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1. The "compensation principle" is implemented for medical expenses, which is a common principle throughout the country. This means that no matter how many reimbursements there are, the final cumulative reimbursement amount will not exceed the total amount of your medical expenses, which means that you will not benefit from illness or injury.
2. No matter which one you apply for reimbursement first, the other one will only reimburse the difference.
3. Generally speaking, if it is determined to be a work-related injury, it can be 100% reimbursed (reimbursed by the unit outside the scope of medical insurance), and it is not the turn of commercial insurance to reimburse at all.
4. Generally speaking, it is impossible to be 100% reimbursed by commercial insurance (there are absolute deductibles, reimbursement ratios, self-financed drugs, etc.), and the insurance company will retain the original invoice after reimbursement, and can only stamp the copy of the invoice and indicate the balance for you to go to the next one for reimbursement. However, the work-related injury insurance does not recognize this copy, and the work-related injury insurance only recognizes the original invoice.
5. Therefore, it is recommended that you also go to the work-related injury insurance office for reimbursement. Not only can medical expenses be fully reimbursed, but also lost work, nutrition, nursing care, ......and other items can be reimbursed, which cannot be replaced by commercial insurance.
6. If the disability standard agreed in the insurance contract is met, then the fixed amount of payment according to the disability standard has nothing to do with the medical expenses and is not in accordance with the principle of compensation, but the situation mentioned in your question may not be met.
For details, you can bring the policy and relevant medical records to the claims department of Ping An Insurance Company for consultation.
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Work-related injury accident insurance refers to the fact that when the insured suffers an accidental injury due to work-related reasons resulting in injury, disability or death, the insurance company bears the liability for compensation, as long as the accidental injury is suffered during work, it is covered by work-related injury accident insurance. There are two main ways to purchase work-related injury accident insurance, one is purchased by the company and the other is purchased by individuals. There are two main types of work-related injury accident insurance purchased by the company for employees, one is the work-related injury insurance in the social insurance, and the other is the work-related injury accident insurance of the commercial group purchased by the company itself.
If the company you work for does not purchase work-related accident insurance for employees, Cigna recommends that you do so on your own. There are many types of work-related accident insurance on the market, and there are differences between different products, so you can choose the right one based on your occupation, financial situation, and protection needs.
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If you are at high risk of accidents, it is recommended that you take out both work-related injury insurance and accident insurance, because work-related injury insurance has a limited coverage amount, and you can supplement it with accident insurance to give yourself more comprehensive protection.
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Answer: Work-related injury insurance and accident insurance can be reimbursed at the same time, that is to say, if the work-related injury insurance is reported, the accident insurance can also be re-reported. Or if the accident insurance is claimed, you can also report the work-related injury insurance. As long as the case of accident meets the reimbursement scope of both work-related injury insurance and accident insurance, then both can be reimbursed at the same time.
In addition, the identification of work-related injury insurance is more complicated than that of accident insurance, so it is recommended that you report accident insurance for compensation first, and then report work-related injury insurance.
Hello question. If I first report the accident insurance and reimburse 40,000 yuan, can I reimburse the 60,000 yuan for the work-related injury, which means that the medical expenses are reported for the accident insurance, can I still report the work-related injury insurance.
Answer to the "Regulations on Work-related Injury Insurance" Article 30 Employees who are injured in accidents or suffer from occupational diseases due to work shall enjoy medical treatment for work-related injuries. **If the expenses required for work-related injuries meet the requirements of work-related injury insurance diagnosis and treatment items, work-related injury insurance drug lists, and work-related injury insurance hospitalization service standards, they shall be paid from work-related injury insurance**. There is only a limit to the scope of payment, and there is no limit to the maximum payment amount.
It mainly includes various expenses such as medical expenses, nursing expenses, and lost work expenses.
Ask this question.
Answer, but accident insurance and work-related injury insurance do not conflict, if you buy accident insurance, it will not affect your enjoyment of work-related injury insurance, accident insurance is paid in accordance with the provisions of the insurance contract, work-related injury insurance is paid in accordance with the work-related injury insurance regulations, the two are complementary relationship.
The question is whether it is a duplicate reimbursement to report the medical expenses of accident insurance and then report the medical expenses for work-related injuries.
If the medical expenses are reimbursed on the accident insurance side, and then the medical expenses are reimbursed on the work-related injury side, will it be a duplicate reimbursement?
