Work-related injury compensation agreement template (I) Party A: _ _ _ _ _ _ _ _ _ _ ID number: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Party B: _ _ _ _ _ _ _ _ _ _ _
Company name: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ In view of the fact that both parties have a clear understanding of the relevant national laws and regulations, whether it is a work-related injury and its treatment results, in order to solve the work-related injury problem of Party A, Party A and Party B, in the spirit of seeking truth from facts, honesty and trustworthiness, have reached the following agreement through equal consultation in accordance with relevant laws and regulations:
I. Amount of compensation
1. Party A and Party B unanimously confirm that Party B has paid _ _ _ _ _ _ _ _ _ _ _ USD to Party A.
2. Party B purchased accident insurance for Party A in Ping An Insurance. After Party A was injured, Tonghua Disability Appraisal Center failed to appraise the disability level after appraisal, and * * * spent the appraisal fee of _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _.
3. On the basis of the expenses confirmed in Item 1 and Item 2 (* * * RMB) of Article 1 of this Agreement, Party A and Party B agree that Party B shall pay the following compensation to Party A in one lump sum: one-time disability allowance, one-time work-related injury medical allowance, one-time disability employment allowance, unpaid work stoppage and subsequent medical expenses * * * RMB.
Second, the payment period
Party B shall pay the above amount in cash from the date of signing this Agreement.
Three. Party A and Party B unanimously agree that the labor relationship between them will be terminated as of the date of signing this agreement.
Four. Since the date of signing this agreement, Party A voluntarily waives the right to compensate the difference.
Verb (abbreviation of verb) Party A voluntarily waives all rights arising from the occurrence and dissolution of labor relations between both parties.
6. As it is less than _ _ _ _ months since Party A worked in Party B's company until the date of work injury, Party B has not completed Party A's social insurance ... Therefore, Party A voluntarily waives the following rights:
1. Have the right to request Party B to handle social insurance for it;
2. The right to enjoy various rights and interests of social insurance according to law.
Seven. After the signing of this agreement, Party A and Party B shall terminate all rights and obligations related to compensation for work-related accidents. Party A shall not claim any rights from Party B, and Party B shall no longer undertake any obligations. There shall be no dispute between the two parties, and one party shall waive all legal responsibilities of the other party. At the same time, from the date of signing this agreement, Party A voluntarily waives all arbitration, litigation and other rights enjoyed by both parties regarding the dissolution of labor relations and compensation for work-related injuries.
Eight. After the signing of this agreement and the termination of labor relations, if Party A voluntarily returns to work for Party B, both parties may re-sign the labor contract and re-determine the labor relations.
Nine. responsibility for breach of contract
Where Party A's breach of contract leads to arbitration, litigation or application for compulsory execution, it shall pay the other party the expenses for realizing the creditor's rights, including but not limited to investigation and evidence collection fees, transportation fees, communication fees, lost time, notarization fees, attorney fees and other economic losses.
X. Party A and Party B voluntarily abide by and perform the above terms and conditions.
XI。 This agreement shall come into force as of the date of signature and seal by both parties. This agreement is made in duplicate, one for each party.
Party A: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Party B: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Template of industrial injury compensation agreement (II) Party A (employer): _ _ _ _ _ _ _ _ _ Co., Ltd.
Party B (laborer): _ _ _ _ _ _ _ _ _ _ _ _
Party A and Party B, through friendly negotiation, request to reach the following agreement with the company on compensation for Party B's _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _.
I. Confirmation of Damage Facts
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1, the eyelid of the left eye was stitched several times, which caused the left eye not to be completely opened and the vision was affected.
2. Comminuted fracture of radius of left hand. After the operation, the strength of the left hand was affected and it was impossible to do heavy work.
3. After the acetabular fracture of the left leg is healed, the activity is affected, which seriously affects the self-care ability of work and life.
4. The fracture of the left pelvis has certain influence on normal movement after recovery.
5. Comminuted fracture of the fifth toe of the left foot, with certain obstacles in normal standing and walking.
Party A and Party B confirm that the above-mentioned injuries and their impact on future work and life are correct.
2. Party A shall pay medical expenses in advance at the first time during the treatment period, and send them to the hospital for treatment at the first time after Party B is injured, so as to control Party B's injury in time and relieve the anxiety of Party B's family. Based on the principle of friendly negotiation, Party A and Party B have reached the following agreement to pay including but not limited to medical expenses, disability allowance, shutdown with pay and life care expenses.
Through negotiation, both parties agree that the industrial injury insurance regulations, _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
1, (i) Medical expenses
1. Legal basis: Paragraph 3 of Article 30 of the Regulations on Industrial Injury Insurance. The expenses for work-related injury treatment meet the catalogue of work-related injury insurance diagnosis and treatment items, the catalogue of work-related injury insurance drugs and the hospitalization service standard of work-related injury insurance.
2. Including: medical expenses during hospitalization, rehabilitation training and recurrence of work-related injuries. Party A shall be responsible for the treatment and rehabilitation of the complications and negative effects caused by the work-related injury during and after Party B's multiple fractures and during his age. In addition, Party A pays the treatment and rehabilitation expenses in advance.
2. Disability allowance. The physical and mental trauma caused by Party B's recovery from injury has brought immeasurable negative impact on Party B's future work and life. Party B needs Party A to pay disability allowance. The subsidy standard is (85% of the original salary × 2100)1785× subsidy period of 25 months = _ _ _ _ _.
3. Life care expenses. Since Party B can't take care of himself for most of his life, Party B shall claim the living care fee from Party A according to relevant laws and regulations until Party B reaches the age of 60.
