广州市工伤保险先行支付政策实施研究

发布时间：2019-02-23 12:29

【摘要】：工伤保险制度有利于保障广大劳动者的切身利益,维护社会的稳定。但是原工伤保险制度疏忽了工伤职工初期治疗的紧急性和必要性,2011年《社会保险法》正式实施,其中提出了工伤保险先行支付政策,正好弥补了原工伤保险制度中缺乏工伤初期治疗的应急程序的不足,得到了社会各界的肯定。然而,从2011年《社会保险法》、《社会保险基金先行支付暂行办法》实施至今,工伤保险先行支付制度的“落地难”、各地经办部门的消极对待、申请成功率低却让广大的劳动者寒了心。当工伤职工满怀希望地向社保经办机构申请先行支付时,总是被要求提供各种对于工伤劳动者来说难以提供的证明手续以及资料。这样一来二去,工伤保险先行支付政策俨然成为一件了看上去很美但是广大的工伤劳动者根本触碰不到的摆设。从2011年7月起到现在,工伤保险先行支付政策已实行将近6年了,但广州乃至全国范围内申请成功的案例却寥寥无几。社保经办部门消极对待,经办人员业务认同度低,政策宣传不足、对工伤基金安全风险的考量、实施细则缺位等都是其原因。为此,广州市于2014年1月开始实施《广州市社会保险基金管理中心关于印发,广州市工伤保险基金先行支付业务经办操作规程的通知》(穗社保中[2013]99号)(以下简称(《广州市操作规程》)。《广州市操作规程》对工伤保险先行支付业务的受理条件和审核支付的业务流程作出了明确规定,为广州市工伤保险先行支付的实施提供了重要依据。但《广州市操作规程》的规定中仍存在一些不甚明确,甚至不合理的地方,导致工伤劳动者对工伤保险先行支付评价仍是“难申请”经办人员则是“难办理”。可见,工行保险先行支付政策要在广州广泛推广实施仍然有漫长的路要走。本文是以《社保法》所确立的工伤保险先行支付制度与工伤保险先行支付的相关法规相结合,深入分析广州市工伤保险先行支付政策与政策实施的情况。从政策的制定、执行、监控等方面展开,以事实、数据、案例进行论述。探讨广州在实施工伤保险先行支付政策过程中存在的问题,进而提出解决办法。本文的重点和创新之处在于本人将自身工作实践与理论分析相结合,根据广州市工伤保险先行支付政策的实际实施情况,分析在实施过程中出现问题的现象和本质,从主体、申请、监督、追偿等多个方面提出了针对广州市工伤保险先行支付政策实施的可行性建议,并对未来我国工伤保险先行支付制度的发展提出了设想。
[Abstract]:Industrial injury insurance system is conducive to protecting the vital interests of workers and maintaining social stability. However, the original industrial injury insurance system neglected the urgency and necessity of initial treatment for workers at work injury. In 2011, the "Social Insurance Law" was formally implemented, in which a policy on advance payment of industrial injury insurance was put forward. It makes up for the lack of emergency procedure in the original industrial injury insurance system and has been affirmed by all walks of life. However, since the implementation of the "Social Insurance Law" in 2011 and the interim measures for Social Insurance Fund first payment, the "landing difficulty" of the work injury insurance advance payment system has resulted in negative treatment from local agencies. The low success rate of the application makes the vast number of workers cold. When industrial injury workers apply to social security agencies for advance payment hopefully, they are always asked to provide all kinds of proof procedures and materials that are difficult to provide for industrial injury workers. In this way, the first payment policy of industrial injury insurance has become a beautiful but the vast number of industrial injury workers do not touch the furnishings. From July 2011 to now, industrial injury insurance has been in effect for nearly six years, but there have been few successful applications in Guangzhou and across the country. The reasons are the negative treatment of social security agencies, the low level of business identity, the lack of policy publicity, the consideration of the safety risk of industrial injury funds, the absence of implementation rules and so on. To this end, Guangzhou City in January 2014 began to implement the "Guangzhou Social Insurance Fund Management Center" issued, Notice on the Operation rules of Guangzhou Industrial injury Insurance Fund in advance payment. (Guangzhou Social Security [2013] 99) (hereinafter referred to as "Guangzhou operating rules"). The terms of acceptance of the payment business and the business process for reviewing the payment are clearly defined. It provides an important basis for the implementation of advance payment of industrial injury insurance in Guangzhou. However, there are still some unclear or even unreasonable places in the provisions of "Guangzhou operating rules", which lead to the evaluation of the first payment of industrial injury insurance by workers at work injury, which is still "difficult to apply for" and "difficult to handle". Visible, ICBC insurance advance payment policy to be widely promoted in Guangzhou, there is still a long way to go. This paper combines the system of advance payment of industrial injury insurance established by the Social Security Law with the relevant laws and regulations on the advance payment of industrial injury insurance, and analyzes deeply the situation of the policy and implementation of the advance payment of industrial injury insurance in Guangzhou. From the policy formulation, implementation, monitoring and other aspects, with facts, data, cases to discuss. This paper probes into the problems existing in the implementation of the industrial injury insurance advance payment policy in Guangzhou, and puts forward some solutions. The emphasis and innovation of this paper lies in the combination of my own work practice and theoretical analysis. According to the actual implementation of Guangzhou industrial injury insurance advance payment policy, this paper analyzes the phenomenon and essence of the problems in the process of implementation. This paper puts forward some feasible suggestions for the implementation of the advance payment policy of industrial injury insurance in Guangzhou from the aspects of application, supervision, recovery and so on, and puts forward a tentative plan for the development of the advance payment system of industrial injury insurance in our country in the future.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：D922.55

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