SPC Provisions on Workplace Injury Insurance Cases

Supreme People's Court

June 18, 2014

Judicial Interpretation [2014] No. 9

Supreme People's Court Provisions on Several Issues Relating to Trial of Workplace Injury Insurance Administrative Cases

(Adopted at the 1613th meeting of the Supreme People's Court's Adjudication Committee on April 21, 2014)

These provisions are formulated on the basis of the "People's Republic of China Social Insurance Law", the "People's Republic of China Labor Contract Law", the "People's Republic of China Administrative Litigation Law", the "Workplace Injury Insurance Regulations" and other relevant laws and administrative regulations, together with administrative trial actualities, so as to correctly hear administrative cases on workplace injury insurance.

Article 1: When people's courts hearing administrative cases identifying workplace injuries are determining whether there are situations such as in the "Workplace Injury Insurance Regulations" article 40(6) "the individual has primary responsibility", article 16(2) "drunk or using drugs" and article 16(3) "self-harm or suicide"; they shall use legal documents such as the accident liability determination document and conclusory opinions issued by an authorized organ and effective judgments of people's courts as their basis, except where there is contradicting evidence sufficient to overturn the accident liability determination and conclusory opinions.

Where the aforementioned legal documents do not exist or their content is unclear, the social insurance administrative departments identify the facts mentioned in the above clause, and the people's courts shall conduct a review of the combined evidence provided in accordance with law.

The determination of 'intentional crimes' under Article 16(1) of the ' workplace injury insurance regulations' shall be based upon effective legal documents or conclusory opinions from the investigative organs, procuratorate organs or trial organs.

Article 2: Where after accepting an administrative case of identifying a workplace injury, a people's court discovers that the plaintiff or a third party has already applied to labor arbitration or raised a civil lawsuit on whether a labor relationship exists, they shall suspend trial of the administrative case.

Article 3: Where social insurance administrative departments find that the following work units bear workplace injury insurance responsibility , the people's courts should sustain:

(1) The employee has established labor relations with two or more work units, and the unit that the employee was working for when the workplace injury occurred is the unit that the bears fter handling an administrative case of identifying a workplace injury responsibility.

(2) Where employees dispatched by a labor dispatch unit are injured or killed while working at the employing work unity, the dispatching unit is the unit that bears workplace injury insurance responsibility.

(3) Where an employee assigned by a unit to work in another unit is injured of dies, the assigning unit is the unit that bears workplace injury insurance responsibility;

(4) Where an employing unit violates laws or regulations and transfers contract work to an organization or natural person that does not have the qualifications to be an employing entity, and employees hired by that organization or natural person are injured or die while engaging in the contracted work, the employing unit is the unit bearing workplace injury insurance responsibility.

(5) Where individuals are affiliated with other units for foreign operations, and their employees are injured or die from work, the affilliated unit is the unit bearing workplace injury insurance responsibility.

The units clarified as bearing workplace injury insurance responsibility in (4) and (5) of the preceeding clause have the right to seek compensation from relevant organizations and units after they bear the responsibility to compensate, or after the social insurance handling organ has paid out benefits from the workplace injury insurance fund.

Article 4: Where social insurance administrative departments find the following forms or workplace injury , the people's courts should sustain:

(1) Where an employee receives an injury during work hours and in a work facility, and the employing unit or the social insurance administrative departments have no evidence showing that it was brought on by a non-work cause.

(2) Where an employee is injured while participating in an activity organized by the employing unit or assigned by the employing unit to participate in an activity organized by another unit.

(3) Where an employee is injured from work during work hours, in a reasonable area while going between several work venues related to their work duties ;

(4) Where other injuries during work hours and a within a reasonable location are related to performance of work duties.

Article 5: Where social insurance administrative departments identify the following situations as 'a period working outside' the people's courts should support it:

(1) The period in which an employee was engaged in an activity related to their professional duties outside of their workplace as assigned by the employing unit, or because it was required for work;

(2) The period where the employee was assigned by the employing unit to go out for studies or to have a meeting;

(3) Other off-site activity periods of employees required for work.

Where workers are injured while engaged in personal activities unrelated to their work or being assigned for outside study or meetings, and the social insurance administrative department does not find it is a workplace injury, the peoples court shall sustain this.

Article 6: Where the social insurance administrative departments find that the following situations are "going to or coming from work', the people's courts shall sustain it.

(1) While coming or going at a reasonable time on a reasonable route between the workplace and their domicile, habitual residence or unit dorms.

(2) While coming or going at a reasonable time on a reasonable route between the workplace and a spouse's, parent's, or child's domicile.

(3) While engaged in activities required for routine work life, and while going to or coming from work at a reasonable time and on a reasonable route.

(4) While en route going to or coming from work on other reasonable routes at a reasonable time.

Article 7: Where the period for applying for a finding of a workplace injury has been exceeded for reasons not owing to the employee or his family, the period of delay is not calculated into the period for finding a workplace injury.

Where any of the following circumstances delays the time of application, it shall be found to not be due to a reason of the employee or their family:

(1) Force majeure;

(2) restrictions of personal freedom;

(3) reasons belonging to the employing unit;

(4) Flaws in the Social Insurance Administration Departments' registration system;

(5) A party has applied for arbitration or filed a civil lawsuit on whether there is an employment relationship.

Article 8: Where an employee is hurt because of a third party, and social insurance administrative departments make a decision to not accept the application to find a workplace injury or do not find that there is a workplace injury, based upon the employee or his relatives having already raised a civil lawsuit against the third party or having received civil compensation, the people's courts shall sustain it.

Where an employee is injured due to a third party and the social insurance administrative departments have already found a workplace injury, and the employee or his family have not raised a civil lawsuit against the third party or received civil compensation, but file a suit requesting that the social insurance management organ pay out workplace injury insurance benefits, the peoples court shall sustain it.

Where an employee is injured due to a third party and the social insurance management organization refuses to pay out workplace injury insurance on the basis of the employee or his family having already filed a civil lawsuit against the third party, the people's court will not sustain it, except as to medical expenses already paid out by the third party.

Article 9: Where the person applying for a finding of a workplace injury or the employing unit conceals relevant circumstances or provides false materials, causing an incorrect finding of a workplace injury, the social insurance administrative department may lawfully make corrections during the course of litigation.

Where after the lawful corrections of the finding of a workplace injury, the plaintiff does not apply to withdraw the suit, and the social insurance administrative department had fault in the original incorrect finding of a workplace injury, the people's court shall make a judgment confirming a violation; where the social insurance administrative department does not have fault, the people's court may reject the plaintiff's suit.

Article 10: Where judicial interpretations previously promulgated by the Supreme People's Court differ from these Provisions, these Provisions are controlling.