職工因工死亡,有關部門核定其工傷保(bao)險(xian)待遇項目時,以(yi)“補差(cha)”模式將其已獲(huo)得(de)的(de)第三人侵權(quan)損害賠(pei)償款自工傷保(bao)險(xian)待遇中核減。這種(zhong)“補差(cha)”模式能否得(de)到(dao)法院支持?死者(zhe)家屬(shu)究竟(jing)應該得(de)到(dao)何(he)種(zhong)賠(pei)償呢?
【案情回顧】
周某系(xi)湘潭(tan)某公司職工(gong)(gong),受(shou)單位(wei)派遣外出期間因第(di)(di)三人全部責(ze)任(ren)在高速公路上發生交通事(shi)故,經搶救(jiu)無效(xiao)死(si)亡(wang)。湘潭(tan)市人力資源和社(she)會保障局認(ren)定(ding)(ding)“周某的(de)(de)此(ci)次死(si)亡(wang)符合(he)工(gong)(gong)傷認(ren)定(ding)(ding)條件,予以認(ren)定(ding)(ding)因工(gong)(gong)死(si)亡(wang)”,并作(zuo)出《工(gong)(gong)傷認(ren)定(ding)(ding)決定(ding)(ding)書》。被(bei)告(gao)湘潭(tan)市工(gong)(gong)傷保險(xian)管理服務局因而作(zuo)出《工(gong)(gong)傷保險(xian)待遇核定(ding)(ding)表》,核定(ding)(ding)周某家屬(shu)可領取喪葬補(bu)助金等項目共計122171.95元(yuan)。(該(gai)金額核減了周某家屬(shu)因提起機動(dong)車(che)交通事(shi)故責(ze)任(ren)之(zhi)訴(su)而獲得的(de)(de)保險(xian)理賠(pei)款336870.05元(yuan))。周某家屬(shu)與(yu)被(bei)告(gao)就第(di)(di)三人侵權與(yu)工(gong)(gong)傷損害賠(pei)償競合(he)等問題產生爭議(yi),遂向(xiang)法院提起訴(su)訟。
【法官說法】
法(fa)(fa)院經(jing)審理(li)認為,周某(mou)家(jia)屬(shu)(shu)已獲得的(de)(de)(de)(de)(de)侵權(quan)(quan)損(sun)害(hai)(hai)賠(pei)償(chang)(chang)包括死(si)亡(wang)(wang)賠(pei)償(chang)(chang)金、喪葬(zang)費(fei)、精神損(sun)害(hai)(hai)撫(fu)(fu)慰金、處理(li)交通事故人員(yuan)誤工(gong)(gong)(gong)費(fei)和(he)交通費(fei)、被(bei)扶養(yang)人生活費(fei)五項(xiang),而(er)被(bei)告核(he)(he)(he)(he)(he)定(ding)其可(ke)獲得的(de)(de)(de)(de)(de)工(gong)(gong)(gong)傷(shang)保(bao)險(xian)(xian)(xian)待(dai)遇(yu)(yu)為核(he)(he)(he)(he)(he)減了侵權(quan)(quan)損(sun)害(hai)(hai)全部賠(pei)償(chang)(chang)款之(zhi)后的(de)(de)(de)(de)(de)喪葬(zang)補償(chang)(chang)金、一(yi)次性(xing)工(gong)(gong)(gong)亡(wang)(wang)補助(zhu)金、供養(yang)親屬(shu)(shu)撫(fu)(fu)恤金三(san)(san)項(xiang)。被(bei)告在核(he)(he)(he)(he)(he)定(ding)工(gong)(gong)(gong)傷(shang)保(bao)險(xian)(xian)(xian)待(dai)遇(yu)(yu)時,將不(bu)(bu)(bu)屬(shu)(shu)于(yu)(yu)工(gong)(gong)(gong)傷(shang)保(bao)險(xian)(xian)(xian)待(dai)遇(yu)(yu)的(de)(de)(de)(de)(de)精神損(sun)害(hai)(hai)撫(fu)(fu)慰金、處理(li)交通事故人員(yuan)誤工(gong)(gong)(gong)費(fei)和(he)交通費(fei)等侵權(quan)(quan)損(sun)害(hai)(hai)賠(pei)償(chang)(chang)項(xiang)目(mu)(mu)一(yi)齊核(he)(he)(he)(he)(he)減的(de)(de)(de)(de)(de)做(zuo)法(fa)(fa),有違(wei)法(fa)(fa)律(lv)、法(fa)(fa)規的(de)(de)(de)(de)(de)相關規定(ding),屬(shu)(shu)審核(he)(he)(he)(he)(he)錯誤。由于(yu)(yu)適用的(de)(de)(de)(de)(de)法(fa)(fa)律(lv)依據不(bu)(bu)(bu)同(tong),侵權(quan)(quan)損(sun)害(hai)(hai)賠(pei)償(chang)(chang)與(yu)工(gong)(gong)(gong)傷(shang)保(bao)險(xian)(xian)(xian)待(dai)遇(yu)(yu)的(de)(de)(de)(de)(de)組成項(xiang)目(mu)(mu)及其計算標準均(jun)不(bu)(bu)(bu)盡相同(tong)。在職工(gong)(gong)(gong)或者其近親屬(shu)(shu)已經(jing)獲得第(di)三(san)(san)人侵權(quan)(quan)損(sun)害(hai)(hai)賠(pei)償(chang)(chang)的(de)(de)(de)(de)(de)情形(xing)下申請工(gong)(gong)(gong)傷(shang)保(bao)險(xian)(xian)(xian)待(dai)遇(yu)(yu)的(de)(de)(de)(de)(de),工(gong)(gong)(gong)傷(shang)保(bao)險(xian)(xian)(xian)經(jing)辦機構理(li)應(ying)區(qu)分不(bu)(bu)(bu)同(tong)的(de)(de)(de)(de)(de)賠(pei)償(chang)(chang)項(xiang)目(mu)(mu)和(he)標準,對(dui)于(yu)(yu)其中性(xing)質(zhi)相同(tong)的(de)(de)(de)(de)(de)、重復(fu)的(de)(de)(de)(de)(de)項(xiang)目(mu)(mu)可(ke)予以(yi)核(he)(he)(he)(he)(he)減,對(dui)于(yu)(yu)其中性(xing)質(zhi)不(bu)(bu)(bu)同(tong)、不(bu)(bu)(bu)重復(fu)的(de)(de)(de)(de)(de)項(xiang)目(mu)(mu)則(ze)應(ying)并行支(zhi)付。因此,依法(fa)(fa)判決(jue)撤銷被(bei)告作出的(de)(de)(de)(de)(de)《工(gong)(gong)(gong)傷(shang)保(bao)險(xian)(xian)(xian)待(dai)遇(yu)(yu)核(he)(he)(he)(he)(he)定(ding)表》,責令被(bei)告重新核(he)(he)(he)(he)(he)定(ding)周某(mou)家(jia)屬(shu)(shu)因周某(mou)工(gong)(gong)(gong)傷(shang)死(si)亡(wang)(wang)事故可(ke)領取(qu)的(de)(de)(de)(de)(de)工(gong)(gong)(gong)傷(shang)保(bao)險(xian)(xian)(xian)待(dai)遇(yu)(yu)。