What are the procedures for applying for accident insurance, and what materials are required for acc

Medical diagnosis certificate, accidental injury certificate issued by the relevant department, original receipt and list of medical expenses, copy of ID card or household registration certificate.

After confirming that the accident is an insured event, the service staff of the insurance company will instruct the insured to fill out the claim form and prepare the relevant materials. After all the materials are ready, they will be submitted to the insurance company. The insurance company will complete it within 10 days.

Based on the results of the audit, a compensation or rejection notice is issued.

Once the insurance company has passed the review, it will issue a notice to settle the claim amount. At this point, it can be used to obtain compensation from the insurance company for ID card and household registration certificate.

If a car accident occurs, it is an accident and can be reimbursed by accident insurance.

The reimbursement process of accident insurance mainly includes four steps: reporting, collecting documents, reviewing by the insurance company, and receiving compensation

1) Report: After an accident or hospitalization, you should call the customer service of the PICC company **95518 in time to understand the documents that need to be prepared, so that the insurance company can quickly settle the claim, and generally report to the insurance company within 3 days.

2) Collection of documents: the procedures required for the insured to handle the claim due to accidental injury, such as medical diagnosis certificate, accidental injury certificate issued by the relevant department, original receipts and prescriptions for medical expenses, and a copy of the applicant's ID card or household registration certificate.

4) Receiving compensation: The insurance beneficiary can receive compensation from the insurance company with his ID card and household registration certificate, or he can directly receive the compensation from the insurance company through his bank account.

1. What materials are required for accident insurance reimbursement?

1. The following materials are required for accident insurance reimbursement:

1) Medical records;

2) Medical certificate;

3) Proof of discharge;

4) a list of expenses;

5) A copy of ID card;

6) A copy of the bank card;

7) Proof of accident and original copy of outpatient treatment manual;

8) The original of the **expense receipt, the original of the **expense itemized list.

2. Legal basis: Article 95 of the Insurance Law of the People's Republic of China.

Business scope of insurance company:

1) Life insurance business, including life insurance, health insurance, accident insurance and other insurance business;

2) Property insurance business, including property loss insurance, liability insurance, credit insurance, guarantee insurance and other insurance business;

3) Other insurance-related businesses approved by the insurance regulatory authority. Insurers shall not concurrently engage in life insurance business and property insurance business. However, insurance companies that operate property insurance business can operate short-term health insurance business and accident insurance business with the approval of the insurance regulatory authority.

Insurance companies shall engage in insurance business activities within the scope of business approved by the insurance regulatory authority in accordance with the law.

2. What is the reimbursement process for accident insurance?

The accident insurance reimbursement process is as follows:

1. Report to the insurance company in a timely manner after an accident or injury, and if conditions permit, explain the general situation of the accident, including time, place, process, etc.;

2. Prepare the relevant materials required for claim settlement and submit them to the insurance company within the specified time;

3. Wait for the review and investigation of the insurance company;

4. After the review is passed, wait for the insurance company to pay and check the compensation.

Accident insurance reimbursement materials include: identity certificate of the accident, original medical expense receipts and diagnosis certificates, outpatient medical records, inpatient medical records and discharge summary, medical expense list prescription, accident certificate issued by relevant departments, disability appraisal report, resident death medical certificate or forensic medical certificate, funeral cremation certificate, accident certificate issued by relevant departments, beneficiary identity certificate, beneficiary and accident relationship certificate, transfer and payment authorization, etc.

The accident insurance reimbursement process is:

The medical expenses incurred shall be paid by the individual in advance, and the insurance company shall apply for compensation after the completion of the accidental injury diagnosis and treatment;

After receiving the application for insurance payment and relevant supporting materials, the commercial insurance company shall review the claim information and determine the insurance liability.

If the conditions for claim settlement are met, the commercial insurance company shall settle the claim within the specified date after receiving the claim materials, and promptly transfer the payment to the account of the owner of the payment;

If it is not an insurance liability, a notice of refusal to pay insurance money shall be issued within the specified date to fulfill the obligation to inform.

Jintou Insurance Network.

Information required for accident insurance:

ID card (ID card or household registration certificate with **) of the insured person

The policyholder's bank account details (bank card or passbook).

Features: (1) Payment of insurance money.

In the event of an insured event, the death insurance benefit is paid according to the agreed insurance amount, and the disability insurance is mostly paid according to a certain percentage of the insured amount.

2) Basis for calculating premiums.

The pure premium of accident insurance is calculated based on the loss rate of the insured amount, and this method believes that the probability of the insured suffering from an accident depends on his occupation, type of work or activity to be carried out, and when all other conditions are equal, the higher the degree of risk of the insured's occupation, type of work and activities engaged, the more insurance premiums should be paid.

3) Duration of insurance.

Accident insurance is for a shorter period of less than one year, with a maximum of three or five years.

4) Liability reserves.

The year-end liability reserve is calculated as a percentage (e.g., %) of the premium income for the year, which is the same as for property insurance.

The accident insurance reimbursement materials are prepared as follows:

1. Insurance reporting period.

After the occurrence of accidents, it is necessary to notify the insurance company in time, and the required preparation materials are as follows:

1) Inform the accident time, approximate course, location, etc.;

2) Providing personal information, or client information.

