Urgent! How do I make a claim? How to make a claim for insurance

1. A such as the nursing fee for the length of hospitalization, the proof of nursing time is the inpatient medical invoice, the nursing fee after discharge, the nursing time certificate issued by the hospital, the general disability is unlikely to have the nursing fee after discharge, B to provide the proof of nursing staff, the salary certificate for the job, the local nursing standard for no work (the general nursing staff is a relative of the injured).

In the future, the first expense can be compensated, because the medical expenses of the injured have exceeded the cost of compulsory insurance, so in addition to the medical expenses of 10,000 yuan (medical expenses, follow-up medical expenses, hospital meal subsidies) to compensate in the commercial three insurance, you are fully responsible, there is no proportion, but because you do not have a deductible, so the commercial three insurance should be deducted from the odds (20%)

3. Death and disability expenses, including disability compensation, nursing expenses, lost work expenses, transportation expenses, etc., can be fully compensated if they do not exceed the limit of compulsory traffic insurance.

5. Insurance is based on the principle of compensation, if you have a lot of compensation for you in the first claim, you can go to another insurance company to make a claim, but according to the information you provide, there is no need to go to another one. And if you want to go to another insurance company to make a claim, you also need the first insurance company to issue a certificate of birth, because you only have one information, so the procedure is very troublesome.

1.It seems that the requirements of each insurance company are different, right? This can be called ** to the personal injury of the personal insurance claim consultation!!

3.Compulsory liability insurance is paid in proportion to the level of disability.

4.If the third party is not enough, it is the third party you said that the commercial insurance is the third party you said, but if the third party does not have a deductible, it is 80% of the compensation (different regions, the proportion of compensation may be different), but if it exceeds your insurance amount, it will not be paid, that is to say, your insurance amount is 50,000 at most, and if you do not have a deductible, it is 80% of 50,000.

5.If it takes effect, you should be able to make a claim.

1.Nursing fee: If you have a job, you will be subject to the salary certificate. Those who are not employed are based on local caregiver standards.

2.The medical expenses of the judicial appraisal can be used as the basis for compensation.

3.Disability expenses are fully compensated in the compulsory traffic insurance.

4.Not prorate, deductible is deducted.

5.Do you duplicate insurance?

Insurance claims must be made within the statute of limitations, beyond which the insured or beneficiary does not make a claim against the insurer, fails to provide the necessary documents and does not receive the insurance money, which is deemed to be a waiver of rights. The timeliness is different depending on the type of insurance. The statute of limitations for life insurance claims is generally 5 years; The statute of limitations for other insurance plans is generally 2 years.

The statute of limitations for claims shall be calculated from the date on which the insured or beneficiary becomes aware of the occurrence of the insured event. After the occurrence of an insured event, the policyholder, insurer or beneficiary must first immediately stop the insurance and file a claim. After the policyholder submits a claim, if the insurance company believes that it is necessary to submit relevant certificates and materials, it shall notify the other party in a timely manner. After the materials are complete, the insurance company shall make an assessment in a timely manner, and if the situation is complicated, it shall make an assessment within 30 days and notify the other party of the verification result in writing; For insurance liability, the insurance company shall pay the compensation within 10 days after the compensation agreement is reached; For those that do not fall within insurance liability, a notice of refusal shall be issued within 3 days from the date of verification, and the reasons shall be explained.

The insurer's claim review time should not exceed 30 days, unless otherwise agreed in the contract. Within 10 days after the agreement is reached, the insurance company shall fulfill the obligation to compensate or pay the insurance money. In addition, if the verification does not belong to the insurance liability, a notice of refusal shall be issued within 3 days from the date of verification and the reasons shall be explained.

The process of insurance claims includes case filing and investigation, review of certificates and materials, investigation, verification of insurance liability, and notification of payment settlement.

1. File a case for investigation.

The insured must report to the insurance company in time when an insured accident occurs, and the insurance company will register the accident for the record, and rush to the scene for investigation as soon as possible; At the same time, according to the requirements of the insurance contract and the accident situation, the insurance company will inform or remind the applicant of the materials to be prepared, and give guidance on the collection methods and ways of relevant materials.

2. Review certificates and materials.

The insurance company will review the claim application materials provided by the applicant to determine whether the materials are complete, whether supplementary materials are required, or whether the insurance company determines whether to accept the claim. If the materials are complete and clear, the applicant shall be immediately informed of the approximate time required to handle the case, and the method of receiving the insurance money.

3. Investigation. The insurance company verifies the authenticity of the insured accident and the materials through the collection of relevant evidence. The investigation process requires not only the cooperation of relevant departments and agencies, but also the cooperation of the applicant.

