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The premise of accident insurance reimbursement is that you must be in a hospital or designated hospital** at a certain level or above specified by the insurance company.
Generally, it is a public hospital of the second level and above.
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If the contract clearly states that there is overseas emergency assistance.
Yes, it is reimbursable, but not if it is not stated in the contract.
If you are insured with Ping An's accident insurance, you can be reimbursed with an additional 10 yuan overseas emergency assistance handling fee.
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Return to your home country and find an insurance company to settle the claim.
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If the injury is caused by an accident, the accident insurance can be reimbursed, whether it is outpatient reimbursement or hospitalization reimbursement. In addition, the reimbursement cost of accident insurance is not unlimited, and the maximum reimbursement can only be within 10,000 yuan each time, and the part exceeding 10,000 yuan can only be paid by yourself.
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Legal analysis: Medical insurance will not reimburse you for your own accidental injury. According to national regulations, medical expenses caused by accidental injuries are excluded from the reimbursement scope of resident medical insurance and urban employee medical insurance.
If the glass of the curtain wall of the building falls off and hits the person, the municipal government opens the manhole cover and the maintenance pipeline is not marked, causing pedestrians to fall. If a clear third-party responsible person can be found for these accidental injuries, the medical reimbursement should be paid by the third-party responsible person and will not be included in the scope of their own medical insurance.
Legal basis: Article 30 of the Social Insurance Law of the People's Republic of China: The following medical expenses are not included in the scope of payment of basic medical insurance**
1) It should be paid out of work-related injury insurance**;
2) It shall be borne by a third party;
3) It should be borne by public health;
4) Seeking medical treatment outside the country.
Medical expenses shall be borne by the third party in accordance with the law, and if the third party does not pay or the third party cannot be determined, the basic medical insurance shall pay in advance. After the basic medical insurance** is paid in advance, it has the right to recover from a third party.
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1. Can I apply for accident insurance if I am injured in an accident?
If you are injured in an accident, you can report accident insurance. If it is a accidental injury, it is not a fight, and it can be compensated after being confirmed by the local police station and issuing relevant certificates. The exclusion of accident insurance is a fight, assault or being ** caused by the insured's provocative or intentional acts; or the intentional act of the policyholder.
2. Legal basis: Article 28 of the Social Insurance Law of the People's Republic of China.
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facility standards, and emergency and rescue medical expenses shall be paid from the basic medical insurance in accordance with national regulations.
Article 29.
The part of the medical expenses of the insured persons that should be paid by the basic medical insurance** shall be directly settled by the social insurance agency and the medical institution and the drug business unit.
The administrative department of social insurance and the administrative department of health shall establish a system for the settlement of medical expenses for medical treatment in other places to facilitate the insured persons to enjoy basic medical insurance benefits.
2. What is the compensation standard of accident insurance?
The compensation standards of accident insurance are as follows:
1. Accidental death. If the insured dies due to accidental injury, the accidental death insurance benefit shall be compensated according to the contract;
2. Accidental disability. If the insured is disabled due to accidental injury, the accidental disability insurance benefits shall be compensated according to the contract and the level of disability;
3. Accidental medical treatment. The insurance institution shall compensate the medical insurance benefits for the reasonable medical expenses caused by the accidental injury of the insured.
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Summary. In the event of an accident, social insurance generally cannot be reimbursed, but some accidents can be reimbursed by medical insurance: 1. The insured person occurs without a responsible person; 2. Accidental injuries for which the insured bears part of the responsibility as determined by the relevant departments; 3. In a criminal or public security case where the insured person is injured due to the illegal acts of others, after the judgment or ruling of the people's court, the responsible person fails to compensate in full, or the case has not been solved for 6 months from the date of occurrence of the injury and the responsible person cannot be determined; 4. Other cases where the responsible person fails to compensate in full after the judgment or ruling of the people's court.
If a traffic accident occurs during the commuting period, it can be counted as a work-related injury, and the work-related injury needs to be reported to the local labor bureau and the work-related injury needs to be identified. According to national regulations, medical expenses caused by accidental injuries are generally excluded from the reimbursement scope of resident medical insurance and urban employee medical insurance.
In the event of an accident, social insurance generally cannot be reimbursed, but some accidental medical insurance can be reimbursed: 1. The insured person occurs without a responsible person; 2. Accidental injuries for which the insured bears part of the responsibility as determined by the relevant departments; 3. In a criminal or public security case where the insured is injured due to the illegal acts of others, after the judgment and ruling of the People's Prefecture Court, the responsible person fails to compensate in full or the case has not been solved for 6 months from the date of occurrence of the injury and the responsible person cannot be determined; 4. Other persons who have been judged and ruled by the People's Court of Filial Piety fail to compensate in full. If a traffic accident occurs during the commuting period, it can be counted as a work-related injury, and the work-related injury needs to be reported to the local labor bureau and the work-related injury needs to be identified.
According to national regulations, medical expenses caused by accidental injuries are generally excluded from the reimbursement scope of resident medical insurance and urban employee medical insurance.
Article 30 of the Social Insurance Law of the People's Republic of China The following medical expenses are not included in the scope of payment of basic medical blind cover therapy insurance**: (1) shall be paid from work-related injury insurance**; 2) It shall be borne by a third party; 3) It should be borne by public health; 4) Seeking medical treatment outside the country.
Medical expenses shall be borne by a third party in accordance with the law, and if the third party does not pay or the third party cannot be determined, the basic medical insurance shall pay in advance. After the basic medical insurance** is paid in advance, it has the right to recover from a third party.
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Summary. Hello, no. If you have just had an accident, you can't buy insurance, and even if you buy insurance, you can't be reimbursed.
Because the insurance will have a waiting period, the insurance company will not pay the claim if the insurance is out during the waiting period. And when you apply for insurance, the insurance company will evaluate your own conditions, and if you have a serious accident, the insurance company may refuse to buy you. If you have had an accident in the past but have now returned to normal, it is okay to buy accident insurance, but the condition for purchasing accident insurance is to be in good health.
Hello, no. If you have just had an accident, you can't buy insurance, and even if you buy insurance, you can't be reimbursed. Because the insurance will have a waiting period for remorse, the insurance company will not make a claim if the insurance is out during the waiting period.
Moreover, when you apply for insurance, the insurance company will evaluate your own conditions, and if your accident is serious, the insurance company may refuse to buy you. If you have had an accident in the past but have now returned to normal, it is okay to buy accident insurance, but the condition for purchasing accident insurance is to be in good health.
Buying insurance should be chosen according to your own situation, and the one that suits you is the best.
Hello, are you there.
The little kid fell and broke his bones, uh-huh.
And then what? If you fall and break a fracture, you have to go to the hospital for examination**.
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One:So what does accident insurance mean? What does it include?
II. II. II: Will the accident insurance reimburse the medical expenses if I am injured in an accident?
Three:How does accident insurance pay when it needs to be compensated?
When there is a need to make a claim when you buy accident insurance, you generally need to call the insurance company as soon as possible to tell the ins and outs of the matter, and then the insurance company will find relevant personnel to check and determine whether it is an accident. If it is determined, all the relevant expenses of the policyholder are borne by the insurance company, and before that, the policyholder must prepare certain procedures, such as hospitalization information and ** diagnosis and expenses are required to provide to the insurance company, and the insurance company will be truthfully compensated after verification.
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Of course, it can, and it can protect our interests very well, and it can also solve a lot of difficulties for us, so this also warns some people to buy accident insurance in their daily life.
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It can be reimbursed, and if you have an accident, these can be reimbursed. And hospitalization is also cheaper.
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From the point of view of the coverage of accident insurance. Injuries sustained from illness are not considered accidental injuries, so accident insurance cannot be claimed.
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