Article 16 (Ratio of Insurance Expenditure to Revenue for Application of Merit Rate)
"The ratio prescribed by the Presidential Decree" in Article 15 (2) of the Act refers to more than 85/100 or 75/100 or less.
<This Article Wholly Amended by Presidential Decree No. 22408, Sep. 29, 2010>
Article 17 (Calculation of Ratio of Insurance Expenditure to Revenue for Application of Merit Rate) (1) In case of calculating the ratio of industrial accident compensation insurance benefits to industrial accident compensation insurance premiums (hereinafter referred to as "industrial accident compensation insurance premiums" ) pursuant to Article 15 (2), the amount of industrial accident compensation insurance premiums shall be the sum of the following amounts as of June 30 of the base insurance year:
1. In the case of the base insurance year: The sum of monthly insurance premiums (hereinafter referred to as "monthly insurance premiums") under Article 16-3 (1) of the Act from January to June [in the case of a business falling under Article 19-2, an amount equivalent to 1/2 of estimated insurance premium (hereinafter referred to as "estimated premiums") under Article 17 (1) of the Act]
2. In the case of the two insurance years preceding the base insurance year: The sum of premiums (hereinafter referred to as "calculated premiums") calculated pursuant to Article 16-9 (1) and (2) of the Act [in the case of a business falling under Article 19-2, the sum of final premiums (hereinafter referred to as "final premiums") under Article 19 (1) of the Act]
3.In the case of the three insurance years preceding the base insurance year: An amount calculated according to the following formula.
(amount of final premiums or calculated premiums for the insurance year three years before the base insurance year) × 6 ÷ (total number of months during which insurance relations continue in the insurance year three years before the base insurance year)
(2) In calculating the ratio of industrial accident compensation insurance benefits to industrial accident compensation insurance premiums pursuant to Article 15 (2) of the Act, the amount of industrial accident compensation insurance benefits shall be the sum of all industrial accident compensation insurance benefits determined to be paid (referring to the causal act for disbursement; hereinafter the same shall apply) from July 1 of the insurance year three years prior to the base insurance year to June 30 of the base insurance year. In such cases, if industrial accident compensation insurance benefits determined to be paid are disability or survivors' compensation annuities, it shall be deemed that the lump-sum disability or survivors' compensation are determined to be paid when the payment of such annuities is first determined .
(3) In calculating the sum of industrial accident compensation insurance benefits pursuant to the former part of paragraph (2), the amount of insurance benefits falling under any of the following subparagraphs shall not be added: <Amended by Presidential Decree No. 23910, Jun. 29, 2012>
1.The amount of vocational rehabilitation benefits under Article 72 of the Industrial Accident Compensation Insurance Act;
2.The amount of insurance benefits determined to be paid due to an accident caused by a third person's action under Article 87 (1) of the Industrial Accident Compensation Insurance Act (excluding the amount of insurance benefits corresponding to the proportion that is not recognized as the third person's faults by a court's final ruling, etc.); and
3.The amount of insurance benefits determined to be paid in a situation where although pneumoconiosis under Article 91-2 of the Industrial Accident Compensation Insurance Act, noise-induced hearing loss under subparagraph 5 of Table 3 of the Enforcement Decree of the same Act and asbestos-related diseases under subparagraph 20 of the same Table have a significant causal relationship with work, so many workplaces are exposed to harmful and hazardous elements that it is not clear which workplace provides the main cause of such diseases.
4.The amount of insurance benefits determined to be paid for accidents that occur due to inevitable reasons, such as natural disasters or power failures, etc.
(4) With regard to the amount of insurance benefits under the proviso of paragraph (3), the date on which the court delivers its final ruling shall be considered the date on which the insurance benefits concerned are determined to be paid.
<This Article Wholly Amended by Presidential Decree No. 22408, Sep. 29, 2010>