How to make a claim for general accident insurance, and how to pay for accident insurance

There are different classification criteria for accident insurance, so there are many different types of products, and it is easy to buy the wrong one if you are not careful. If you don't know what kind of accident insurance you are suitable for, you can take a look at this article: Accident insurance for different ages is bought like this, it is right!

How does accident insurance pay?

1. Report the accident

If the nature, extent and cause of the insured accident cannot be confirmed because the applicant has not reported the accident for a long time, the insurance company shall not be liable for the payment of insurance money for the part that cannot be confirmed. Generally speaking, accident insurance requires notification to the insurance company within 10 days of the occurrence of the insured event.

2. Prepare the claim materials

After the applicant reports the case, he needs to prepare insurance materials, he can check the "insurance application" or "claim application" clause in the insurance contract, prepare the materials as required, or contact the official customer service of the insurance ** or the broker claims specialist to consult the materials that need to be prepared, and the policyholder should pay attention to the application and retention of the materials involved.

3. Nuclear materials

After the insurance company receives the information, the claims department will review and investigate the information, generally speaking, the accident responsibility is clear, the claim information is complete, the case can be approved within 5 working days; If the situation is complicated, the Insurance Law clearly stipulates that the approval shall be made within 30 days. If the terms of the contract agree otherwise, it shall be handled according to the time agreed in the terms.

4. Pay compensation

Finally, after verification, the insurance company will pay compensation to the beneficiary within the specified time for the insurance liability; For those who do not belong to the insurance liability, a notice of refusal to compensate the insurance money shall be issued within 3 days from the date of verification, and the reasons shall be explained.

General accident insuranceWhen you have an accident, report it to the insurance company, and the insurance company will accept it.

Now 101 general accident insurance has a deductible of 100 yuan, and then 80% of the claims.

Accident insurance payouts are based on three aspects: accidental medical treatment, accidental disability and accidental death.

(1) Accidental death

If the insured dies as a result of an accidental injury, the insurance company shall pay the accidental death insurance benefit in accordance with the insurance contract.

(2) Accidental disability

If the insured suffers a disability caused by an accidental injury, the insurance company shall pay the accidental disability insurance benefit in accordance with the insurance contract.

Disability benefits are paid according to the level of disability.

The disability level of personal accident insurance is assessed in accordance with the "Disability Assessment Standards for Life Insurance".

According to the definition of disability, it can be divided into 10 levels, and the specific compensation ratio of each level is shown below**:

(3) Accidental medical treatment

The insurance company will pay medical insurance benefits to the insured if he or she incurs reasonable and necessary medical expenses due to an accidental injury as stipulated in the insurance contract.

Accident medical insurance is generally not covered separately but as an add-on to personal accident insurance.

(1) Sudden death

Sudden death satisfies the condition of "sudden", but does not satisfy the condition of "non-illness" because sudden death may be caused by the insured's own health problem or illness and is not an accident.

However, the probability of sudden death is increasing, so there are many accident insurance products that include sudden death in the scope of coverage.

(2) Pregnancy

Many accident insurance products will include pregnancy, miscarriage, etc. in the exclusion clause, so the insurance company may not pay for the accident that occurs during the pregnancy of the insured person.

(3) Personal food poisoning

Normally, if it is not a group poisoning, the individual poison insurance company will not pay, because it is likely to be caused by the individual's poor constitution or the disease.

(4) Surgical accidents

Before the surgery, it was clear that it was a high risk and did not meet the conditions of non-disease, suddenness, and non-intent conditions.

(5) High-risk exercise

Many insurance companies deny coverage for high-risk sports because of the high probability of accidents in high-risk sports, such as extreme sports such as rock climbing, skydiving, bungee jumping, and adventure.

The above is the basic situation of accident insurance payment standards and non-compensation, friends who still have questions about accident insurance compensation can take a look at ".What is covered by accident insurance? These common accident insurance companies do not pay

Hope the above information can help you!

