Medical Claim Criteria for Commercial Motor Vehicle Insurance

If the hospital you live in has excessive medication, the insurance company will remove it, and the reimbursement should be 80%-90%, if the patient is discharged from the hospital to do a disability assessment, there will be disability compensation, which is implemented according to national regulations, and the insurance company will not deduct it. Subsequent expenses can only be reimbursed after being determined with the insurance company. The cost of accompanying care must provide proof of relevant salary for the past three months.

What is the standard of compensation for commercial auto insurance?

Car Insurance, Commercial Insurance.

The scope of compensation is:

1. Collision and overturning; Fire**; Collapse of external objects, falling of objects running in the air, parallel falls of insured vehicles while driving;

2. Lightning strikes, storms, tornadoes.

Heavy rains, floods, tsunamis.

ground subsidence, ice subsidence, cliff avalanche, avalanche, hailstorm, mudslide, landslide;

3. The ferry carrying the insured vehicle suffers from a natural disaster.

resulting in loss of the insured vehicle.

The car insurance claim process is as follows:

1. After reporting the case, carefully fill in the "Notice of Claim for Motor Vehicle Insurance" and sign it;

2. Inform the insurance company of the location of the damaged vehicle in a timely manner, so as to investigate and assess the damage of the vehicle;

3. Provide documents and vouchers for property loss;

4. After the vehicle repair and accident handling are closed, the information required for handling insurance claims;

5. Collect the claim payment.

The documents provided to the insurance company are as follows:

1. Insurance policy;

2. Notice of Accident;

3. Accident certificate and liability certificate of insured vehicle;

4. Invoices and lists of repair costs and rescue costs;

5. If the property loss of a third party is involved, the accident mediation letter and relevant expense documents shall be provided;

6. For some cases, the insurance company also requires the driver's driver's license.

Copy of the copy of the bureau and identity card.

Copy.

The scope of compensation for motor vehicle commercial insurance is: the property loss of the three, the medical expenses, lost work expenses, food expenses, nursing expenses, secondary expenses, disability subsidies, death compensation, maintenance and other expenses, generally Huaizhong is the first by the insurer who underwrites the compulsory insurance of motor vehicles to compensate within the limit of compulsory insurance liability; The shortfall will be compensated by commercial insurance.

[Legal basis].

Article 1213 of the Civil Code: If a motor vehicle is damaged in a traffic accident and is the responsibility of the motor vehicle, the insurer underwriting the compulsory inspection insurance of the motor vehicle shall first compensate within the limit of the liability of the compulsory insurance; For the shortfall part, the insurer underwriting the commercial insurance of motor vehicles shall compensate in accordance with the provisions of the insurance contract; If it is still insufficient or has not taken out commercial insurance for motor vehicles, the infringer shall compensate for it.

The insurance company shall compensate for the part of the non-medical insurance drugs. Generally, insurance companies will stipulate in the insurance clauses of compulsory traffic insurance and commercial third-party liability insurance: "The insurer shall verify the amount of compensation for medical expenses in accordance with the standards of national basic medical insurance."

This is a standard clause. So in the claim, is it necessary to compensate according to the agreement between the car owner and the insurance company, and only in the medical expenses, it will be compensated according to the standard of the national basic medical insurance? The author believes that insurance companies should compensate for non-medical insurance drugs.

First of all, according to the second paragraph of Article 17 of the Insurance Law, "the insurer shall, when concluding the contract, make a reminder sufficient to attract the attention of the policyholder on the insurance policy, insurance policy or other insurance certificate for the clause exempting the insurer from liability, and make a clear explanation to the policyholder in written or oral form for the clause to be exempted from liability; If there is no reminder or clear explanation, the clause shall not be effective. "Article 19:

The following clauses in an insurance contract concluded using the standard clauses provided by the insurer are invalid: (1) exempting the insurer from its obligations in accordance with the law or increasing the liability of the policyholder or the insured; "The insurance company is actually exempting itself from liability for medical expenses only in accordance with the national basic medical insurance standards, so if the policyholder does not make a reminder or clear explanation of the clause when applying for insurance, then the clause is invalid. Secondly, according to Article 19 of the Interpretation of the Supreme People's Court on Several Issues Concerning the Application of Law in the Trial of Personal Injury Compensation Cases:

Medical expenses are determined on the basis of the receipt vouchers for medical expenses, hospitalization fees, etc., issued by medical institutions, combined with relevant evidence such as medical records and diagnosis certificates. If the person obligated to compensate has objections to the necessity and reasonableness of **, it shall bear the corresponding burden of proof. ”