What are the legal responsibilities of social insurance and commercial insurance?

Social insurance and commercial insurance are both related and essentially different. Functionally, both of them are social risk resolution mechanisms. Social insurance is the main body of multi-level social insurance system, and commercial insurance can be used as a supplement to social insurance and is an integral part of multi-level social insurance system.

There are essential differences between social insurance and commercial insurance: First, they are different in nature. Social insurance is enforced by national legislation, which belongs to government behavior, is a welfare undertaking and is non-profit. Commercial insurance is a kind of commercial behavior, and the relationship between the insurer and the insured is completely voluntary. Having the nature of taking profit as the purpose; Second, the purpose is different. Social insurance is not for profit, its starting point is to protect the basic livelihood of workers, maintain social stability and promote economic development. The fundamental purpose of commercial insurance is to obtain profits, but only on this premise can the insured be given economic compensation; Third, the sources of funds are different. Social insurance is borne by the state, employers and individuals. Commercial insurance is entirely borne by the insured person; Fourth, the level of treatment is different. Starting from stabilizing society, social insurance focuses on the protection of long-term basic life, and should be adjusted and gradually improved with the rise of prices. Commercial insurance focuses on one-time economic compensation. Fifth, the government has different responsibilities. Social insurance is a basic right enjoyed by citizens. The government has the ultimate responsibility to society. Commercial insurance is restricted by market competition mechanism, and the government mainly supervises commercial insurance according to law to protect the interests of investors.

Commercial insurance is mainly the difference between life insurance and social security;

First, the business entities are different, and the business entities of life insurance must be commercial insurance companies. Social insurance can be handled by the government or its established institutions, and can also be entrusted to financial institutions such as fund companies, banks and insurance companies. Social insurance has administrative characteristics. In China, social insurance agencies are authorized by the Ministry of Labor and Social Security.

Second, the behavioral basis is different. Personal insurance is a civil act in accordance with the contract. The establishment of insurance relationship is embodied in the form of insurance contract, and the rights and obligations enjoyed by both parties are also based on insurance contract. Social insurance, on the other hand, is a government act implemented according to law, and the protection of social insurance is the basic right given to citizens or workers by the Constitution. In order to ensure the realization of this right, the state must promulgate social insurance laws and regulations and enforce them.

Third, the implementation methods are different. To conclude a life insurance contract, the principles of equality and mutual benefit, consensus and voluntary conclusion must be implemented. Except for a few types of insurance, most types of insurance have no mandatory provisions in law. On the other hand, social insurance is compulsory. All members of society within the scope of social insurance law must participate, and there is no choice. And those who refuse to pay or pay the insurance premium late without reason will be fined and even investigated for legal responsibility.

Fourth, the application principles are different. Life insurance reflects the contractual relationship between the two parties, and the rights and obligations of both parties are equal, that is, the insurer's liability for compensation and the liability for paying insurance benefits depend entirely on whether the insured pays insurance benefits and the amount paid. In other words, more investment and more insurance, less investment and less insurance, no investment and no insurance. Therefore, life insurance emphasizes the principle of "personal fairness". Social insurance, because it is related to the social and economic goals of the government, aims at implementing the national social policy and labor policy and emphasizes the principle of "social equity". The payment level of the insured is not closely related to the level of protection. In order to reflect the responsibility of the government, no matter how much the insured pays, the payment standard is the same in principle, and even some people can get social insurance protection without paying insurance premiums.

Fifth, the safeguard function is different. The protection goal of life insurance is to pay insurance money for the damage caused by insurance accidents within the limit of insurance amount. This goal can meet the needs of people at all levels of life consumption, that is, by purchasing life insurance, survival, development and enjoyment can be guaranteed. The goal of social insurance is to protect the basic needs of social members, that is, survival needs, by paying social insurance premiums, so the level of protection is relatively low.

6. The premium burden is different. Paying the insurance premium is the basic obligation of the life insurance applicant. The insurance premium includes not only the expenses of death, disability and illness, but also the business and management expenses of the insurer, and the applicant must bear all of them. Therefore, the charging standard of life insurance is generally higher. The guarantee fee of social insurance is usually shared by individuals, enterprises and the government. As for the burden ratio of all parties, it varies with different projects and economic affordability.

Compared with social security, commercial insurance is your choice to pay, and social security is not enough. Commercial insurance is a crutch of social insurance and a supplement to social security. With commercial insurance, you can maintain your relatively high standard of living. Retirement pension is up to you, because it actually depends on how much you pay in the insurance company.

