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Supervision Overview標題圖示

 

I.Commission Assembly:

The commission assembly is the top decision making mechanism for the Commission. In principle, the Assembly shall be convened once a month, and may be called for temporary meetings if necessary. Before submitting to the Assembly for review, all cases shall be attached with the preliminary proposals by the responsible body. The significant ones as assessed preliminarily shall be submitted to the responsible members of Commission for substantial opinions. After having been approved by the Assembly, resolutions shall be submitted to the Council of Labor Affairs, Executive Yuan for approval or submitted as an enclosed letter to the Labor Insurance Bureau or Bureau of Employment and Vocational Training for further proceedings. The relevant decided cases shall be documented for future monitor and reported in the following Assembly.

II.Statutory Supervisory Duties:

Pursuant to the Laws for the Supervisory Commission of Labor Insurance, Labor Insurance Act, Employment Insurance Law, Occupational Accident Labor Protection Law, and other relevant laws and regulations, the Commission shall carry out the supervisory duties.

1. Reviews on the annual insurance plan and annual report:

In principle, the Bureau of Labor Insurance and Bureau of Employment and Vocational Training submit annually, and respectively the letters enclosed with the coming year performance plan and previous year final work report. All divisions in the Commission shall formulate review opinions according to the relevant laws and policies. Subject to the approval from the Assembly, further submission to the Council of Labor Affairs, Executive Yuan shall be reviewed accordingly.

2. Reviews on annual insurance budget and final account:

In principle, the Bureau of Labor Insurance annually submits the letter enclosed with annual labor insurance budget, final account, and annual budget for workers incurring occupational accidents; the Bureau of Employment and Vocational Training submits the letter enclosed with annual employment insurance budget and final account. Thus, the Commission makes assessments on the budgets and final accounts submitted by the Bureaus, and then the Commission submits those for the review to the Assembly before the final submission to the Council of Labor Affairs, Executive Yuan for inspection and approval.

3. Reviews on the auditing and the use of the insurance fund and funds keeping
  for workers incurring occupational accidents:

In principle, the Bureau of Labor Insurance shall formulate and submit labor insurance plan, proposal allocation of employment insurance fund and budgets of receipts and payments before the new fiscal year starts; after the submission to and approval by the Assembly, the implementation shall take place.

The letter enclosed with the information of allocation of insurance fund, management of funds for workers incurring occupational accidents, and the classifications, amounts, and profits of investments regarding domestic & overseas valuable securities and foreign currencies savings shall be submitted monthly to the Assembly for review or report. Subsequently, the administrative procedures shall be applied.

4. Examinations of insurance performance:

The Commission drafts the examination plan of insurance performance annually before the new fiscal year starts. The plan takes place after the submission to and approval by the Assembly. The performance can be examined regularly and irregularly. The regular examination is carried out seasonally in form of internal checkup and external interview. The former examines all performances of the Bureau of Labor Insurance and up-to-date executions of the employment insurance performances of the Bureau of Employment and Vocational Training; whereas, the later collects suggestions and comments on the labor insurance via interviewing the insured parties. The irregular examinations take place in accordance with the Assembly's decisions, significant public opinions, and the needs of performance improvement. The implementation of checkups and interviews is performed according to the examination items set up by the examination division, which is formed by the members of the Commission, to understand and resolve problems. As a result, the final examination report and suggestions shall be submitted for the Assembly's approval, the Council of Labor Affairs, Executive Yuan's inspection and approval, then sent to the Bureau of Labor Insurance or Bureau of Employment and Vocational Training for further proceedings, and then documented for future monitor to achieve the inspection goal.

5. Reviews on the essential affairs of insurance and protection for workers
  incurring occupational accidents:

The reviews on the essential affairs of insurance include the alterations of annual insurance plan or budget, consignation of insurance affairs, insurance affairs, formulation of important financial agreements, adjustment of insurance premiums, research and proposal on insurance reserve fund, estimate of the insurance financial balance, auditing of bad debts, and administrative measures of insurance oriented policies. The suggestion agreed by the Assembly and submitted to the approval by the Council of Labor Affairs, Execution Yuan shall be proceeded and the enclosed letter of relevant information sent to the Bureau of Labor Insurance or Bureau of Employment and Vocational Training for further proceedings.

Nonetheless, the Bureau of Labor Insurance submits letters twice a year enclosed with the subsidy proposals for occupational accident prevention and rehabilitation of workers incurring occupational accidents to the Assembly for review and discussion, then suggestion on the proposals will be referred back to the Bureau of Labor Insurance for further proceedings.

6. Examinations of insurance financial accounts:

The Commission stipulates and carries out the examination plan for labor insurance financial accounts before the new fiscal year starts. The implementation is adopted by full or random case examinations, depending on the actual needs. The examination results shall be submitted as a compiled report to the Assembly for review first, then to the Bureau of Labor Insurance, Executive Yuan for inspection and approval or to the Council of Labor Affairs for further proceedings. The suggested matters should be documented for future monitor to achieve the inspection goal.

7. Dispute examination and review:

According to the Regulations of the Labor Insurance Disputes Settlement, Insured Units, Insured Persons, Beneficiaries or Medical Service Institutions of National Health Insurance, have dispute related the following matters with the Bureau of Labor Insurance

(1)For the qualifications of Insured Persons and Beneficiaries, and underwriting;

(2)For the particulars of Insured Persons' Insurance Salary or Accumulated
  Insurance Seniority;

(3)For the particulars of Insurance Premium or Overdue Fine;

(4)For the particulars of Insurance Benefit;

(5)For the particulars of Occupational Injury and Disease;

(6)For the particulars of Degree of Disability;

(7)For the particulars of Medical Expenses of Occupational Injury and Disease;

(8)For the particulars of Insurance rights and interests, if one considers a
  deprivation of rights, the Commission is responsible for the reviews.

The meeting of Committee of Examination and Review will be held semimonthly in principle; it can be called for meeting provisionally when it is need. Moreover, pursuant to Article 3 Paragraph 2 of the Employment Insurance Act, "If the insured person and the insured establishment, dispute a case approved by the insurer, can apply for review to the Supervisory Commission of Labor Insurance; if the result of the review is unsatisfactory, a legal appeal and administrative action may be filed."

8. Reviews on the research and suggestions related to the insurance laws and
  regulations, insurance affairs:

For the research and suggestions related to the insurance laws and regulations, affairs, and finance stipulated by the Bureau of Labor Insurance and the Bureau of Employment and Vocational Training, Council of Labor Affairs, Executive Yuan, the Commission, specialists, scholars, and other representatives in the relevant field were invited to formulate opinions and submit to the Assembly for further review.

9. Other insurance supervisory matters:

Besides the above said matters, the Commission dedicated the matters which is consigned by the Assembly or the central authority, which is based on the need to research on insurance operation and finance.

 
Copyright © 2007 The Labor Insurance Supervisory Commission, ROC. All rights reserved.
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