4. Treatment during paid shutdown:
First, during the paid shutdown, the original wages and benefits will remain unchanged and will be paid by the unit on a monthly basis;
Second, those who still need treatment after the expiration of paid suspension will continue to enjoy medical treatment for work-related injuries;
Third, calculate the initial date, which is _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _.
Four, calculate the standard monthly salary of _ _ _ _ yuan.
Fifth, workers with work-related injuries who can't take care of themselves need care during paid shutdown, and their units are responsible for it;
Sixth, employees who die of work-related injuries during the paid shutdown period are regarded as work-related injuries and enjoy all treatment of work-related injuries.
3. Party B voluntarily gives up any other economic compensation requirements, and also gives up the idea of bringing work-related injury identification, work-related injury grade identification, arbitration or litigation to relevant departments. Except for the contents listed in this agreement, Party B shall not recover any treatment and economic compensation from Party A for any reason in the future.
Four. This agreement is made in duplicate, one for each party, and shall come into effect as of the date of signature by both parties.
Party A: _ _ _ _ _ _ _ _ _ _ Party B: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _.
(Signature): _ _ _ _ _ _ _ _ _ (Signature of Party B's representative): _ _ _ _ _ _ _
Model work-related injury compensation agreement (III) Party A (employing unit): _ _ _ _ _ _ _ _ _ _ _ _ _
Party B (worker): _ _ _ _ _ _ _ _ _ ID number: _ _ _ _ _ _ _ _
After _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _, Party A immediately sent Party B to the hospital for emergency treatment. Review after treatment, no serious problems. In order to properly solve the problem of Party B's injury, Party A and Party B reached the following agreement through friendly negotiation on the principle of equality, voluntariness, mutual understanding and mutual accommodation:
1. The medical expenses, transportation expenses and other expenses actually incurred by Party B from the date of injury to the date of signing this agreement have all been paid by Party A before signing this agreement. After the signing of this agreement, Party B shall not claim any expenses incurred during the above period from Party A for any reason.
2. Upon mutual agreement between Party A and Party B, Party A will pay all expenses payable by Party A in accordance with the law (hereinafter referred to as "one-time subsidy") to Party B in a lump sum, totaling RMB _ _ _ _ _ _ _ (in words: _ _ _ _ _ _), which will be paid by Party A at the time of signing this Agreement.
3. After receiving the one-time subsidy, Party B shall allocate and handle it reasonably, and consciously reserve enough expenses for possible follow-up treatment, rehabilitation and life. The way for Party B to allocate and handle the above expenses shall be decided by Party B, and the consequences shall be borne by Party B. ..
4. After both parties sign this agreement, the rights and responsibilities of both parties will be terminated. Party B promises not to ask Party A for any other expenses or undertake any labor-related responsibilities in any form or for any reason.
5. This Agreement is made in duplicate, with each party holding one copy. This agreement shall come into effect after being signed by both parties.
6. This agreement is a one-time termination, and both parties shall take this as a break, fully and conscientiously perform the contract, and shall not be entangled for any reason. Party A has nothing to do with any physical or mental problems of Party B in the future.
Signature of Party A (responsible person): _ _ _ _ _ _ _ Signature of Party B: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Date: _ _ _ _ _ _ _ _ _ _ _ _ _ Date: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Model work-related injury compensation agreement (IV): The employer _ _ _ (hereinafter referred to as Party A) and its employee _ _ _ _ (□ male □ female, born on _ _ _ _ _ _ _ _ _ (hereinafter referred to as Party B), began to establish labor contract relationship on _ _ _ _ _ _ _ _.
After the accident occurred on a certain day in _ _ _ _ _ _ _ _ _ _ _, Party A immediately took active medical rescue measures for Party B, and assumed all medical treatment, nursing and other related expenses incurred by Party B during the medical treatment.
After Party B's medical treatment for work-related injuries expires on _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Party B has no objection to its appraisal conclusion and decided not to apply for re-appraisal. Based on Party B's initiative, Party B continues to work in the original department of the company. For this reason, Party A also respects its wishes and considers its original position and current position. Therefore, Party B can continue to be competent for the original post. Therefore, the two parties agree on a _ _ _ _ labor contract relationship. Now, both parties have reached the following terms and conditions on compensation for Party B's labor dysfunction (disability) according to law, and hereby sign this agreement for mutual compliance.
Article 1: Party B confirms that before signing this agreement, Party A has promised to pay all medical treatment, nursing and other related expenses incurred by Party B during the medical treatment.
Article 2: Party A shall pay _ _ _ _ _ work-related injury benefits in one lump sum within three days after the signing of this agreement, with a total payment of (RMB) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _. After receiving the corresponding payment, Party B shall sign the receipt voucher; Otherwise, Party A has the right to refuse to pay.
Article 3: Party B agrees that when the labor contract expires or I propose to dissolve the labor contract, Party A shall pay the work-related injury treatment in one lump sum. And the total payment amount is (RMB) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _, otherwise, Party A has the right to refuse the payment.
Article 4: After the signing of this agreement, Party B will not claim any other industrial injury treatment from Party A according to law, nor will it claim any other industrial injury treatment related to labor relations, and there is no other dispute between the two parties.
Article 5: This Agreement shall come into force as of the date of signature by the representatives of both parties. This agreement is made in triplicate, one for each party, and one for Party A to report to relevant departments for filing.
Employer (Party A): _ _ _ _ _ _ _ _ _ _
Representative: (signature) _ _ _ _ _ _ _ _ _ Date of signature: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Employee (Party B): (signature) _ _ _ _ _ _ Date of signature: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _