of insurance shall be displayed in a conspicuous place. One copy of the insurance card for the insured persons shall be safe kept by the insured units and the other copy shall be signed and safe kept by the insured person.

For those workers qualified under Article 6 of the Statute, when the insured units inform the insurer with a name-list on the dates their employees formally report to work, become a member of their associations or receive the professional training, the effective dates of the insurance shall be commenced from the zero hour of the dates when the application forms for joining insurance coverage from the insured united reached the insurer or when they are mailed; when the insured units did not inform the insurer with a name-list on the dates their employees formally report to work, become a member of their associations or receive professional training, the effective dates of the insurance shall be commenced from the zero hour of the next dates when the application forms for joining insurance coverage from the insured units reached the insurer or when they are mailed.
When the insured units withdraw from insurance coverage on the dates after their employees leave their jobs, withdraw memberships from their associations or finish (or withdraw from) professional training programs, the effectiveness of the insurance shall be terminated from the 24th hour of the dates when the application forms for withdrawing from insurance coverage from the insured units reached the insurer or when they are mailed; when the insured units did not withdraw from the insurance coverage on the dates after their employees leave their jobs, withdraw memberships from their associations or finish (or withdraw from) professional training programs, the effectiveness of the insurance shall be terminated on the 24th hour of the dates when employees leave their jobs, withdraw their memberships or finish (or withdraw from) professional training programs.
The dates of the mails are posted referred to in the preceding paragraphs are set in accordance with the post-marks of the original sending post offices.

When the insurer received the application forms for joining or transferring insurance, forms for adjusting insurance wages submitted by the insured units, except for those without names shall be immediately rejected, it shall notify the insured units in writing to correct the errors such as missing of the seals of the insured units, the persons in charge, or the birthdates of the insured persons, serial numbers of the national identification cards and the mistaken insurance wages. The insured units shall make the necessary corrections within 10 days upon receipt of the said notification.
When the application forms for joining or transferring insurance are corrected by the insured units on time, they shall take effect on the dates of their submission. When the corrections are overdue, they shall take effect on the next date upon correction. When no correction after overdue in made, they shall not take effect.
When forms for adjusting insurance wages are corrected by the insured units on time, they shall take effect on the first day of the next month from the date of submission. When the correction are overdue, they shall take effect on the first day of the next month from the date of correction. When no correction after overdue is made, they shall not take effect.
The submission of the corrections referred in the preceding three paragraphs shall be set on the date which they reach the insurer. When the corrections are mailed, they shall be set in accordance with the post-marks of the original sending post offices.
When the insured units make an overdue correction or make no correction at all after overdue, they shall be liable for any loss incurred to workers.

In case the insured units are suspended, disbanded or bankrupted, or the premiums payable remain unpaid and after the proceedings of compulsory execution the late fees for overdue premiums still cannot be paid, the insurer may notify them in writing to withdraw from insurance coverage. The termination of the effectiveness of insurance, the calculation of the premiums payable and the added penalties for overdue premiums shall be set on the dates the above-mentioned facts are ascertained; if the facts cannot be ascertained, the dates shall be set by the insurer after investigations.
In case the insured units are overdue in the payment of premiums or late fees for overdue premiums, and after the notification to pay within a set time-limit but still cannot pay, and there are apparent facts to indicate that the possibility of payment is none, the insurer may withdraw insurance coverage immediately. The termination of the effectiveness of insurance, the calculation of the premiums payable and the added penalties for overdue premiums shall be set on the dates the notifications for payment within a set time-limit are arrived.

The insured units shall submit the application forms for the changes in the insured units and other related documents to the insurer within so days after the occurrence of the following:
1. The changes of names, addresses or other corresponding addresses of the insured units.
2. The changes of persons in charge of the insured units.
3. The changes of seals of the insured units or the persons in charge.
In case the name of the insured unit is changed, the original insurance certificate shall be returned to the insurer and a new insurance certificate shall be issued.
The insurer shall make the change referred to in the preceding paragraph within 30 days.

When the persons in charge of the insured units are changed, the unpaid premiums or the penalties for overdue premiums owed by the original persons shall be individually and jointly assumed by the new persons.
When the insured units are terminated after merger and acquisition, their unpaid premiums or penalties shall be assumed by the remaining insured units after merger and acquisition or the new insured units.