Accident insurance pays according to different benefits 3.When the insured suffers death due to an accident, the insurance company pays a lump sum death deposit

4.When the insured suffers an accident that causes disability, the insurance company will pay the disability insurance benefit according to the degree of disability

The current situation depends on the exact extent of your father's injury.

and the terms and conditions of your insurance.

Specific communication must be done by the insurance officer to come to the hospital after the assessment.

Question: I heard that the total compensation amount is 30,000 yuan, and the preferential support object is 15,000 yuan, but it will be decided after negotiation and how much the compensation will be paid.

Q: What should I pay attention to when talking to insurance companies?

What if the insurance company pays too low?

It is mainly in accordance with the contract.

It's good to be reasonable and legal.

If the payout does not come according to the contract.

It is possible to claim compensation.

Question: If I died nearly half a month after falling and fractured my hip, is there any response to the compensation?

As long as there is an accident.

If it's a death, it can be said that the accident payout is higher.

Question: It's not easy to get the insurance company to pay for it, do you have a good idea?

My father fell and died in life insurance of 50 yuan, how much can the insurance company pay? The elderly are the target of preferential support, how to construct the insurance company appropriately?

My father fell and died in life insurance of 50 yuan, how much can the insurance company pay? The elderly are the target of preferential support, how to construct the insurance company appropriately?

My father fell and died in life insurance of 50 yuan, how much can the insurance company pay? The elderly are the target of preferential support, how to construct the insurance company appropriately?

My father fell and died in life insurance of 50 yuan, how much can the insurance company pay? The elderly are the target of preferential support, how to construct the insurance company appropriately?

My father fell and died in life insurance of 50 yuan, how much can the insurance company pay? The elderly are the target of preferential support, how to construct the insurance company appropriately?

My father fell and died in life insurance of 50 yuan, how much can the insurance company pay? The elderly are the target of preferential support, how to construct the insurance company appropriately?

My father fell and died in life insurance of 50 yuan, how much can the insurance company pay? The elderly are the target of preferential support, how to construct the insurance company appropriately?

My father fell and died in life insurance of 50 yuan, how much can the insurance company pay? The elderly are the target of preferential support, how to construct the insurance company appropriately?

My father fell and died in life insurance of 50 yuan, how much can the insurance company pay? The elderly are the target of preferential support, how to construct the insurance company appropriately?

If you have taken out accident insurance and need to make a claim, you should notify the insurance company as soon as possible after the accident, and truthfully inform the details and prepare the required materials for the claim to avoid missing the time limit for claims, resulting in the insurance company not being able to determine the compensation loss, so that the insurance money cannot be paid in time.

General accident insurance will include accidental death or total disability, accidental medical treatment and other benefits, the specific protection content depends on the product you insured, and the signed insurance contract will be specified.

In the case of accidental death, the insurance company will directly pay the agreed accidental death benefit. For accidental disability, the insurance company will pay the disability insurance benefits according to the level of disability recognition; If medical treatment is required due to accidental injury, the insurance company will pay the medical insurance benefits according to the medical insurance amount agreed upon at the time of insurance application, combined with the actual medical expenses, and reimburse according to the agreed proportion.

Of course, when applying for insurance, you should also pay attention to some situations that cannot be paid in the insurance company's exclusion clause, so as not to make a claim a little embarrassing and cause some unnecessary trouble.

Does the accident insurance pay the money to the policyholder's bank card or the injured person's bank card? The risk covered by accident insurance is accidental injury. Generally, an insurance company's casualty insurance product defines an accident injury as:

Injury to the body caused by an external, sudden, or unintended objective event as a direct and isolated cause.

The compensation of accident insurance is generally to pay for the person who actually suffers the damage, and the question is how the surgery fee and hospitalization fee are reported.

For example, now that the patient has undergone surgery, does this report the material fee, and answers all the medical expenses, including the operation fee and the hospitalization fee, these are all questions that can be reported by insurance, please ask if it is reported by tens of percent.

Question: How long does it take to process a claim?

Question Okay, thank you.

