| Article 30 |
After receiving the Insurance Premium Payment Slip with the calculation description from the insurer, insured units are required to pay the premiums to the financial institution designated by the insurer before the deadline and get the receipt back as proof of payment.
In the event that the insured units have not received the premium payment bills referred to in the preceding paragraph by the end of month the insurer shall send them, they shall notify the insurer to resend them within five days or download the premium payment bill from the website of the insurer, and pay the premiums within the grace period of fifteen days. In case the insured unit fails to make such notices, the premium payment bills shall be considered to have been received before the 25th day of the next month. |
| Article 36 |
For the insurance premium to be subsidized by the central government under Article 15 of the Act, the insurer shall prepare and issue a payment bill of insurance premium every month, and submit it before the end of the next month to the central government for payment by transfer according to relevant provisions.
Where the insurer finds there is a difference in the above-mentioned insurance premium to be subsidized by the government, it shall be settled upon accounting the insurance premium next time. |
| Article 49-1 |
Interest that should be added in overdue premium prescribed in Article 29-1 herein shall be based on the fixed interest rate on January 1st every year for a one-year postal saving time deposit, calculated in NT dollars per day, and NT dollars below 0.1 shall be rounded. |
| Article 61 |
In the event that the insured persons cannot submit or submit for review the related required documents due to the facts that they have not received the occupational injury or disease outpatient medical treatment bills, hospitalization application forms, national health insurance cards, or seeking emergency treatments for injuries or diseases, they shall prepare and submit other related documents that can verify their identities and proclaim they are in the possession of labor insurance status, and proceed to register and receive medical treatments. Under such circumstances, the medical service institutions affiliated with the national health insurance programs shall provide medical services , receive insurance medical expenses , and issue receipts to the persons seeking medical treatments. In case the insured persons obtain and submit the required documents within ten days (excluding regular days off) or before hospital discharge after the date they are admitted for medical treatments, the medical service institutions affiliated with the national health insurance program shall refund the paid insurance medical expenses. |
| Article 62 |
In the event that the insured persons are unable to provide the necessary documents within the ten days or before hospital discharge after receiving medical treatments as stipulated in the preceding article as the result of any circumstances not of their own faults, they shall prepare and submit the occupational injury or disease outpatient medical treatment bills or hospitalization application forms and the receipts of medical expenses prepared and issued by the medical service institutions affiliated with the national health insurance programs, within six months from the date of receiving outpatient medical treatment or the date of releasing from hospitalization, to the insurer responsible for the jurisdictional districts to apply for reimbursement of the paid medical expenses. |
| Article 67 |
In the event that the insured persons are stricken with occupational injuries or diseases outside of the jurisdictional area which this Act is implemented and require outpatient medical services or hospitalization, they may retain the documents of proof and bills of expenses issued by the hospitals or clinics where they received medical treatments and present them, within six months from the dates they received clinical services or the dates they are discharged from the hospitals, to the insured units they are affiliated with. The insured units shall apply to the insurer responsible for the jurisdictional districts for reimbursement of the outpatient or hospitalization expenses.
The preceding outpatient medical treatments or hospitalization bills shall be verified for payment by the insurer according to Enforcement Rules and the relevant regulations. In the event that the application fee is higher than the daily average cost basis for emergency, outpatient and hospitalization medical treatment per person-time in contracted medical center in the quarter prior to the date of the insurer’s emergency, outpatient and hospitalization medical treatment, the excess portion shall not be paid.
When the insured is in treatment in non-contracted hospital or clinics paid by National Health Insurance, benefit periods and insurer’s benefit basis applied for shall be applicable to the Regulations for National Health Insurance Reimbursement of the Self-advanced Medical Expenses. |
| Article 69 |
The date an insured person applies for disability benefits in accordance with Article 53 or 54 of the Act and is diagnosed by a contracted hospital or clinic paid by National Health Insurance, as with permanent disability shall be the day the benefits become payable as set forth in Article 30 of the Act. If injury or accident occurred to the insured person during the effective period of insurance, the insured in compliance with the treatment period prescribed in the attachment of Article 3 of Labor Insurance Benefit Payment Criteria after insurance effect is terminated, diagnosed permanent disability with the degree equivalent to that in expiration of a year of insurance effect, and having fixed symptoms shall apply for disability benefit payment according to Paragraph 1 of Article 20 of the Enforcement Rules.
If the date of the diagnosis for permanent disability prescribed in the preceding paragraph is unclear or in dispute, the insurer may check the relevant medical records or documents to confirm the date.
In the event that the insured persons request the diagnosis report for disability, the hospitals or clinics under special contracts with the National Health Insurance Program shall issue and mail the documents within five days. |
| Article 99 |
These rules shall come into force from January 1, 2009.
The amended article of the Enforcement Rules hereof shall come into force as of the day of promulgation besides Article 61 amended to promulgate on July 26, 2013, Article 62 and 67 on January 1, 2013. |