cciia.org.cn 2023-10-27 9:56:33 人民法院(yuan)報
用人單位在知曉員工出(chu)事(shi)故受傷后，未在工傷保(bao)險(xian)條(tiao)例規定(ding)(ding)的(de)30日內(nei)為(wei)其申報工傷認(ren)定(ding)(ding)。近(jin)日，安徽省蕪湖市弋江區人民法院對這(zhe)起(qi)勞動爭議案作出(chu)判決(jue)，用人單位應承擔員工工傷認(ren)定(ding)(ding)前產生的(de)醫療費用。
原告楊(yang)某(mou)于(yu)2021年(nian)入職蕪(wu)湖(hu)某(mou)公(gong)司(si)，公(gong)司(si)依(yi)法為(wei)其(qi)參加了(le)工(gong)傷(shang)(shang)保(bao)險。2022年(nian)1月，楊(yang)某(mou)在上(shang)(shang)班(ban)途中駕(jia)駛電動(dong)自行(xing)車與一輛無(wu)號牌電動(dong)三輪車發生(sheng)碰撞(zhuang)，無(wu)號牌電動(dong)三輪車駕(jia)駛員離開(kai)(kai)現場。經交(jiao)警部(bu)門認定，離開(kai)(kai)現場的(de)駕(jia)駛員負事(shi)故全部(bu)責任，楊(yang)某(mou)無(wu)責任。楊(yang)某(mou)受(shou)傷(shang)(shang)后(hou)，被送往醫院(yuan)治療(liao)，住院(yuan)期間接(jie)受(shou)了(le)相應的(de)手術(shu)。事(shi)故發生(sheng)50天后(hou)，楊(yang)某(mou)自行(xing)向社保(bao)行(xing)政部(bu)門申請工(gong)傷(shang)(shang)認定，被認定為(wei)工(gong)傷(shang)(shang)。楊(yang)某(mou)受(shou)傷(shang)(shang)后(hou)，未能(neng)再返崗上(shang)(shang)班(ban)。楊(yang)某(mou)與用人單(dan)位因對工(gong)傷(shang)(shang)待遇、解除勞動(dong)合同(tong)經濟補(bu)償金等(deng)產(chan)生(sheng)爭(zheng)議(yi)，楊(yang)某(mou)遂向仲裁委(wei)申請仲裁。之(zhi)后(hou)，楊(yang)某(mou)對裁決不服(fu)，向弋江區法院(yuan)提(ti)起訴(su)訟。
庭(ting)審中，雙方的(de)主要(yao)爭議在于楊某因該次事(shi)故產生的(de)醫(yi)療費用承(cheng)擔問題。
法(fa)院(yuan)審理后認為(wei)，楊(yang)(yang)(yang)某(mou)受(shou)傷(shang)(shang)系(xi)因第(di)(di)三(san)人(ren)(ren)侵權(quan)(quan)造成(cheng)，但(dan)因負事故(gu)全部責(ze)任的(de)(de)(de)(de)(de)對方駕(jia)駛員離開現場未能找到，楊(yang)(yang)(yang)某(mou)所受(shou)事故(gu)傷(shang)(shang)害未能獲(huo)侵權(quan)(quan)責(ze)任人(ren)(ren)賠償。根據《中(zhong)華人(ren)(ren)民共和國社會保(bao)險法(fa)》第(di)(di)四(si)十二條(tiao)(tiao)規定(ding)，由(you)于第(di)(di)三(san)人(ren)(ren)的(de)(de)(de)(de)(de)原因造成(cheng)工(gong)(gong)(gong)傷(shang)(shang)，第(di)(di)三(san)人(ren)(ren)不支付工(gong)(gong)(gong)傷(shang)(shang)醫療(liao)費(fei)用或者無法(fa)確定(ding)第(di)(di)三(san)人(ren)(ren)的(de)(de)(de)(de)(de)，由(you)工(gong)(gong)(gong)傷(shang)(shang)保(bao)險基(ji)金(jin)先行(xing)支付。工(gong)(gong)(gong)傷(shang)(shang)保(bao)險基(ji)金(jin)先行(xing)支付后，有(you)權(quan)(quan)向(xiang)第(di)(di)三(san)人(ren)(ren)追償。因此，楊(yang)(yang)(yang)某(mou)的(de)(de)(de)(de)(de)工(gong)(gong)(gong)傷(shang)(shang)醫療(liao)費(fei)用依(yi)法(fa)應由(you)工(gong)(gong)(gong)傷(shang)(shang)保(bao)險基(ji)金(jin)先行(xing)支付。結合該案事實，楊(yang)(yang)(yang)某(mou)受(shou)傷(shang)(shang)后未能在30日(ri)內向(xiang)社保(bao)行(xing)政部門申(shen)報工(gong)(gong)(gong)傷(shang)(shang)認定(ding)，則按照(zhao)工(gong)(gong)(gong)傷(shang)(shang)保(bao)險條(tiao)(tiao)例第(di)(di)十七條(tiao)(tiao)第(di)(di)四(si)款(kuan)規定(ding)，用人(ren)(ren)單位未在本條(tiao)(tiao)第(di)(di)一款(kuan)規定(ding)的(de)(de)(de)(de)(de)時限內提交工(gong)(gong)(gong)傷(shang)(shang)認定(ding)申(shen)請(qing)，在此期(qi)間發生符合本條(tiao)(tiao)例規定(ding)的(de)(de)(de)(de)(de)工(gong)(gong)(gong)傷(shang)(shang)待遇等(deng)有(you)關費(fei)用由(you)該用人(ren)(ren)單位負擔。
蕪(wu)湖(hu)(hu)某(mou)公(gong)司在(zai)(zai)知(zhi)曉楊某(mou)事故受傷后，未能在(zai)(zai)工(gong)傷保險條例規定(ding)的30日(ri)內為(wei)其(qi)申(shen)報工(gong)傷認(ren)定(ding)，既未能充(chong)分舉證證明其(qi)積極(ji)履(lv)行了申(shen)報義(yi)務(wu)，亦未向社(she)保行政(zheng)部門(men)提出申(shen)報時(shi)限(xian)延(yan)長(chang)，也未能提供證據(ju)證明原告在(zai)(zai)配合提供申(shen)報材(cai)料過程中存在(zai)(zai)故意拖延(yan)行為(wei)。作為(wei)用(yong)人單位，蕪(wu)湖(hu)(hu)某(mou)公(gong)司應對楊某(mou)在(zai)(zai)申(shen)報工(gong)傷認(ren)定(ding)前產生的醫療費用(yong)承(cheng)擔支付(fu)義(yi)務(wu)，其(qi)負擔該部分費用(yong)后，有權(quan)向導致原告受傷的實際侵權(quan)人進行追償。
法(fa)院遂依(yi)法(fa)作(zuo)出上述判(pan)決。宣判(pan)后，雙方(fang)均服判(pan)。
日期：2023-10-27 9:56:33 | 關閉 |
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