2. Period.

1) Medical certificates and invoices for expenses;

2) Medical records; 3) a list of medications;

4) Proof of admission;

5) Discharge summary.

3. Claim settlement period.

1) Insurance claim application;

2) A copy of the ID card;

3) All original invoices and vouchers;

4) Copies of medical records.

Extended Information] Personal Accident Insurance, where the risk covered is accidental injury. Generally, the insurance company's accident insurance product defines accidental injury as "injury to the body caused by an external, sudden, and unintentional objective event as a direct and independent cause".

If the insured suffers an unintentional, external, or sudden accident during the validity period of the insurance, resulting in physical injury and death, the insurance company shall pay the insurance money in accordance with the provisions of the insurance contract.

Accidental injuries must meet the following requirements:

1. Caused by external factors refers to accidents caused by external reasons of the insured's body, such as car accidents, attacks by gangsters, drowning, food poisoning, etc.

2. Sudden refers to an accident caused in an instant, without a long process, such as falling into the water, electric shock, falling, etc. Occupational diseases, on the other hand, are caused by injuries that are gradually formed and can be foreseen and prevented, so they are not accidents.

3. Accidents that occur refer to accidents that the insured did not expect and did not intended, such as aircraft crashes, etc., and other accidents that could have been foreseen or avoided but could not be avoided due to the inability to resist or perform their duties, and should also be included in the scope of "accidents", such as a ship caught fire and was forced to jump into the sea to escape, or was injured in a fight with gangsters.

4. Non-disease, the injury caused by the disease, although it is not foreseen by the person in advance, it is the result of the human body itself, and is not an accident. If you have a cerebral hemorrhage and are unconscious.

5. If the body is injured, the object of the accidental injury must be the part of the insured's body, and the fact of injury is established (for example, although the electric shock does not injure the body, the fact of injury is not established).

The documents required for accident insurance reimbursement are subject to the terms and conditions of the insurance. In general, the following materials are necessary:

1. The insured's valid identity documents and related identity documents, such as household registration certificates, marital relationship certificates, etc.;

2. Accident insurance claim application;

3. Medical accident certificates and invoices, medical records, diagnosis certificates, receipts and lists of medical expenses, discharge summaries, etc.

It is very important for the accident insurance to reimburse the above documents, if there is any omission, it will affect the claim, of course, the reimburser will also need to provide other necessary documents according to the actual insurance policy.

Generally speaking, accident insurance includes three forms: accidental injury, accidental dismemberment, and accidental death.

1. Accidental Injury Medical Insurance Reimbursement Materials:

1) Claim application;

2) Insurance policy or certificate of insurance;

3) Proof of the identity of the beneficiary;

4) A copy of the beneficiary's bank passbook (card);

5) Original outpatient manual;

6) Original receipts for medical expenses;

7) A detailed list of medical expenses;

8) Accident certificate;

9) Discharge summary (issued by inpatient medical treatment);

10) Proof of surgery (surgery fee issued).

2. Accidental disability insurance reimbursement materials:

1) Claim application;

2) Insurance policy or certificate of insurance;

3) Proof of the identity of the beneficiary;

4) A copy of the beneficiary's bank passbook (card);

5) Accident certificate;

6) Disability Certificate.

3. Accidental death insurance reimbursement materials:

1) Claim application;

2) Insurance policy or certificate of insurance;

3) Proof of the identity of the beneficiary;

4) A copy of the beneficiary's bank passbook (card);

5) Accident certificate and death certificate;

6) Proof of funeral or cremation;

7) Certificate of cancellation of household registration.

Legal basis

Insurance Law of the People's Republic of China

Article 22 After the occurrence of an insured event, when the insurer is requested to compensate or pay insurance money in accordance with the insurance contract, the policyholder, the insured or the beneficiary shall provide the insurer with the certificates and materials that it can provide to confirm the nature, cause and extent of loss of the insured accident.

If the insurer finds that the relevant certificates and materials are incomplete in accordance with the provisions of the contract, it shall promptly notify the policyholder, the insured or the beneficiary to provide supplementary information in a one-time manner.

Generally speaking, accident insurance includes three forms: accidental injury, accidental dismemberment, and accidental death. 1. Accidental injury medical insurance reimbursement materials: (1) Claim application; 2) Insurance policy or certificate of insurance; 3) Proof of the identity of the beneficiary; 4) A copy of the beneficiary's bank passbook (card); 5) Original outpatient manual; 6) Original receipts for medical expenses; 7) A detailed list of medical expenses; 8) Accident certificate; 9) Discharge summary (issued by inpatient medical treatment); 10) Proof of surgery (surgery fee issued).

2. Accidental disability insurance reimbursement materials: (1) Claim application; 2) Insurance policy or certificate of insurance; 3) Proof of the identity of the beneficiary; 4) A copy of the beneficiary's bank passbook (card); 5) Accident certificate; 6) Disability Certificate. 3. Accidental death insurance reimbursement materials:

1) Claim application; 2) Insurance policy or certificate of insurance; 3) Proof of the identity of the beneficiary; 4) A copy of the beneficiary's bank passbook (card); 5) Accident certificate and death certificate; 6) Proof of funeral or cremation; 7) Certificate of cancellation of household registration. Article 22 of the Insurance Law of the People's Republic of China.