When the insurance wages are adjusted or other related contents are changed, the insured units shall duely fill them out on the insurance cards of the insured person's safe kept by them to reflect such changes. When the original cards are totally filled out, the insured units shall notify the insurer to issue new blank cards. They shall put these cards together and used and safe kept them accordingly.

In the event of employing persons under the age of 15 to perform the work, the insured units shall submit Xeroxed copies of their certificates of graduating from national middle high schools or Xeroxed copies of approval certificates issued by the municipal or county (city) governments at the worksites when apply for joining insurance coverage.

Foreign workers referred to in Paragraph 3 to Article 6 of the Statute applying for joining insurance coverage shall submit Xeroxed copies of work permits approved and issued by the central competent authority or other related business competent authorities.
The national identification cards referred to in these Regulations shall be applicable to the foreign workers mentioned in the preceding paragraph, who shall present their residence permits for foreign nationals or foreign passports.

When the insured persons referred to in Article 9 of the Statute intend to continue to join insurance coverage, the insured units shall not deny them.
When the insured persons referred to in Article 9 of the Statute continue to join insurance coverage, the insured units they affiliated with shall continue to pay premiums for them, and except under the circumstances of Items 2 and 4 of the same Article, shall notify in writing to the insurer about their names, birthdates, serial numbers of their national identification cards, the dates of their national military service, unpaid leaves, suspension from the job because of pending lawsuits or detention. The same procedure shall apply when the insured persons are discharged from national military service, reinstated to the former positions or their detention are revoked or stopped.
When the insured persons referred to in Item 3 of Article 9 of the Statute continue to join insurance coverage, in addition to processing according to the procedures stipulated in the preceding paragraph, they shall also submit medical records issued by the hospitals or clinics.

When insured persons leave their employment and withdrew from insurance coverage without receiving old-age benefits resuming employment after reaching the age of 60, if their suspension of insurance seniority has not exceeded two years, the insured unit they affiliated with may apply for rejoining insurance coverage for them.

In the event that the insured person's death, termination of employment, withdrawal from membership of associations, conclusion (or withdrawal) of vocational training programs, or disability after medical evaluations, the insured units shall, on the dates on which death, termination of employment, withdrawal from membership of associations, conclusion (or withdrawal) of vocational training programs occurred or upon receipt of the notification of disability, fill out the application forms for withdrawal of insurance coverage and submit them to the insurer.
In the event that the insured persons are on the leave of absence due to injuries or illness, the insured units may not withdraw their insurance coverage.

In the event that the insured persons are transferred in the insured units with the same affiliation, the transferring units shall fill out the transfer-out part of the application forms for transfer of insurance coverage and forward them directly to the receiving units. The receiving units shall fill out the receiving part of the forms and submit both parts to the insurer. The effectiveness of the transfer of insurance coverage shall be set on the date when the application forms for transfer of insurance coverage reach the insurer. In case of mailing, they shall be set in accordance with the post-marks of the original sending post offices.

In the event that the insured persons are hospitalized because of injuries or illness and those continue to join insurance coverage in accordance with Subparagraphs 1, 3, 5 of Article 9 , and Article 9-1 of the Act, or Second paragraph of Article 16 of the Act of Gender Equality in Employment, their insurance salaries may not be adjusted during the period of insurance coverage.
The insurance salary for the insured persons in the above paragraph should not be lower than the First Grade of the “Table of Grades of Insurance Salary ". Should there be any amendment in the First Grade of the " Table of Grades of Insurance Salary "; the insurer can adjust the suitable insured salary accordingly.

All related insurance files and records shall be safe kept and regularly maintained by the insurer.

Persons who have the option to select and receive labor insurance coverage or civil service insurance concurrently may only be permitted to select one for insurance coverage.

For those insured persons who are qualified under Item 7 of Paragraph 1 to Article 6 of the Statute, in the event that their insured units are those professional labor unions not affiliated with their own specialties, or those who have changed their own specialties but have not transferred to the professional labor unions with their own specialties, the insurer, after knowing the facts, shall notify the original insured units to transfer insurance coverage within a set time-limit. Nevertheless, their insurance seniority before and after the transfer shall be calculated in combines.