Dear Hello Wan Hui, I am happy to answer for you, the general accident insurance claim process is as follows: 1. Submit an application: After the insured has an accident, he needs to call the customer service of the insurance company to explain the situation; 2. After receiving the application for reporting, the insurance company needs to send staff to the accident site for investigation and confirmation; 3. The insured fuel insurer submits a copy of the ID card, the vouchers of various expenses and other materials to the insurance company to apply for reimbursement; 4. After receiving the reimbursement information, the insurance company shall carefully check the authenticity of the materials, start to confirm the responsibility according to the survey results, and compensate according to the scope of the contract liability.

I hope you find my unburial answer helpful

Other insurance questions can be consulted.

Pre-sales product consultation: 400-880-3633

After-sales service: 95362

The normal casualty insurance claim process consists of four steps: reporting, preparing materials, submitting materials, and closing the claim. Accident insurance product information.

1. Report the case. When an accident occurs, you should immediately take the initiative to contact the insurance company to report the accident and explain the accident to the insurance company in time. After the insurance company understands the circumstances of the accident, it will generally assist in arranging rescue and guiding the insured to make a claim.

Many accident insurance products stipulate that the accident must be reported within 10 days after the accident, and it is recommended to report the accident as soon as possible to avoid affecting the later claim.

2. Prepare claim materials.

After the report is made, the claim will be settled, and the insured should pay attention to collecting relevant materials in the process of handling the accident. For example, accident certificates, hospital receipts and invoices and other documents. The specific required claim materials can be found in the insurance contract or confirmed with the insurance company.

3. Submit claim information.

After preparing the claim materials, you can submit them to the insurance company for online or offline review, and the insurance company will review the materials according to the process, and if the materials are missing, the insured will be notified to submit additional materials.

4. Compensation is closed.

The insurance company will decide whether to pay the compensation based on the results of the review of the claim materials. If it passes the review, it will enter the compensation stage, and the insurance company will pay compensation according to the insurance money stipulated in the insurance contract. If there is an objection to the outcome of the claim, you can apply for a reconsideration.

1. Call ** to report the case in a timely manner.

If the insured has accident insurance coverage, when the accident occurs, you must call the insurance company** to report the accident as soon as possible, preferably within 3 days, so that the insurance company can review and follow up the claim as soon as possible.

2. Prepare relevant materials.

During the claim process, the insurance company will require us to prepare some relevant procedures, such as medical diagnosis certificate, accidental injury certificate issued by the relevant department, original receipts and prescriptions for medical expenses, copies of my ID card or household registration certificate, etc. You can consult the insurance company to understand what procedures and materials need to be prepared, so as not to affect the claim process because of omissions, and in the process, you should also pay attention to retaining the relevant materials.

3. Review by the insurance company.

After the materials are handed over to the insurance company, the insurance company will make a notice of closure within a certain period of time, and if the claim conditions are met, the compensation will be made as soon as possible.

4. Receipt of compensation.

After receiving the claim notice, the insured or beneficiary can go to the insurance company to receive compensation with his ID card and household registration certificate.

5. Other precautions.

1. Effective Date.

The effective date of accident insurance refers to the starting point of time when the insured person starts to receive coverage. Most accident insurance policies start to take effect the next day after the application is purchased, but there are some products with a waiting period of 7 days, 14 days, or even a month, so you need to be aware when purchasing.

2. Restrictions on hospitals.

Many accident insurance products will limit the hospital to public hospitals, such as hospitalization in a secondary or higher hospital recognized by the insurance company to be eligible for compensation. If you go to the hospital because of an accident, try to diagnose and ** in a hospital approved by the insurance company.

3. Limit for minors.

When parents and friends choose accident insurance for their children, they should pay attention to the fact that the insurance company has a limit on the amount of compensation for minors. The maximum compensation for 0-9 years old is 200,000 yuan, and the maximum compensation for 10-17 years old is 500,000 yuan. Therefore, the child's accident insurance protection does not need to be particularly high, and parents had better do their own protection before protecting the child.