産業災害 補償保險制度에 관한 分析的 硏究

Abstract

本 論文은 Neil Gilbert & Harry Specht의 社會福祉政策分析들을 적용하여 우리나라 産災補償保險의 實施現況과 問題點을 分析하고 그에 따른 改善方案을 제시하고자 한다. 우리나라 産災補償保險은 1963年 제정 실시된 이후 여러차례에 걸친 法律改定으로 그 내용면에서 많은 發展을 하여 왔으나 아직도 많은 問題點들이 남아 있다. 本 論文의 연구결과 얻어진 産災補償保險의 改善方案을 요약하면 다음과 같다. 첫째, 産災補償保險의 適用對象에서 16人미만의 小規模 雰細事業場을 제외시킨 것은 시급히 개선되어야 할 문제점으로 이들 기업에 대한 政府의 財政的 支援이 요구되며, 아울러 適用對象의 확대에 따르는 行政力이 강화되어야 할 것이다. 業務上 災害로 인정하여 給與對象에 包含하도록 한다. 둘째, 우리나라 産災補償保險의 給與水準은 I.L.O. 條約 및 勸告內容과 先進國의 補償水準에 크게 뒤떨어져 있으므로 給與水準의 引上이 要求되어진다. 最低補償制度의 最低補償基準額을 現實的인 生活保護가 可能한 水準으로 인상하여야 하며 年金制度의 실시에 있어서도 年金制度에 대한 인식강화와 年金水準의 引上이 요구된다. 給與種類에 따르는 문제점과 개선방안을 살펴보면 療養給與의 경우 요양제한기간을 단축하여야 하며, 障害給與의 경우 장해등급판정을 위한 과학적 기반이 마련되어야 한다. 遺族給與와 遺族特別給與에 있어서는 民事上의 損害賠償請求와 給與體係의 一元化가 이루어져야 하며, 一時給與는 長期傷病年金制度로의 전환이 이루어져야 할 것이다. 셋째, 産災指定의료기관의 지역간의 不均衡과 綜合病院에로의 환자집중현상은 우리나라 全體的인 의료공급체계의 과감한 수정과 病·醫院級 의료기관에 대한 政府의 財政的 支援과 함께 일반국민의 이들에 대한 不信感의 제거가 요구되어진다. 産災補償保險이 운영하는 保險施設로써 産業再活院의 경우 수용시설의 확장과 재활훈련후의 계속적인 職業輔導가 이루어져야 하며, 産災病院에 있어서는 職業病分野에 대한 특수의료시설의 확충과 工團과 鑛山勞動者 밀집지역에의 의료기관設立이 요구되어 진다. 또한 産災補償保險의 진료수가지불제인 點數制의 문제점을 고려하여 제도적인 개선이 이루어져야 한다. 넷째, 産災補償保險의 財源體系에 있어서 적절한 保險料의 결정을 위하여 우선 保險料 引下의 문제는 災害率의 감소에 의한 保險料率이 引下로 기업의 經濟的 損失을 감소시켜야 하며, 또한 個別實績料率制의 效果的인 活用을 위해서는 각 사업장의 産災發生에 대한 산재감독관의 감독이 철저하게 이루어져야 하며, 危險分散이라는 保險의 역할이 저해되지 않는 한 적용범위를 확대하도록 한다. 아울러 保險料의 支出에 있어서도 災害豫防對策에 대한 投資와 함께 産災補償保險 積立金의 效果的인 活用方案이 모색되어야 한다.;It is the fact that social welfare politics summary written by Neil Gilbert & Harry Specht was applied for the preparation of this thesis. And also, it has been summarized the problems and present situation of compensational insurance of property loss & damages in Korea. Accordingly, it demanded the improvemental method of such problems faced on present circumstance. Since compensational insurance for property loss & damages was enforced in 1963, it was outstandingly developed by revision of legal regulations throughout several times. However, there are many problems at present as yet. As a result of study of this thesis, solutions of such problems are as described on hereunder for its improvement demands of compensational insurance for loss & damages. 1). It demands to improve the problems that small industries workmenshop which employed less than 16 persons was excluded from applying of this compensational insurance for property loss & damages emergently. Otherwise, governmental financial assistance are demanded for above mentioned small workman shop and that, political power must be strengthened for additional expansion of applied available systems. In the viewing of official administration, requirements of recognition for official duties must be expanded for more widely to the circumstance beyond of two kinds of requirements views for recognition doctrines. In another words, loss and injurious damages occured by trafic accidents must be involved to official loss and damage. Also, compensation might be paid for such accidents in accordance with insurance regulations. 2). The payment level of compensation for property loss & damages are very lower than the payment level which applied by advanced countries at present including the terms and conditions and its requirements of I.L.O. However, it demands increasing the payment level now. Anyhow, payment level must be increased upto the level which maintains and secure the posibilities of support for living by the practical lowest compensational basic amount of lowest compensational system. Meanwhile, in the enforcement of annuity system, such enforcement must be widely apprehended for the commencement of annuity system as well as it demanded the increase of annuity level. Improvemental solutions for its payment status are as described on hereunder. In the event of payment for recuperation, period of recuperation limit must be deducted. In the event of payment for hindrance, determination of hindrance classification might be prepared for its basic requirement scientifically. For the payment and special payment for bereaved family, modification is required for request of loss 'compensation on civil sui suit and its payment system for the purpose of its equalization into the settlement of payment at sight. Compensational payment in a lump might be applied for the injurious annuity system. 3) Subsquent regulations must be amended straitly for improvement of the problems of concentrates appearance of patients to the hospital and districtical disproportion of nominating for medical insurance handling agencies. For the mobilization of such amendment, governmental assistance are required for hospitals and medical doctor's clinics. Meanwhile, distrustable sense against handling agencies must be eliminated by the customers. Also, it is deemed to mention about the insurance facilities operated by compensation insurance for property loss and damages. In the event of industrial rehabilitation house, its facilities must be expanded for accomodation, and instant vocational guidance is required for the jobless persons after they completed for the vocational training at the vocational institute. In the event of medical insurance handling hospital, expansion of particular medical facilities are required for the field of professional disease treatment. Meantime, each medical agencies must be facilitated at the place of mass area, like a mine and industrial groups compounds over the Korea. At the same time, the problem for numerical point system may be considered for its basic payment system in accordance with num numbers of medical treatments. Its systemical improvement are required for successful administration of compensational insurance for loss & damages. 4) In the financial systemetic foundation for compensational insurance, insurance fee must be decreased for the prupose of deduction of loss for the industries economically. Otherwise, insurance fee might be decreased for the deduction of loss &damage rate. Meantime, it demanded to adjust the insurance fee for its proper rate. For the effective mobilization of individual performance rate system, perfect supervision is required by its concerned supervisor for the occurance of incidental matters subjected to compensational loss & damage problems. So far as it is not harmful for the insurance movement in the viewing of its dissolution of dangers dimension of its appliance must be expanded for its utilization. Accordingly, in the payment of insurance fee, effective utilization pledge must be prepared for investment of prevent problems for loss & damages and performance bond for compensational insurance for loss & damages.