The total monthly wages referred to in Paragraph 1 to Article 14 of the Statute shall be set in accordance with the wages stipulated in Item 3 of Article 2 of the Labor Standards Law. For those without fixed or steady monthly incomes, they shall be set according to the average monthly incomes in the recent three months. For those who are paid in kind, they shall be calculated in cash pursuant to the prices publicly announced by the Government.
In the event the insured units filing application forms for joining insurance coverage for their newly employed workers and their total monthly wages are not ascertained, they shall be set at the total monthly wages received by the workers with the same working grades in the insured units and apply pursuant to the requirements contained in the Insurance Wages Grading Table.

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In the event that the insured persons are hospitalized because of injuries or illness and those continue to join insurance coverage in accordance with Items 1, 3, 5 of Article 9 and Part One of Article 9 of the Statute, their insurance wages may not be adjusted during the period of joining insurance coverage. When the Insurance Wages Grading Table is adjusted, their insurance wages may not be set below the grades applicable to the basic wages.

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The insurer shall separately calculate payable insurance premiums in accordance with the insured persons' insurance wages reported by the insured units each month and prepare insurance premium payment bills with the statements of methods of calculation regularly. The bills shall be sent to the insured units before the 25th day of the next month and request them to pay the premiums.

When the insured units received the premium payment bills with the statements of methods of calculation sent by the insurer, they shall pay the premiums immediately to the banks or post offices especially designated by the insurer. When the payments are made through deposit accounts of the post offices, the insured units shall fill out their names, serial number of their insurance certificates, the monthly payments are made and the amounts of payments on the correspondence part of the deposit bills and keep the receipt as the proof the insurance premium payments.
In the event that the insured units have not received the premium payment bills referred to in the preceding paragraph by the end of month the insurer shall send them, they shall notify the insurer in writing to resend them within five days. Under this circumstance, the insured units shall pay the premiums within the grace period (fifteen days) or pay to the special labor insurance accounts in the banks or post offices in accordance with the amounts of premiums set in last month temporarily and set the amounts straight later when they pay the premiums of the next month.

If the insured units object to the amounts of premiums stated in the premium payment bills, they shall pay the said amounts first and then list the reasons to file a formal objection to the insurer. When the insurer discovers errors after investigation, it shall set the amounts straight later when it calculates premiums of the next month.

In the event that the insured units are overdue in the payment of premiums or late fees for overdue premiums, and after the insurer suspend insurance payments temporarily in accordance with Paragraph 3 to Article 17 of the Statute, they shall pay insurance premiums continually during this temporary suspension period. After the payment of these owed fees, the insured persons can file their applications for their insurance payments.

The insurer shall calculate the amounts of insurance premiums payable by the insured units in yuan (N.T.$1) and to count five and higher fractions as units and disregard the rest when calculating a tenth of a yuan (N.T.$0.1).

In the event that the insured units cannot set-off or receive insurance premiums within the time-limits set by Article 16 of the Statute due to various reasons, they shall pay them first.

In the event that the insured persons are recruited to assume national military service, take unpaid leaves, are suspended from the job because of pending lawsuits or are detained and continue to join insurance coverage, the portion of their premiums payable by the insured units shall be paid by the insured units during the period. As for the portion of premiums payable by the insured persons, those have already been paid shall be deducted from the payments and those have not already paid shall be paid by the insured units first and recover from the insured persons later.

In the event that the central and the municipal governments shall be responsible to pay or subsidize insurance premiums pursuant to Article 15 of the Statute, the insurer shall prepare and issue insurance premium payment bills each month and send them to the central and the municipal governments by the end of the next month and request them to pay in accordance with the related regulations.
After the insurer discovers that insurance premiums payable by the governments referred to in the preceding paragraph are inadequate after investigation, it shall set the accounts straight later when it calculates premiums of the next month.

When employers or persons in charge of the insured units deduct insurance premiums payable by the insured persons pursuant to Item 1 of Paragraph 1 to Article 16 of the Statute, they shall explain them clearly on the insured persons' wage bills (bages) or issue receipts to them.

The insurer shall determine the applicable categories of occupations and premium rates of the occupational incident insurance for the insured units in accordance with the applicability list concerning categories of occupations and premium rates for the occupational incident insurance, and after assessing the following principles, notify the insured units in writing:
1. The same category of occupations shall use the same premium rates of the occupational incident insurance.
2. In the event that the same insured unit uses the same premium rates of the occupational incident insurance and its line of business includes various occupations, premium rates of the occupational incident insurance shall be decided by its most principal or representative business.
If the insured units object to the categories of occupations and premium rates referred to in the preceding paragraph, they shall prepare and submit necessary documents or materials, and file an application for reexamination to the insurer within fifteen days after the next day of receiving the notification.
After the applicable categories of occupations and premium rates of the occupational incident insurance are determined and ascertained, the insured units are not allowed to request for readjustment except in the event of changing their business.

The insured units with employees above a certain number referred to in Paragraph 2 to Article 13 of the Statute, the standard of the number of persons shall be determined by the central competent authority.

Late fees payable by the insured units referred to in Paragraph 2 to Article 47 of the Statute shall be calculated by the insurer and notify them to pay to the designated banks or post offices.

For the purpose of letting the insured person pay their insurance premiums by transfer of money or to deposit accounts of the post offices, the insured units that the insured persons are affiliated with and referred to in Items 7, 8 of Paragraph 1 to Article 6 and Item 4 of Paragraph 1 to Article 8 of the Statute may establish special "labor insurance" accounts in the financial institutions or post offices and notify the insurer.
The insured units the insured persons are affiliated with and referred to in the preceding paragraph, after receiving approvals from the insured persons or the general meeting of the members, may take three-or-six months' insurance premiums in advance and issue receipts to the insured persons and pay to the insurer monthly. Those insurance premiums received in advance and not yet payable to the insurer shall be deposited in special accounts in the financial institutions or post offices. The interests thus accumulated shall be used within the scope of the insurance transactions referred to in the Statute.
The insured units which are receiving insurance premium in advance referred to in the preceding paragraph may join the insurance programs for their chiefs or personnel in charge of the business for the purpose of guaranteeing their honesty and credibility.
The management of insurance premium received in advance referred in Paragraph 2 to the Article shall be pursuant to the related regulations concerning financial transactions of the groups affiliated with the insured units.

In the event that the insurance premiums payable by the insured persons are exempt from payment pursuant to Paragraph 1 to Article 18 of the Statute, the insurer shall calculate the amounts in accordance with the approved documents of payment and issue the insurance premium exemption bills, and subtract the amounts from the total insurance premiums payable by the insured units.

The insured units shall process the application of insurance benefit payment procedures for their affiliated insured persons or their beneficiaries and shall not receive any form of monetary compensation.

Persons continuing to apply for receiving injury or sickness benefits or hospital care benefits referred to in Article 20 of the Statute are those insured persons who have already received injury or sickness benefits or hospital care benefits due to the incidents of injury and sickness before withdrawing from insurance coverage, and continue to apply for receiving such benefits after withdrawing from insurance coverage.
In the event that the insured persons apply for the payments of insurance benefits after the termination the effectiveness of insurance pursuant to Article 20 of the Statute, the procedures shall be processed by the original insured units. However, if the original insured units are suspended, disbanded or bankrupted as provided in Article 18 of these Regulations, the insured persons or their beneficiaries may apply for these payments by themselves.

The "average monthly insurance wages" referred to in Paragraph 2 to Article 19 of the Statute shall be calculated by dividing by six the insured persons' total monthly insurance wages in the most current six months prior to the occurrence of the insurance incidents. For those who have joined insurance coverage less than six months, their average monthly insurance wages shall be calculated by their actual seniority in joining insurance coverage. However, the old-age benefit payments shall be calculated by dividing by thirty-six the insured persons' total month insurance wages in the most current three years prior to the retirement.
The "six months" or "three years" referred to in the preceding paragraph shall include the month when the insurance incidents occur.
In the event that before the occurrence of the insurance incidents the insured persons have more than two insurance wages in the same month for calculating their insurance wages in the most recent six months or the most recent three years before their retirement, the highest wages shall be used as a standard and calculated on average along with the monthly insurance wages of the other months.

When applying for the payments of missing person allowance in accordance with Paragraph 3 to Article 19 of the Statute, the following documents must be prepared:
1. Application forms for missing person allowances.
2. Receipts of benefits payments.
3. Copies of whole household registration form (with the date of disappearance listed).
The order for receiving missing person allowance shall be executed pursuant to Article 65 of the Statute.
In the event that beneficiaries of missing person allowances are grandchildren, brothers or sisters, they shall be limited to those who have been specially raised and supported by the missing persons.

In the event that death benefits are paid pursuant to Paragraph 4 to Article 19 of the Statute but the insured persons are in fact alive, if they return the paid death benefits and rejoin labor insurance, their prior insurance sonority shall be restored and recognized.

In case insurance benefits are payable in cash in accordance with the Statute, upon calculation by the insurer, they shall be transferred directly to the insured persons or their beneficiaries. The insured units they are affiliated with shall be notified and record the facts on the insurance cards safe kept by them.

Upon request by the insured persons or their beneficiaries, the insurance benefit payments payable to them may be paid in advance by the insured units in portion or in whole. After the insured units make the payments and receive the proofs from the insured persons or their beneficiaries, while they are in the process of applying for the payments of insurance benefits, they may request the insurer to transfer the paid amounts to them directly. Under such circumstances, the insurer shall record the facts on the benefit payment notification bills.
The advance payments made by the insured units referred to in the preceding paragraph shall be paid to the insured persons or their beneficiaries directly and in persons.

After reviewing the applications for cash payments filed by the insured persons or their beneficiaries and all procedures are deemed complete, the insurer shall make the payments within ten days after receiving the application forms.

The intentional criminal activities referred to in Article 26 of the Statute shall be determined by the final decisions of the civil judicial authorities or the military adjudication authorities.

All categories of insurance benefit payment application forms, receipts, diagnostic documents and certificates used by the insured persons, insured units, hospitals, clinics or licensed doctors or midwives shall be filled out according to related written instructions.

With the exception of those stipulated in Articles 76 and 78 of these Regulations, the medical diagnosis or birth certificates used in applying for all kinds of insurance benefit payments shall be valid only after they are prepared and issued by the hospitals, clinics or licensed doctors.
Birth certificates prepared and issued by licensed midwives shall also be valid.

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For those insurance benefit payments that are calculated on a daily or instance basis, they shall be calculated to the tenth of a yuan. If the total amount of payments are calculated on a yuan basis, five and higher fractions shall be counted as units and disregard the rest when calculating a tenth of a yuan.

When applying for the payments of birth benefits in accordance with Article 31 of the Statute, the following documents must be prepared:
1. Application forms for birth benefit payments.
2. Receipt of benefits payments.
3. Birth certificate of the newborn babies or copies of valid household registration form with the names of the mothers and the birth dates, months and years of the newborn babies listed. In the event of miscarriage, the certificates of miscarriage prepared and issued by the hospitals, clinics, or licensed doctors or midwives.

When applying for the payments of injury or sickness benefits in accordance with Article 33 or 34 of the Statute, the following documents must be prepared:
1. Application forms for injury or sickness benefit payments.
2. Receipt of benefit payments.
3. Written medical diagnosis of the injury or sickness. In the event that hospitalization is required, the documents prepared and issued by the hospitals concerned which contain the names of the injury and sickness and the dates of entry and release can be served as substitutes.
For those persons infected with dust-lung diseases and apply for the payments of occupational diseases compensation diseases, copies of x-rays and the reports of dust-related operation employment history shall be attached and submitted. However, if the insurer has verified that the applicants have been hospitalized and registered for dust-lung diseases, the aforementioned required documents can be waived.

A term for the insured persons to apply for the payments of injury or sickness benefits is set at every fifteen days and the applications shall be made at the end of the term.

After the approval of the central competent authority, the insurer may delegate the management of the payments of occupational injury and disease medical benefits to the central health insurance board. The contract of delegation shall be drawn up by the insurer and the central health insurance board and submit to the central competent authority and the central health competent authority for review and approval.
After the insurer delegates the management of the payments of occupational injury and disease medical benefits to the central health insurance board, if the insured persons suffering from occupational injuries or occupational diseases, they shall apply to the medical service institutions affiliated with the National Health Insurance Program for treatment and diagnosis. With the exception of other regulations provided for by the Statute and these Regulations, the medical payments paid by the insurer shall be executed pursuant to the related regulations of the national health insurance program.

