Undertaking letter of undertaking for workers over the statutory retirement age and other specific personnel to participate in industrial injury insurance

This unit (organization) ____________, According to the provisions of the Measures on the Participation in Work related Injury Insurance for Specific Persons Engaged by Units, such as Workers Over the Legal Retirement Age (Trial) (YRSG [2020] No. 55), the unit (organization) voluntarily chooses to participate in work related injury insurance and pay work related injury insurance premiums for specific persons who have not established labor relations. Now, we apply for individual work-related injury insurance, and fill in and confirm the following items:

1、 Confirm the applicable situation

（1） Confirm company (organization) type (unique choice)
□ Enterprise (non domestic service enterprise, non Internet platform enterprise)
□ Housekeeping service enterprise (institution)
□ Internet platform enterprise
□ State organs and public institutions
□ Social organization
□ Private non enterprise unit
□ Foundation
□ Individual industrial and commercial households insured in the form of unit
□ Village committee, village party committee (general branch, branch), residents committee, community party committee (general branch, branch)
□ Other employers (organizations)

（2） Type of personnel who apply for single work-related injury insurance (multiple choices based on actual conditions)

□ Persons over the statutory retirement age (not enjoying pension or pension)
□ Persons who have enjoyed pension or pension, disability allowance and disability allowance
□ Domestic service employees
□ New business type practitioners (online car hailing, express delivery, meal delivery, etc.)
□ Intern students (including work study students), interns
□ Members of the two committees of the village (community)
□ Volunteer
□ Other employees

2、 Commitments

（1） The unit (organization) promises to comply with the provisions of the Measures on Participation in Work related Injury Insurance for Specific Persons Engaged by the Unit, such as Workers Over the Legal Retirement Age (Trial) (YRSG [2020] No. 55), voluntarily apply for single participation in work related injury insurance for specific persons/village (community) committee members who have not established labor relations and pay work related injury insurance premiums as required.

（2） The unit (organization) promises to timely and truthfully inform the employees/village (community) committee members of the two committees about their individual participation in work-related injury insurance and payment, as well as their rights and obligations related to work-related injury insurance, and fulfill the obligation to apply for work-related injury recognition according to law and regulations.

（3） The unit (organization) promises to participate in social insurance for workers who have established labor relations in accordance with the law, and does not apply for individual work-related injury insurance for workers who have established labor relations, otherwise they will bear relevant legal liabilities in accordance with the law.

（4） The unit (organization) promises that it has not purchased a single work-related injury insurance (i.e., "affiliated insurance", etc.) for other personnel who have no employment relationship with the unit (organization), otherwise their personnel may not be recognized as work-related injuries.

（5） The unit (organization) promises to provide all materials truthfully according to regulations and cooperate with the human resources and social security department to investigate and verify when handling industrial injury identification, labor capacity appraisal and application for industrial injury insurance benefits. Those who fabricate industrial injury accidents or forge industrial injury materials to defraud industrial injury insurance funds will bear legal liabilities according to law.

3、 Notes

（1） The industrial injury insurance relationship of the insured who has paid the industrial injury insurance premium as required shall take effect from the day after the insurance registration formalities are handled. If the employee fails to pay the work-related injury insurance premium as required, the work-related injury insurance relationship will not take effect during this period. For those who died at work in the current month, they should continue to declare and pay the industrial injury insurance premiums for them, and stop paying the industrial injury insurance premiums for them from the next month of death, so as to link up the issuance of industrial injury insurance benefits.

（2） The employer (organization) shall strengthen the safety production and occupational health training and education of the employees, organize the occupational health examination before, during and after work for the employees engaged in the operation exposed to occupational disease hazards, provide corresponding labor protection, and do a good job in occupational injury prevention.

（3） The employer (organization) can agree with the insured on the treatment of non work related injury insurance fund payment, such as shutdown leave salary period treatment, disability employment subsidy, and encourage the increase of personal accident insurance to provide better protection.

□ The applicant promises that: the unit (organization) has read this letter of commitment, confirmed that the information filled in is true and complies with the commitments, and is willing to bear the corresponding legal responsibility in case of false commitments or violations of commitments.                  
Seal of employer (organization)