4. Verify the insurance liability.

The insurance company needs to accurately calculate the payment amount and make a claim settlement conclusion after verifying the insurance liability according to the insurance contract and determining the insurance liability under the condition that the proof and information are legitimate.

5. Notify the payment and close the case.

After the case has been reviewed, the insurance company can notify the beneficiary to bring the relevant identity certificate and proof of relationship to come to the payment formalities.

Hello! An insurance claim can be made in the following steps:

1. Determine whether the insurance situation meets the conditions for claims.

After an accident, we first need to determine the nature of the accident: was it an injury caused by an accident, or was it an illness?

Is the illness covered by the insurance you purchased? For example, if I buy a million medical insurance, does the cost exceed the deductible of 10,000 yuan? If I have purchased critical illness insurance, does the severity of the illness meet the criteria for contract claims?

Is the accident excluded?

The above questions can basically determine whether the accident that occurred and whether the insurance we bought can be compensated.

2. Notice of danger report.

After confirming that the accident is within the scope of insurance, you should report the accident to the insurance company in time, and the main ways to report the accident are as follows:

3) Report the case at the counter of the local insurance company branch.

3. Submit claim materials.

Claim information includes insurance contract, claim application, legal and valid identity certificate of the insured, etc.

Different types of insurance claims require different claim materials, such as illness and disability claims, which need to provide medical appraisal certificates issued by hospitals recognized by insurance companies, such as medical records, disease diagnosis certificates, etc.;

For the death claim, a death certificate issued by the public security department is required, such as a certificate of cancellation of household registration, cremation certificate, etc.

After sorting out the materials, submit them to the insurance company through online uploading, mailing, counter, etc.

4. The insurance company reviews the materials.

After the insurance company gets the claim materials, it will generally review the relevant materials within 5-10 days, and if there is no problem with the materials, the insurance company will issue a claim notice within a week;

If the documents are incomplete, the insurance company will also ask for the information to be completed as soon as possible.

5. Payment of claims.

If the claim application is approved, the insurance company will complete the payment of the claim within 10 days after reaching an agreement with the applicant to pay the claim money.

Hope daddy's is helpful to you!

The insurance claim process is divided into five processes: reporting, acquiring, preliminary verification, investigation and compensation. Insurance claim settlement refers to the act of the insurance company performing the liability of compensation or payment in accordance with the provisions of the contract when the insured suffers damage to the property or personal life of the insured due to the occurrence of an insured accident on the subject matter of the insurance, or when the insurance money needs to be paid due to the occurrence of other insured accidents as stipulated in the insurance policy, which is a direct embodiment of the insurance function and the performance of the insurance liability.

Insurance Claims Process.

1. Report the case. The first step in insurance claims is to report the case, and after the accident, the policyholder should report the case in time to prevent losses. Generally speaking, the policyholder should notify the insurance company within 10 days after the occurrence of the insured accident, but the reporting time requirements for different types of insurance are different, and it should be operated according to the provisions of the insurance contract, such as the effective reporting time of car insurance is within 48 hours.

When reporting the case, it is necessary to accurately describe the time, place, cause, and process of the accident, and introduce the current basic situation of the insured.

2. Acquiring. Acquiring, that is, collecting customer claim information, including claim applications and various documents. For policyholders, it is necessary to prepare detailed supporting materials, and different types of insurance have different requirements.

It can be roughly divided into two types: one is the applicant's certification information and identity certification information. The second is the claim certificate, death certificate, medical report of major illness, etc.

3. Initial nucleus. If the materials are complete and meet the claim requirements, the compensation will be notified within 2-3 working days. If this time is exceeded, it means that the initial audit has not passed. If it is a liability exemption or suspected liability exemption, it will directly proceed to the next claim settlement step.

4. Investigation. The main purpose of insurance claims investigation is to further clarify the facts, clarify the insurance liability, and eliminate malicious insurance situations such as concealing medical history and taking out insurance with illness. In the case of health insurance, the insured will be investigated in great detail such as medical records, hospital pharmacy visits, consumption records, and physical examination reports.

5. Indemnity. After the insurance company makes a compensation decision, it notifies the insured or recipient to receive the insurance money.

The 150 yuan claim method of Longjiang Hui Insurance is as follows:

1. After the insured is out of insurance, contact the corresponding insurance company as soon as possible, report the accident and submit the reimbursement application.

2. The insurance company will inform the policyholder of some information that needs to be prepared, submit relevant claim materials as required, and the insurance will review the information.

3. After the insurance company has passed the review, it will provide a compensation plan to the policyholder in accordance with the reimbursement ratio stipulated by the insurance, and the policyholder needs to judge whether it meets its own compensation needs after a detailed review.