When the insured persons applying for outpatient medical treatments or hospitalization for occupational injuries or diseases, they shall submit the occupational injury or disease outpatient medical treatment bills or hospitalization application forms prepared and issued by the insured units they are affiliated with, as will as the national health insurance cards and national identification cards or other related documents that can verify the identities of the insured persons for review. In the event of failing to submit these documents or the required documents are not suitable, the medical service institutions affiliated with the national health insurance program shall deny their registration and medical treatment as patients with the status of the insured persons.

In the event that the insured persons cannot submit or submit for review the related required documents due to the facts that they have not received the occupational injury or disease outpatient medical treatment bills, or hospitalization application forms, or national health insurance cards, or are seeking emergency treatments for injuries or diseases, they shall prepare and submit other related documents that can verify their identities and proclaim they are in the possession of labor insurance status, and proceed to register and receive medical treatments. Under such circumstances, the medical service institutions affiliated with the national health insurance programs shall provide medical services, receive insurance medical expenses and issue receipts to the persons seeking medical treatments. In case the insured persons obtain and submit the required documents within seven days (excluding regular days off) after the date they are admitted for medical treatments, the medical service institutions affiliat
ed with the national health insurance program shall refund the paid insurance medical expenses.

In the event that the insured persons are unable to provide the necessary documents within the seven days after receiving medical treatments as stipulated in the preceding article as the result of any circumstances not of their own faults, they shall prepare and submit the occupational injury or disease outpatient medical treatment bills or hospitalization application forms and the receipts of medical expenses prepared and issued by the medical service institutions affiliated with the national health insurance programs, within six months from the date of receiving outpatient medical treatment or the date of releasing from hospitalization, to the branch offices Central Health Insurance Board responsible for the jurisdictional districts to apply for reimbursement of the paid medical expenses.

The instructions for receipt, issuance and usage of bills and forms for medical treatments of occupational injuries and diseases shall be drawn up the insurer and submitted to the central competent authority for review and approval.

Upon receipt of the insured persons' occupational injury or disease outpatient medical treatment bills, the medical service institutions affiliated with the national health insurance program shall attach them to the medical histories of the insured persons and preserve them for review and examination. Upon receipt of the occupational injury or disease hospitalization application forms, they shall fill out in detail the verification portions of the application forms and submit them within three days to the insurer for review and examination.
After the insurer review the applications for hospitalization referred to in the preceding paragraph and decides that they are not qualified as occupational injuries or diseases, it shall notify the Central Health Insurance Board, the medical service institutions affiliated with the National Health Insurance Program, insured units and the insured persons.

In the event that the insured persons are hospitalized several times with the same occupational injuries or diseases, the total number of days used to calculated the amount of benefits for coverage of food expenses as provided for in Item 4 of Paragraph 1 to Article 43 of the Statute shall be counted from the first day of hospitalization and calculated in combine every six months.
The standards for payments of the food expenses referred to in the preceding paragraph shall be drawn up by the central competent authority with the central health competent authority.

In the event that the occupational injury or disease hospitalization application forms issued by the insured unit contain any incomplete information, errors, or the whole procedure is not complete. After two notifications from the insurer to make the necessary corrections within certain time limits but to no avail without due causes, thus creating a situation that the insurer cannot make proper assessments and payments medical benefits, the insurer shall not pay the benefits.

After the implementation of the National Health Insurance Program, the hospital rooms belong to the Government Employees' Insurance Programs referred to in Item 5 of Paragraph 1 to Article 43 of the Statute shall be designated as the insurance rooms belong to the National Health Insurance Program.

In the event that the insured persons are stricken with occupational injuries or diseases outside of the jurisdictional areas which this Statute is implemented and require outpatient medical services or hospitalization, they may retain the documents of proof and bills of expenses issued by the hospitals or clinics where they received medical treatments and present them, within six months from the dates they received clinical services or the dates they are released from the hospitals, to the insured units they are affiliated with. The insured units shall apply to the branch offices of the Central Health Insurance Board responsible for the jurisdictional districts for reimbursement of the outpatient or hospitalization expenses.
The insurer shall pay the outpatient or hospitalization expenses referred to in the preceding paragraph in accordance with the real and true fees. However, if the amounts applied for exceed the average standardized fees payable to the outpatient and hospitalization expenses as compiled by the medical research centers under special contracts with the National Health Insurance Program three months prior to the dates the contingencies occurred or the dates the insured persons were released from the hospitals, the excessive portions of the expenses shall not be paid by the insurer.
If the insured persons received emergency injury or sickness treatments but not at the medical service institutions affiliated with the National Health Insurance Program, their time-limits for applying benefit payments and the standards of payments of the insurer shall be executed pursuant to the related regulations contained in the Measures for the Reimbursement of Emergency Injury or Sickness Medical Expenses Paid by the Patients Themselves in the National Health Insurance Program.

