發文單位：司法院
解釋字號：釋字第549號
解釋日期：民國91年8月2日
解釋爭點：勞保條例就勞保遺屬津貼受領之規定違憲？
資料來源：司法周刊 第 1094 期 1 版
                    司法院公報 第 44 卷 9 期 1-16 頁
                    司法院大法官解釋（十五）（99年5月版）第 223-246 頁
                    考選周刊 第 877 期 2 版
                    總統府公報 第 6480 號 11-28 頁
                    法務部公報 第 288 期 60-78 頁
                    法令月刊 第 53 卷 8 期 61-62 頁
   
相關法條：中華民國憲法 第 153、155 條 ( 36.01.01 )
                    中華民國憲法增修條文 第 10 條 ( 89.04.25 )
                    民法 第 1138 條 ( 91.06.26 )
                    勞工保險條例 第 15、27、62、63、64、65、66 條 ( 90.12.19 )
                    勞工保險條例施行細則 第 89、90、91 條 ( 90.09.12 )

解釋文：
勞工保險係國家為實現憲法第一百五十三條保護勞工及第一百五十五條、憲法增修條文第十條第八項實施社會保險制度之基本國策而建立之社會安全措施。保險基金係由被保險人繳納之保險費、政府之補助及雇主之分擔額所形成，並非被保險人之私產。被保險人死亡，其遺屬所得領取之津貼，性質上係所得替代，用以避免遺屬生活無依，故應以遺屬需受扶養為基礎，自有別於依法所得繼承之遺產。勞工保險條例第二十七條規定：﹁被保險人之養子女，其收養登記在保險事故發生時未滿六個月者，不得享有領取保險給付之權利。﹂固有推行社會安全 暨防止詐領保險給付之意，而同條例第六十三條至第六十五條有關遺屬津貼之規定，雖係基於倫常關係及照護扶養遺屬之原則，惟為貫徹國家負生存照顧義務之憲法 意旨，並兼顧養子女及其他遺屬確受被保險人生前扶養暨無謀生能力之事實，勞工保險條例第二十七條及第六十三條至第六十五條規定應於本解釋公布之日起二年內予以修正，並依前述解釋意旨就遺屬津貼等保險給付及與此相關事項，參酌有關國際勞工公約及社會安全如年金制度等通盤檢討設計。

