The types of benefits of the Insurance are as follows:
1.Medical care benefit.
2.Injury or sickness benefit.
3.Permanent disability benefits.
4.Survivor benefit.
5.Disappearance benefit.

When an insured person suffers occupational injury or occupational disease (hereinafter referred to as “occupational injury or disease”) and incurs an insured medical, injury or sickness, permanent disability, death or disappearance incident after the insurance coverage starts and before it ends, the insured person, the beneficiary of the funeral cost payer may seek insurance benefit in accordance with the Act.
When an insured person suffers occupational injury or disease during the existence of the insurance coverage, he/she may seek medical care benefit, Injury or sickness benefit, permanent disability benefit or survivor benefit for the same injury or sickness and the disease caused by the Injury or sickness within one year from the day following the end of coverage.
The central competent authority shall prescribe the guidelines for the types of occupational injury, types of occupational disease, standards of review and determination, categorized investigation review procedure and other relevant matters of the occupational injury or disease under the first paragraph.

For insurance benefits issued in cash, the amount shall be calculated based on the average monthly insured salary of the insured person and the payment standards.
The average monthly insured salary under the previous paragraph shall be based on the average of the actual monthly insured salary during the 6 months before the month during which the insured person suffers the insured incident. If the period is less than 6 months, it shall be calculated based on the average monthly insured salary during the actual period of the insurance.
Insurance benefit paid on a daily basis shall be based on the average monthly insured salary under the previous paragraph, divided by 30.
When the insured unit of a worker under Article 6 fails to complete insurance participation or withdrawal procedure in accordance with Article 12 and if an insured incident occurs, the monthly insured salary during the period for which the procedure was not completed shall be determined by the insurer based on the insured salary category chart level that corresponds to the total amount of monthly salary, provided that it shall not be higher than the level corresponding to the average monthly insured salary of all insured persons during the most recent year published by the insurer at the time of occurrence of the incident.
If the insured unit or the insured person does not provide information showing relevant salary to the insurer for review and approval in relation to the monthly insured salary during the period for which the procedure was not completed under the previous paragraph, the calculation shall be based on the first level of the insured salary category chart.

Insurance benefits of the same type shall not be collected more than once for the same incident.
For the same insured incident occurred to an insured person, if the insured person, the beneficiary or the funeral cost payer meets the conditions for the Insurance, labor insurance, farmer health insurance, farmer occupational accident insurance, civil servant/educator insurance, military personnel insurance or national pension insurance (hereinafter referred to as “Other Social Insurance”), only one claim may be made.

If a person is covered by the Insurance while the qualifications for participation defined by the Act are not satisfied, the insurer shall cancel the qualification of such insured person. If the person has received insurance benefits, the insurer shall issue a written administrative decision to order reimbursement before a deadline.
If excess or wrongful collection of insurance benefits without meeting the conditions for collection defined under the Act, the insurer shall issue a written administrative decision to order the reimbursement of the excess or wrongfully collected insurance benefit before a deadline.
The provisions about reimbursement of benefit under the previous two paragraphs apply mutatis mutandis to beneficiaries, claimants and legal successors.

The insurer shall not issue insurance benefits if supporting documents required are not submitted without justification or in case of failure to accept repeat examination by the hospital or physician designated by the insurer in accordance with Article 47.

When the insurer or the central competent authority needs information required for the processing activities of the Insurance or for the review of insurance dispute, it may ask the insured person, beneficiary, insured unit, medical service institution, physician or other relevant authority (institution), organization, corporation or individual to provide such information. The party receiving such request shall not evade, interfere, refuse or provide false justification, report or statement.
The information referred to under the previous paragraph is as follows:
1.Information related to the records of work attendance, medical history, prescriptions, records of examinations, x-ray diagnosis report and use of medical services of the insured person.
2.Information related to the work of the insured person and occupational exposure to health hazard.
3.Accounts, books, lists and documents of the insured unit related to the handling of Insurance.
4.Other documents and electronic files related to the handling of the Insurance or insurance dispute matters.
If the authority (institution) referred to in the first paragraph has computerized the information under the previous paragraph, the insurer may seek a link to acquire such information and such authority (institution) shall not refuse.
The insurer and the central competent authority shall exercise the due care of good administrators in relation to the information acquired in accordance with the previous three paragraphs. The retention, processing and use of relevant information shall be in accordance with the provisions of the Personal Data Protection Act.

No right to collect any insurance benefit by the insured person, beneficiary or funeral cost payer shall be assigned, set off, seized or provided as security.
When the insured person or beneficiary seeks cash payment according to the Act, supporting documents issued by the insurer may be used to open an account with a financial institution to depositing the cash paid.
The deposit in the account under the previous paragraph shall not be subject to setoff, seizure, security or enforcement.

If the insurer cancels or revokes any insurance benefit already collected and such benefit should be returned and is not returned, the insurer may make a deduction from the insurance benefit collected by the same person or the beneficiary.
The central competent authority shall prescribe the regulations about the types, manner, amount of insurance benefit deduction under the previous paragraph and other relevant matters.
Any insurance benefit that should be returned and not yet returned under the first paragraph shall be repaid before normal claims and shall not be subjet to the following:
1.Provisions about waiver of indebtedness in relation to company reorganization under the Company Act.
2.Provisions about waiver of indebtedness in relation to liquidation under the Consumer Debt Cleanup Act.
3.Provisions about waiver of indebtedness in relation to bankruptcy under the Bankruptcy Act.

Insurance benefit issued in cash in accordance with the Act shall be paid within 15 days from the insurer’s approval. Pension payments shall be made before the end of the following month. In case of delayed payment imputable to the insurer, interest shall accrue on the delayed portion.
Interest under the previous paragraph shall be based on the one-year term deposit fixed interest rate offered by the post office on 1 January of each year and shall accrue on a daily basis in NT Dollars, rounded to 1/10 of a dollar.

When an insured unit fails to complete insurance participation or withdrawal procedure for any worker meeting the requirements under Article 6 in accordance with Article 12 and if the worker suffers Occupational injury or disease and seeks insurance benefit, after the insurer issues the insurance benefit, to the extent of such insurance benefit, the insurer shall confirm the amount due from the insured unit and issue a written administrative decision to order payment before a deadline.
If the insured unit has made payment in accordance with the previous paragraph, the insurance benefit collected by its worker may be used to set off against occupational accident compensation due in accordance with Article 59 of the Labor Standards Act.
The scope of the amount payable under the previous paragraph, the calculation manner, payment manner, payment deadline and other compliance matters shall be prescribed by the central competent authority.

The claim to receive insurance benefit shall cease to exist if it is not exercised within 5 years from the date on which the claim can be made.