雇主责任险的赔偿项目,雇主责任险免赔的情形有哪些

2025-03-27 19:18:29
推荐回答(2个)
回答1:

看你是什么项目的,比如包工头,搞建筑,他与保险公司签了雇主责任险,下面的人因为在建筑工作的时候出现合同上的事件,保险公司就得帮包工头支付一定的赔偿金。

回答2:

一、雇主责任保险如何赔偿
在处理雇主责任保险索赔时,保险人必须首先确立受害人与致害人之间是否存在雇佣关系。根据国际上流行的做法,确定雇佣关系的标准包括:
(一)雇主具有选择受雇人的权力;
(二)由雇主支付工资或其他报酬;
(三)雇主掌握工作方法的控制权;
(四)雇主具有中止或解雇受雇人的权力。
雇主责任保险的赔偿限额,通常是以每一雇员若干个月的工资收入作为其发生雇主责任保险时的保险赔偿额度,每一雇员只适用于自己的赔偿额度。
在一些国家的雇主责任保险界,保险人对雇员的死亡赔偿额度与永久完全残废赔偿额度是有区别的,后者往往比前者的标准要高。但对于部分残废或一般性伤害,则严格按照事先规定的赔偿额度表进行计算。其计算公式为:
赔偿金额=该雇员的赔偿限额×适用的赔偿额度比例
如果保险责任事故是第三者造成的,保险人在赔偿时仍然适用权益转让原则,即在赔偿后可以代位追偿。
二、雇主责任保险有哪些拒赔情形
由于下列原因造成的任何损失、费用或赔偿责任,保险人不负责赔偿:
(一)被保险人或其代表的故意行为、犯罪行为;
(二)战争、敌对行为、军事行动、武装冲突、恐怖主义活动、罢工、暴动、民众骚乱;
(三)行政行为、司法行为;
(四)核爆炸;
(五)被保险人职员接触、使用放射性同位素或含有放射性物质的材料;
(六)被保险人职员接触、使用石棉、石棉制品或含有石棉成份的物质。
被保险人职员有下列情形之一,导致自身遭受人身损害的,保险人不负责赔偿:
(一)故意行为、犯罪行为、违反治安管理法律、法规和规章;
(二)自残、自杀、醉酒;
(三)服用、吸食、注射毒品;
(四)饮酒后或者服用国家管制的精神药品、麻醉药品后驾驶机动车;
(五)无驾驶证,驾驶证失效或者被依法扣留、暂扣、吊销期间驾驶机动车,驾驶与驾驶证载明的准驾车型不相符合的机动车;
(六)无国家有关部门核发的有效操作证使用各种专用机械车或特种车的。
对于下列损失、费用或赔偿责任,保险人不负责赔偿:
(一)除本合同列明负责赔偿的项目外,其他超出被保险人职员所在地工伤保险和基本医疗保险诊疗项目目录、药品目录、医疗服务设施范围和支付标准的医疗费用;
(二)罚款、罚金或惩罚性赔款;
(三)在合同或协议中约定的应由被保险人承担的赔偿责任,但即使没有这种合同或协议,被保险人依法仍应承担的赔偿责任不在本款责任免除范围内;
(四)保险单中载明的应由被保险人自行承担的免赔额。

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