When applying for the payments of disability benefits in accordance with Article 53 or 54 of the Statute the following documents must be prepared:
1. Application forms for disability benefits payments.
2. Receipt of benefits payments.
3. Written medical diagnosis of the disabilities.
4. For persons examined with x-rays shall supply the x-ray picture.
The written medical diagnosis of the disabilities referred to in the preceding paragraph shall be prepared and issued by the hospitals or clinics performing the treatments under special contracts with the national health insurance program. The central competent authority may announce the item of disability based on the need of recognition technique and facilities, by which these National Health Insurance contract hospitals, while evaluated by law should be qualified and belong to the local teaching hospital or above level would accordingly issue written medical diagnosis of the disabilities. For those disabilities stricken outside of the jurisdictional area which this Statute is implemented, they shall be prepared and issued by the original hospitals or clinics performing the treatments.
While reviewing disability benefit payments, the insurer, in addition to designating hospitals, clinics or doctors under special contracts with the national health insurance program to perform re-examinations pursuant to Article 56 of the Statute, may also notify the hospitals or clinics which prepared and issued the written medical diagnosis and request them to submit any necessary records of examinations or other related medical history records.

The term "termination of medical treatments" referred to in Paragraph 1 to Article 53 and Paragraph 1 to Article 54 of the Statute means after medical treatments, the injuries or sickness suffered by the insured persons remain stable and unchanged and are not expected to improve even resume medical treatments.

When applying for the payments of disability benefits in accordance with Article 53 and 54 of the Statue, the dates for applying the payments of the benefits pursuant to Article 30 of the Statute shall be set on the dates on which the hospitals or clinics under special contracts with the national insurance disabilities or will never recover.
In the event that the insured persons request the issuance of the written medical diagnosis referred to in the preceding paragraph, the hospitals or clinics under special contracts with the National Health Insurance Program shall issue the documents within three days.

The term "on the same part" referred to in Items 8 and 9 of Article 55 of the Statute means the same portions that are physically on or linked to the disabled system of the insured persons' bodies.

For those subject-matters not that are not covered by Article 55 of the Statute and the Chart of Payment Standards for Disability Benefits of Labor Insurance Program, may be supplemented by the regulations issued by the central competent authority.

In the event that the insured persons who was unable to perform work due to physical disabilities and apply for disability benefit payments in accordance with the Chart of Payment Standards for Disability Benefits of Labor Insurance Program and die afterwards, their beneficiaries may select to receive death benefits or disability benefits.

In the event that insured persons apply for the payments of old-age benefits, the insured units they are affiliated with shall at the same time proceed to the procedures of with drawing from insurance coverage.

The term "joining insurance program in the same insured units" referred to in Item 3 of Paragraph 1 to Article 58 of the Statute means any one of the following situations:
1. The insured persons join insurance coverage with their affiliated employers, institutions or groups.
2. The insured persons join insurance coverage with the employers, institutions or groups that are merged or reorganized in accordance with related statutes and administrative regulations.
3. The insured persons join insurance coverage with the employers, institutions or groups that are transferred from public enterprises to private enterprises in accordance with the Statute for Transferring Public Enterprises to Private Enterprises.

When apply for the payments of old-age benefits in accordance with Article 58 of the Statute, the following documents must be prepared:
1. Application forms for old-age benefit payments.
2. Receipt of benefit payments.
3. Copies of household registration form or copies of the front and back pages of the national identification cards. The copies of the national identification cards shall be stamped by the insured units to verify that they are authentic to the original documents.
4. For those persons qualified under Item 4 of Paragraph 1 to Article 58 of the Statute, related certificates of employment shall also be submitted.