理由書：
勞工保險係國家為實現憲法第一百五十三條保護勞工及第一百五十五條、憲法增修條文第十條第八項實施社會保險制度之基本國策而建立之社會福利措施，為社會保險之一種，旨在保障勞工生活，促進社會安全。社會保險所提供之保障，依國際公約及各國制度，通常分為兩類：金錢補助及福利服務。金錢補助係為補償被保險人因為老年、殘障、死亡、疾病、生育、工作傷害或面臨失業情況喪失所得時所為之金錢給付，此類金錢給付分別具有所得維持、所得替代之功能；社會福利服務則指直接提供諸如住院照護、醫療服務、復健扶助等，學理上稱為﹁實物給付﹂。負擔上述各項給付及服務之社會保險基金，其來源初不限於被保險人所繳納之保險費，我 國現行勞工保險制度亦同。依勞工保險條例第四章規定對於被保險人或其受益人所提供之保險給付，計有生育、傷病、醫療、殘廢、老年、死亡等項，勞工保險之保險費，則依同條例第十五條所定之比例，由被保險人、投保單位分擔及中央政府與直轄市政府補助。
保險事故發生時被保險人或其受益人所受領之保險給付，係由勞工保險創立時政府一次撥付之金額、當年度保險費及其孳息之收入與保險給付支出之結餘、保險費滯納金、基金運用之收益等所形成之勞工保險基金支付之﹙勞工保險條例第六十六條參照﹚，可知保險給付所由來之保險基金並非被保險人私有之財產。被保險人死亡， 同條例第六十三條規定之遺屬所得領取之津貼，乃勞工保險機構出於照護各該遺屬所為之設計，用以避免其生活無依，故遺屬津貼有別於依法所得繼承之遺產，上開遺屬之範圍與民法第一千一百三十八條所定遺產繼承人亦有不同。
勞工保險條例第二十七條規定：﹁被保險人之養子女，其收養登記在保險事故發生時未滿六個月者，不得享有領取保險給付之權利。﹂以養子女收養登記滿六個月為領 取保險給付之限制，雖含有防止詐領保險給付之意，惟為貫徹國家對人民無力生活者負扶助與救濟義務之憲法意旨，以收養子女經法院認可後，確有受被保險人生前 扶養暨其本身無謀生能力之事實為請領遺屬津貼之要件，更能符合勞工保險條例關於遺屬津貼之制度設計。又同條例第六十三條及第六十四條之遺屬津貼，於配偶、 子女、父母、祖父母係基於倫常關係，一律得依同條例第六十五條順序受領。至其餘孫子女與兄弟姊妹則須有專受被保險人扶養之事實，始能受領給付，係基於應受 照護扶養遺屬之原則而為之規定。然鑑於上開規定之遺屬得受領遺屬津貼，原為補貼被保險人生前所扶養該遺屬之生活費用而設，以免流離失所，生活陷於絕境，從而其請領遺屬津貼亦應同以受被保險人生前扶養暨無謀生能力之事實為要件，始符前開憲法旨意。勞工保險條例第二十七條及第六十三條至第六十五條規定應於本解 釋公布之日起二年內予以修正，並依前述解釋意旨就遺屬津貼等保險給付及與此相關事項，參酌有關國際勞工公約及社會安全如年金制度等通盤檢討設計。

J. Y. Interpretation No.   549
Date：2002.8.2
Issue：Is the Labor Insurance Act constitutional in prescribing that the child adopted by the insured with the adoption to be recorded in the household registry in less than six months shall not be entitled to insurance payment upon said insured’s death?

Holding：
Labor insurance is a social security measure established to fulfill the fundamental national policies on labor protection (regulated by Article 153 of the Constitution) and implementation of the social insurance system (regulated by Article 155 of the Constitution and Article 10, Paragraph 8, of the Amendment to the Constitution). The sources of the insurance fund are the premium paid by the insured, the subsidy provided by the government and the contribution disbursed by the employer. Therefore, the insurance fund is not the private property of the insured. The allowance that the survivor is entitled to claim when the insured dies is an income substitute and is purported to help the survivor avoid financial difficulties. The payment of the survivor allowance should therefore be based upon the survivor's need to be supported. The survivor allowance is also different from a lawful inheritance. Article 27 of the Labor Insurance Act provides that "The children adopted by the insured are not entitled to claim insurance benefits if the time between the registration of the adoption and the insurance peril is less than six months." The legislative purpose of this Article is to implement the social security and to avoid fraudulent claims. The regulations governing the survivor's benefits, stipulated in Articles 63 to 65 of the Act, are based on ethical relations and the principle of taking care of the survivor. However, it is a constitutional principle that the government is responsible for the people’s welfare. Therefore, the adopted children and other survivors of the insured should be entitled to claim the survivor allowance when it is a fact that they were truly supported by the insured during his/her lifetime and they are unable to make a living after the insured dies. As a result, Articles 27, 63, 64 and 65 of the Labor Insurance Act should be amended within two years from the date of this Interpretation. Moreover, an overall examination and arrangement, regarding the survivor allowance, insurance benefits and other relevant matters, should be conducted in accordance with the principles of this Interpretation, international labor conventions and the pension plan of the social security system.

