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Regulations of the Settlement Labor Insurance Disputes(2022.03.23) Chinese

Except that the provisions amended and promulgated on March 23th, 2022, should take effect on May 1st, 2022, this amendment shall and shall become effective on the date of promulgation.
Article 2  An insured unit, insured person, beneficiary, person paying for the funeral, or National Health Insurance medical service ational health insurance hospitals or clinics(hereinafter all referred to as the applicant) having disputes with the Bureau of Labor Insurance, Ministry of Labor (hereinafter referred to as BLI) over the recognition of the following particulars may apply for reviewing and evaluation according to these Regulations:
1. Qualifications of the insured or the beneficiary, and insurance particulars.
2. An insured person's insured salary or length of insurance enrollment.
3. Insurance premiums or overdue fines,or dues to be settled by the insured units within specific time limit.
4. Payment of insurance benefits.
5. Occupational injuries and Diseases.
6. Levels of disability.
7. Medical expenses for occupational accidents and illness .
8. The rights and interests of the insured.

Article 5  If respective Applicants apply for review, the BLI shall forward the application documents to the central competent authority within 10 days after receiving them.
After the BLI receives the application forms for settlement, it shall review the original appraised and decide in advance for its legitimacy and properness. If the application for examination or review is reasonable, the BLI can appraise and decide anew, and inform the applicant and copy to the central competent authority.
If the BLI does not comply with the request by the applicant to withdraw or change the original appraised and decide, it shall submit its written opinions together with the necessary archives within two months of the date of receiving the application to the central competency authority and copy the written opinions to the applicant.

Article 9 In order to examine and review insurance disputes, the central competent authority has created the Labor Insurance Dispute Evaluation Committee (hereinafter referred to as LIDEC). The committee shall consist of eleven to fifteen members. One committee member shall serve as the convener. The Head of the central competent authority shall appoint or assign on a part-time basis either the Deputy Head of the central competent authority or an official at the ranking of selected appointment. Other committee members shall be recruited (appointed) on a part-time basis from those with the following qualifications:
1. Two to four people with at least three years of experience as an assistant professor in law, social insurance, insurance, social welfare or labor studies.
2. Two people with at least three years of experience as a judge, lawyer or civil servant having conducted legal affairs with the ranking of selected appointment.
3. Three to five people with at least three years of experience as an assistant professor in a medical school or an attending physician in a regional hospital or higher and qualified as specialist physician in occupational medicine.
4. Two people currently working in the competent authority of labor insurance with the ranking of selected appointment.The gender ratio for both sexes in the committee shall not fall below 1/3.The maximum term of service for the committee members described in the preceding paragraph shall be 2 years; at the end of each term, the term may be extended on a part-time basis by being recruited (or appointed).
5. One representative from the labor group.
The gender ratio for both sexes in the committee shall not fall below 1/3.The maximum term of service for the committee members described in the preceding paragraph shall be 2 years; at the end of each term, the term may be extended on a part-time basis by being recruited (or appointed).

Article 14  When the meeting of the Committee of E&R is held, it can invite BLI or related personnel to attend as nonvoting delegates for explanations.
If Applicants requests for presenting a statement with a justifiable reason, the review meeting shall grant an opportunity for Applicants to present a statement at a designated place.
Article 16  On receiving the statement of opinion from the BLI, the central competent authority shall refer the application and the statement of opinion to a functional committee consisting of at least 2 members for review and send the results to the review meeting for a final review.
The decision of the preceding examination and review should be made within 3 months while received the Application Form for the Settlement the next day. It can be lengthened when necessary but cannot over 2 months, and has to inform the applicant.
The period of preceding paragraph will be calculated from the next day when one resubmits Application Form for the Settlement following by the proviso in Article 3 paragraph 3. The one who did not resubmits Application Form for the Settlement; the period will be calculated from the next day of expiration of resubmitted duration. The one who follows stipulation of Article 8 for informed to resubmit and correct, then the period will be calculated from the next day of resubmission and correction; for the one who did not resubmit and correct, the period will be calculated from the next day of expiration of resubmission and correction.

Article 22  If the BLI cannot present an opinion with the necessary documents on file by the deadline specified in paragraph 3 under Article 5, to the central competent authority, the review meeting may revoke the original examination and approval of BLI and return the case to BLI for a new round of decision-making for approval.
For the applications of examination and review without reason, the committee shall turn down the application according to examination and approval.
The original examination and approval of BLI relies on reason by although to be is improper, but takes other reason warrants, should apply for the consideration as unreasonably by.
The application consideration has the reason; the committee shall rescind whole or part of original examination and approval of BLI and regard plot of the event to change the examination and approval directly or send back to BLI for another disciplinary action. But to the applicant indicated refuses to accept in the scope, can not have much detrimental examination and approval or disciplinary decision.


Article 26  These regulations shall be effective from July 1, 2016.
Except that the provisions amended and promulgated on March 23th, 2022, should take effect on May 1st, 2022, this amendment shall and shall become effective on the date of promulgation.