The grandchildren, brothers or sisters who are specially raised and supported referred to in Articles 63 and 64 of the Statute are those persons who do not have abilities to earn their own living and cannot maintain their own life, and are raised and supported by the deceased insured persons prior to their death.

When the parents, spouses or children of the insured persons are legally proclaimed death, the time of their death shall be set by the count's formal decisions, and the time shall be regarded as the time of death referred to in Article 62 of the Statute. The amounts of their burial subsidies shall be calculated in accordance with the following stipulations:
1. If the time of death and the count's decision fall during the insurance coverage period of the insured persons, they shall be calculated according to the monthly insurance wages in the six months prior to the month the related decision is rendered by the court.
2. If the time of death falls during the insurance coverage period of the insured persons, and when the related decision is rendered by the court the insurance coverage is with drawn, they shall be calculated according to the monthly insurance wages in the sic months prior to the month the insurance coverage is withdrawn.

In the event that when the applications for the payments of death benefits are submitted and the insured units affiliated fail to proceed with the process of withdrawing from insurance coverage, the insurer shall terminate insurance coverage directly and immediately.

When the insured persons applying for burial subsidies referred to in Article 62 of the Statute, the following documents must be prepared:
1. Application forms for burial subsidies.
2. Receipt of subsidy payments.
3. Death certificates or written autopsy reports issued by the public prosecutors, and in the event of legally proclaiming death, the related court decisions.
4. Copies of valid household registration form with the dates of death listed. In case the deceased are adopted children, the dates of their adoption and registration shall also be listed.

When applying for burial subsidies and survivors' subsidies referred to Article 63 or Article 64 of the Statute, the following documents must be prepared:
1. Application forms for burial subsidy and survivor's subsidies.
2. Receipt of subsidy payments.
3. Death certificates or written autopsy reports issued by the public prosecutors, and in the event of legally proclaiming death, the related court decisions.
4. Copies of whole household registration form with the dates of death listed. In case the deceased are adopted children, the dates of their adoption and registration shall also be listed.

In the event that when the applications for the payments of death benefits are submitted and the applications and the deceased are not belong to the same household, they shall submit separate copies of the household registration forms at the same time.

In the event that the insured persons do not have any survivors referred to in Articles 63 and 64 of the Statute, those responsible for their burials shall submit relevant documents and apply to the insurer for the payments of burial subsidies.

In the event that the beneficiaries of the payments of survivors' subsidies are minors, their submitted application forms and receipts shall be signed and stamped with the seals of their legal guardians.

In the event that the beneficiaries of the payments of survivors' subsidies with the same order as referred to in Article 65 of the Statute and there are more than two persons, they shall jointly apply and receive these payments. In the event that there are still other beneficiaries exist and do not file their applications, those beneficiaries applied and received the payments shall be responsible for paying them later their entitled shares.

In the event that after the insured persons died and their beneficiaries are minors and cannot apply for the payments of insurance benefits as referred to in Article 92 of these Regulations, the insured units they are affiliated with shall notify the insurer immediately. Under such circumstances, except the payments of burial subsidies may be processed in accordance with Article 91 of these Regulations, their survivors' subsidies shall be deposited by the insurer and receive interests. The subsidies shall be paid by the item their beneficiaries are qualified to apply and received.

The expenses referred to in Article 68 of the Statute shall include all costs needed for handling personnel and business affairs of the insurance program.

The forms, lists and charts of the various documents provided for in the Statute and these Regulations shall be designed and determined by the insurer.
The forms and lists referred to in the preceding paragraph, with the exception of those required by the medical service institutions under special contracts with the National Health Insurance Program to implement medical service for labor insurance matters, shall be produced and issued by the insurer.

These Regulations shall become effective on the day of promulgation.

The expenses referred to in Article 68 of the Statute shall include all costs needed for handling personnel and business affairs of the insurance program.

Shall the labor wish to institute a lawsuit for the impact to his/her insurance payment due to employer's violation to the regulations in insurance enrollment or inaccurate insured salary of the Enforcement Rules, he/she could apply for legal assistance to central competent authority.
For the legal assistance service mentioned above, the central competent authority could authorize private organization for providing such service.

These rules shall come into force from January 1, 2009.　
The amended article of the Enforcement Rules hereof shall come into force as of the day of promulgation.