Reasoning：
In order to implement the fundamental national policies of labor protection (regulated by Article 153 of the Constitution) and realization of the social security system (regulated by Article 10, Paragraph 8, of the Amendment to the Constitution), the labor insurance system is established as one of the social welfare measures. The labor insurance system is to secure workers' livelihoods and promote social security. According to international conventions and other countries' relevant systems, social insurance generally provides two kinds of protection-- cash benefits and welfare services. Cash benefits are used to compensate the insured for loss of income caused by age, disability, death, illness, maternity, work-related injuries or unemployment. This kind of benefit has the functions of helping to maintain the insured person’s livelihood and substituting for income. On the other hand, social welfare services directly offer hospitalized care, medical services and rehabilitation aid. This kind of benefit is called "benefit in kind" academically. The premium paid by the insured is not the only source for the social insurance fund. The current labor insurance system in Taiwan is the same as that of other modern nations. According to Title IV of the Labor Insurance Act, the benefits paid to the insured or their beneficiaries include the benefits for maternity, injuries, illness, medical care, disability, age and death. The insured and the insurance entity pay the labor insurance premium in accordance with the percentage stipulated in Article 15 of the Act. The central government and municipal city governments also provide subsidies to the insurance fund.

　　When the insurance peril occurs, the insurance payments received by the insured or their beneficiaries are disbursed from the labor insurance fund, which includes the money appropriated by the government when the labor insurance system was established, the premium of the said year, the interest of the premium of the said year, the remainder left after the expenditure of insurance payment, the overdue charge of the premium, and the revenues derived from operating the fund (See Article 66 of the Labor Insurance Act). Therefore, the insurance fund, from which the insurance payment comes, is not the private property of the insured. The allowance (regulated by Article 63 of the Labor Insurance Act) that the survivor is entitled to claim when the insured dies is paid by the labor insurance program for the purpose of taking care of the survivor and helping the survivor avoid financial difficulties. It should thus be based upon the survivor's need to be supported. Therefore, the survivor allowance is different from a lawful inheritance. The purview of survivors is also different from that of heirs as stipulated in Article 1138 of the Civil Code.

　　Article 27 of the Labor Insurance Act provides that "The children adopted by the insured are not entitled to claim the insurance benefits if the time between the registration of the adoption and the insurance peril is less than six months." Under this regulation, the children adopted by the insured are entitled to claim the insurance benefits only if the time between the registration of the adoption and the insurance peril is no less than six months. Although fraudulent claims can be avoided by this regulation, it can not satisfy the constitutional principle that the government is responsible for supporting people who are incapable of making a living. Therefore, the restrictions made by Article 27 of the Labor Insurance Act should be amended. As long as the court approves the adoption and the adopted children are truly supported by the insured during his/her lifetime and they are unable to make a living after the insured dies, the adopted children should be entitled to claim the survivor allowance. Such an amendment will better satisfy the purpose of the survivor allowance system regulated in the Labor Insurance Act. Moreover, under the regulation of Articles 63 and 64 of the Act, spouses, children, parents and grandparents are entitled to claim the survivor allowance based on their ethical relationship. They may receive the benefits mentioned above unconditionally in the sequence stipulated in Article 65 of the Act. As for the insured's grandchildren and siblings, they are entitled to claim the survivor allowance only if they have been financially supported by the insured before the insured dies. The survivor allowance was originally designed to provide living expenses to the survivors who were truly supported by the insured while he/she was alive, so that the survivors would not suffer from financial need after the insured dies. Therefore, the right to claim the survivor allowance should be based on the condition that the claimant is in fact supported by the insured during his/her lifetime and the claimant is unable to make a living after the insured dies. To interpret the right to claim the survivor allowance this way is more consistent with the abovementioned constitutional principle. Therefore, Articles 27, 63, 64 and 65 of the Labor Insurance Act should be amended within two years from the date of this Interpretation. Moreover, an overall examination and arrangement, regarding the survivor allowance, insurance benefits and other relevant matters, should be done in accordance with the principles of this Interpretation, international labor conventions and the pension plan of the social security system.

' Translated by Professor Chin-Chin Cheng