Social security generally has little or no death benefits, while commercial insurance generally has death benefits (of course, some types of death benefits only guarantee survival)

The regulation of social insurance legal liability is the core part of the national coercive force that embodies the legal norms of social insurance. The purpose of legislation is to establish a good order of social relations. For a country, it is important not only to make laws, but also to implement them. Without effective implementation and compliance, even the best law is a dead letter and cannot play its due role. Therefore, the establishment of a scientific and strict legal liability system for social insurance is not only an inherent requirement to improve the legal system of social insurance, but also an inevitable need to ensure the correct implementation of the social insurance law and crack down on illegal and criminal acts.

■ Types of social insurance legal liability

The legal liability of social insurance refers to the legal liability consequences caused by the illegal behavior of the actor in the process of auditing, collection, operation and distribution of social insurance premiums. From the subject of responsibility, it mainly includes the employer's responsibility, the laborer's responsibility, the social insurance agency's responsibility and other subject responsibilities.

Insurance criminal legal liability

(A) the concept of insurance crime

The so-called insurance crime refers to the behavior of participants in the insurance market who violate the provisions of the insurance law and criminal law and disturb the normal management order of the insurance market in the process of insurance, claim settlement, underwriting, claim settlement, insurance agent, insurance broker, insurance assessment and insurance behavior supervision. And the circumstances are serious, which constitutes a crime.

According to the provisions of the Criminal Law, insurance crimes mainly include the following specific charges:

(1) Crime of setting up financial institutions without authorization; (article 174 of the criminal law)

(2) Company and enterprise personnel accept bribes; (article 184 of the criminal law)

(3) Crime of misappropriating funds; (article 185 of the criminal law)

(4) the crime of intermediary organizations and personnel providing false documents; (Article 229 of the Criminal Law)

(5) The certification documents issued by the personnel of the intermediary organization are guilty of material inaccuracy;

(6) the crime of duty embezzlement; (Articles 183 and 27 1 of the Criminal Code)

(7) Crime of insurance fraud; (article 198 of the criminal law)

(8) the crime of illegal business operation; (Article 225 of the Criminal Law)

(9) fraud; (Article 266 of the Criminal Law)

(10) Crime of corruption; (Article 382 of the Criminal Law)

(1 1) Crime of misappropriating public funds; (Article 384 of the Criminal Law)

(12) bribery; (Article 385 of the Criminal Law)

(13) Crime of abuse of power and dereliction of duty; (Article 397 of the Criminal Law)

(B) the meaning of several typical insurance crimes

1. Crime of setting up a financial (insurance) institution without authorization; (article 174 of the criminal law)

It refers to the act of setting up an insurance company in China without the approval of the insurance regulatory authority of China. Including those that fail to apply for establishment according to legal conditions and procedures; It also includes two cases of establishment after application but not approved.

2. Crime of occupational embezzlement (by employees of insurance companies); (Articles 183 and 27 1 of the Criminal Code)

It refers to the behavior that the staff of an insurance company, taking advantage of their position, deliberately fabricated an insurance accident that had never happened to make false claims, defrauded the insurance money for themselves, and actually occupied a large amount of funds of the insurance company.

Staff members of state-owned insurance companies and personnel assigned by state-owned insurance companies to engage in official business in non-state-owned insurance companies who commit the above acts shall be punished according to the crime of corruption.

3. Crime of insurance fraud; (article 198 of the criminal law)

Refers to the insured, the insured or the beneficiary for the purpose of illegal possession, by fabricating facts or concealing the truth, insurance fraud activities, a large amount of behavior.

Article 198 of the Criminal Law stipulates five specific fraudulent acts:

(1) The insured deliberately fabricated the subject matter of insurance to defraud the insurance money;

(2) The applicant, the insured or the beneficiary fabricates false reasons or exaggerates the loss of the insured accident to defraud the insurance money.

(3) The applicant, the insured or the beneficiary fabricates that there has never been an insurance accident to defraud the insurance money;

(four) the insured, the insured or the beneficiary intentionally caused an insurance accident that caused property losses and defrauded the insurance money;

(5) The applicant, the insured or the beneficiary intentionally causes the death, disability or illness of the insured to defraud the insurance money.

At the same time, this article stipulates that if an expert witness, witness or property expert of an insurance accident intentionally provides false documents to provide fraudulent conditions for others, he shall be punished as an accomplice in the crime of insurance fraud.

Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.