Question: You mean that medical expenses cannot be reimbursed repeatedly, but you also say that there are two different types of insurance, so can medical expenses be reimbursed repeatedly, and how can I reimburse it cost-effectively?
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There is compensation for work-related injuries, and accident insurance is how much you spend.
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Legal analysis: If the risk of suffering an accident is high, it is recommended to take out both work-related injury insurance and accident insurance, because the insurance amount of work-related injury insurance is limited, and it can be supplemented by accident insurance to obtain more comprehensive protection.
Legal basis: Regulations on Work-related Injury Insurance
Article 17 If an employee is injured in an accident or is diagnosed or appraised as an occupational disease in accordance with the provisions of the Law on the Prevention and Treatment of Occupational Diseases, the unit to which he belongs shall, within 30 days from the date of occurrence of the accident injury or the date of diagnosis or appraisal of an occupational disease, submit an application for recognition of work-related injury to the social insurance administrative department of the coordinating region. In case of special circumstances, the time limit for application may be appropriately extended with the consent of the social insurance administrative department. If the employer fails to submit an application for recognition of work-related injury in accordance with the provisions of the preceding paragraph, the injured employee, his close relatives or trade union organization may, within one year from the date of occurrence of the accident injury or the date of diagnosis or appraisal of the occupational disease, directly submit an application for recognition of work-related injury to the social insurance administrative department of the coordinating area where the employer is located.
Article 20: The social insurance administrative department shall make a decision on the determination of work-related injury within 60 days of accepting the application for work-related injury determination, and notify in writing the dust-based employee or his close relatives and the worker's unit of the work-related injury determination. The social insurance administrative department shall make a decision on the determination of work-related injury within 15 days of accepting an application for a work-related injury determination where the facts are clear or the judgment is clear, and the rights and obligations are clear. Where it is necessary to base a decision on the determination of work-related injuries on the basis of the conclusion of the judicial organ or the relevant administrative department, the time limit for making a determination of work-related injury is suspended during the period that the judicial organ or the relevant administrative department has not yet made a conclusion.
Where the staff of the social insurance administrative department has an interest in the applicant for work-related injury determination, they shall recuse themselves.
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If the employer has paid the accident insurance and work-related injury insurance, the employee can receive compensation from the accident insurance after being injured due to the accident, and can apply for work-related injury insurance compensation at the same time after the work-related injury is determined. Legal basis: "Social Insurance Law of the People's Republic of China" Article 36 Employees who are injured in accidents or suffer from occupational diseases due to work-related reasons, and the radical cluster type is recognized as work-related injury, shall enjoy work-related injury insurance benefits; Among them, those who have lost their ability to work after the appraisal of their working ability shall enjoy disability benefits.
The determination of work-related injuries and the evaluation of labor ability shall be simple and convenient.
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Do I need to buy accident insurance if I have work-related injury insurance?
It should be analyzed on a case-by-case basis.
1. Work-related injury insurance has compensation requirements, and some scopes or circumstances do not pay, and if the worker is injured if he or she buys accident insurance, then he can get the corresponding compensation.
2. Work-related injury insurance and accident insurance are not in conflict, when injured due to accidents in the course of work, work-related injury insurance and accident insurance can be used for reimbursement at the same time, but the reimbursement amount cannot exceed the invoice amount. Work-related injury insurance can only reimburse injuries caused in the course of work, while for other accidental injuries, accident insurance can supplement relative protection.
3. The protection time of work-related injury insurance is limited, and it must be met during work or on the way to and from work"Work-related injuries"There is no so-called time limit for accident insurance, as long as you purchase accident insurance, when an accident occurs, you can get compensation within the validity period of the insurance contract.
4. Participation in work-related injury insurance is a mandatory requirement and a necessary basic guarantee; Whether or not to participate in accident insurance is a voluntary choice for enterprises according to their own economic conditions; In addition, accident insurance is subject to market competition mechanisms.
5. However, the accident insurance has related non-claims, such as not insured during high-risk sports, and the rest of the time can be insured; Accidents caused by illness are not covered, but other conditions that meet the four conditions of accidents can be insured. At the same time, some accident insurance premiums are high and the reimbursement scope is limited, so whether you need to buy accident insurance should take into account your own economic situation and physical fitness.
and so on. Test your anti-risk index, experts will interpret it for you for free!
