These regulations are enacted in accordance with the regulation of Paragraph 5 of Article 13 of the Labor Insurance Act (hereafter referred to as this Act).
In addition to regulations applicable to specific professions and rates, the occupational accident experience rates prescribed in Paragraph 4 of Article 13 of this Act shall be the values achieved by calculating and adjusting respectively according to the ratio of the total occupational accident benefits of the insured unit to its total payable occupational accident insurance premiums in the three previous years.
The total occupational accident benefits and total payable occupational accident insurance premiums described in the preceding paragraph do not include insurance benefits for accidents that take place when the insured are on the way to or from work and the corresponding premiums.
The minimum number of employees required for an insured unit as prescribed in Paragraph 4 of Article 13 of this Act means the number of employees insured shall be no less than 70.
The number of insured employees described in the preceding paragraph shall be the average number of insured employees each year beginning on the 1st of July of the year before the date the annual experience rate for each insured unit takes effect.
In the event that the number of employees of an insured unit to which these regulations apply decrease to below the number prescribed in the preceding article, the same rate shall continue to apply within that year.
In the event that the number of employees of an insured unit to which these regulations do not apply increase to the number prescribed in the preceding article and the period of insurance conforms with the regulation of Article 6, these regulations shall apply beginning from the following year.
The total occupational accident insurance benefits prescribed in Paragraph 4 of Article 13 of this Act include the following benefits:
1. Cash payment of occupational accident benefits: illness, disability, and death benefits, as well as missing allowance.
2. Medical benefits for occupational accidents: benefits for outpatient treatment and hospitalization expenses.
Calculation of the cash payment of occupational accident benefits prescribed in the preceding paragraph is based on approved expenses an insured person has paid in cash. Medical benefits for occupational accidents are calculated in accordance with the actual medical expenses.
When applying for disability or survivor pensions, the insured or the beneficiary may apply once only for payment of the cash benefits described in the two preceding paragraphs in a lump sum.
The three-year period described in Paragraph 4 of Article 13 of this Act refers to the three years previous to the 1st of January of the year before the adjusted experience rate takes effect each year.
These regulations shall not apply to insured units with a period of insurance shorter than the period prescribed in the preceding paragraph.
When the business category of an insured unit changes, the rate for the new business category shall apply beginning from the month the change is reported and approved. The new experience rate shall be assessed in accordance with the original adjusted ratio of business category accident premium rate.
The insurer shall establish the experience rate for the upcoming year for each insured unit before the end of September each year and notify the insured unit before the end of the following month.
When an insured person applies for occupational accident benefits, the experience rate to be calculated shall be the on-going experience rate for the insured unit when the accident took place. Where discrepancies occur, the insurer shall make the decision in line with established facts.
These regulations take effect on January 1, 2010.