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Legal analysis: No, injuries at work are work-related injuries, and the enterprise needs to declare the work-related injury, and after the appraisal and review is completed, it meets the scope of work-related injury, and it will be reimbursed by work-related injury insurance.
Legal basis: Article 30 of the Regulations of the People's Republic of China on Work-related Injury Insurance Employees who are injured in accidents or suffer from occupational diseases due to work-related injuries shall enjoy medical treatment for work-related injuries. Employees who are injured at work shall seek medical treatment in a medical institution that has signed a service agreement, and in case of emergency, they can first go to the nearest medical institution for first aid.
**If the expenses required for work-related injury meet the requirements of work-related injury insurance diagnosis and treatment items, work-related injury insurance drug list, and work-related injury insurance hospitalization service standards, they shall be paid from work-related injury distribution insurance**. The catalogue of work-related injury insurance diagnosis and treatment items, the catalogue of work-related injury insurance drugs, and the hospitalization service standards of work-related injury insurance shall be prescribed by the social insurance administrative department in conjunction with the health administrative department, the food and drug supervision and administration department and other departments. The food subsidy for the hospitalization of the employee for the work-related injury, as well as the transportation, accommodation and accommodation expenses required for the work-related injury employee to seek medical treatment outside the co-ordination area shall be paid from the work-related injury insurance, and the specific standard of payment shall be stipulated by the people of the co-ordination area.
Employees with work-related injuries are not entitled to medical treatment for work-related injuries and are treated in accordance with the basic medical insurance measures. If the work-related injury employee goes to the medical institution that has signed the service agreement to carry out the work-related injury**, if it meets the requirements, it shall be paid from the work-related injury insurance**.
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The work-related injury of social insurance is what enterprises need to purchase for employees, and the advantage of commercial accident insurance is that it is guaranteed 24 hours a day nationwide, so it is also important for enterprises to purchase accident insurance for employees. Here's a recommendation for you. It is recommended to buy a hospitalization without excellent accident insurance for each person in Chinese Life for 128 yuan a year, with 10,000 disease hospitalization medical treatment, 10,000 accidental injury medical expenses, 10,000 accidental injury hospitalization, and 100,000 accidental injury death and disability.
Issue age is between 18 and 60 years old. As long as three cents a day, you can protect your health for a whole year! The advantage of this accident insurance is that it can also be reimbursed for hospitalization with illness, and other insurance companies basically cost more than 300 yuan for hospitalization with illness.
Paper contracts.
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Hello! Work-related injury insurance is a part of social insurance, and it is a type of insurance that the state requires enterprises to purchase for employees, so even if enterprises purchase accident insurance for employees, they also need to apply for work-related injury insurance. It is reported that the process of handling work-related injury insurance is as follows:
1. The unit participating in work-related injury insurance for the first time shall prepare the original and copy of the business license of the unit, the original and copy of the unit's organizational certificate, the original and copy of the ID card of the legal person of the unit, the labor contract of all employees of the unit, the copy of the ID card and other materials;
2. After the information is prepared, fill in the social insurance registration form, pay the salary declaration roster at the social security bureau, and pay the employee's work-related injury insurance premium;
3. If there is a change in personnel after the unit participates in the insurance payment, the list of changed personnel shall be submitted to the social insurance agency in a timely manner, and the new employees who have been injured at work in the next month after the initial insurance and payment of the unit shall begin to enjoy the work-related injury insurance benefits in accordance with the provisions of the "Regulations on Work-related Injury Insurance".
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If you buy enough accidents, you can not buy them.
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Hello: These are two different ways to insure, accident is recommended that everyone has this is a consumer-based commercial insurance, and social security is work-related injury insurance.
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It is recommended to purchase employer's liability insurance, regardless of whether it is a work-related injury or accident, the employee still has the right to claim compensation.
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Hello work-related injury insurance is to protect you from accidental injuries at work. Accident insurance is about protecting every minute of your life
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Hello! A work-related injury is defined as working at work. Accident insurance is covered in Nadu. If the accident insurance is not enough, the work-related injury insurance can be supplemented.
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Do you buy 24 minor accidental death and accidental medical treatment? Yes, you don't need to.
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Enough to buy accident insurance and accident medical treatment.
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Buy accidental injuries and accidental medical treatment.
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