4. Both parties can pay some claims if they have no objection to sign and seal.

Classification of insurance companies' claim methods:

1. Normal claims.

This is relatively easy to understand, that is, if the insured has or suffers from the situation stipulated in the contract, the relevant claim information will be provided, and the insurance company will pay the policyholder or beneficiary according to the insurance amount stipulated in the contract after reviewing and verifying it.

2. Negotiate the claim.

When applying for a claim for the first time, the insurance company refused to make a claim, but there is still a possibility of a claim. Negotiation of claims is, you say you don't pay, there is still the possibility of compensation. You say compensation, but not all of them need to be compensated.

One party is responsible, or some places cannot obtain evidence, and the responsibility is not clear, so it is necessary for both parties to sit down and negotiate how to pay.

3. Accommodating claims.

When applying for a claim for the first time, the insurance company refused to make a claim, but there is still a possibility of a claim. Accommodating claims means that they cannot meet the conditions for claims, and they should not be compensated, but the insurance company for some reason should appropriately compensate a little. <>

1. Claim report: After the occurrence of the corresponding insured accident, it is necessary to submit a claim plan to the insurance company as soon as possible, because the insurance claim is generally timely, and the claim can only be obtained within the limited time when the accident occurs;

The above is the specific process of insurance claim.

What is an insurance claim?

Insurance claim means that the insurance company will provide insurance compensation for the property or personal damage of the insured person in the event of the insured accident. There are two main ways to make insurance claims, one is compensation, after the property loss of the policyholder, the insurance claims the corresponding loss, and the compensation is only the actual loss of the policyholder; The other is payment, when the policyholder is physically injured, the insurance company pays the insurance money to the policyholder according to the agreement.

The insurance company's claim process is as follows:

Regulations on Compulsory Insurance of Motor Vehicle Traffic Accident Liability

Article 28.

If the insured motor vehicle is involved in a road traffic accident, the insured shall apply to the insurance company for compensation for insurance benefits. The insurance company shall, within one day from the date of receipt of the compensation application, inform the insured in writing of the proof and materials related to the compensation that need to be provided to the insurance company.

Article 29.

The insurance company shall, within 5 days from the date of receipt of the certificate and materials provided by the insured, verify whether it is an insurance liability and notify the insured of the result; If it does not belong to the insurance liability, the reasons shall be explained in writing; For those who are liable for insurance, the insurance money shall be compensated within 10 days after reaching an agreement with the insured to compensate the insurance money.

Article 30. If there is a dispute between the insured and the insurance company over compensation, it may apply for arbitration or file a lawsuit in the people's court in accordance with the law.

Insurance Law of the People's Republic of China

The insurer shall make a timely review after receiving a request for compensation or payment of insurance money from the insurer or the beneficiary; Where the circumstances are complicated, an approval shall be made within 30 days, unless otherwise agreed in the contract.

1. Accept and report the case.

Acceptance of reporting means that the insured must report to the insurance company in a timely manner when an insured accident occurs, and the insurance company shall register the accident for the record. Generally speaking, reporting is an important part of the insurance company's claim settlement process, which helps the insurance company to understand the accident situation in a timely manner, and if necessary, it can intervene in the investigation and verify the nature of the accident as soon as possible; At the same time, the insurance company can inform or remind the applicant of the materials to be prepared according to the requirements of the insurance contract and the accident situation, and give guidance on the collection methods and ways of relevant materials.

2. Accept materials and file cases.

Acceptance and filing is a process in which the insurance company reviews the claim application materials provided by the applicant to determine whether the materials are complete, whether supplementary materials are required, or whether the insurance company determines whether to accept the claim. In the case filing process, if the applicant of the insurance company submits incomplete and unclear supporting materials, he will immediately tell the applicant to submit the relevant materials; If the materials are complete and clear, the applicant shall be immediately informed of the approximate time required to handle the case, and the method of receiving the insurance money.

3. Investigation. Investigation is the process by which the insurance company verifies the authenticity of the insured accident and the materials through the collection of relevant evidence. The investigation process not only requires the cooperation of relevant departments and agencies, but also the cooperation of the applicant is an indispensable link, otherwise it will affect the timely payment of insurance money.

4. Audit. Review refers to the process in which the case handler determines the objective facts based on relevant evidence, determines the insurance liability, accurately calculates the payment amount, and makes a claim conclusion.

5. Sign and approve. Approval refers to the process in which the signatory of the claim case reviews the work of the above links and examines and approves the case that is verified to be correct.

6. Notification and payment.

After the case is signed and approved, the insurance company can notify the beneficiary to bring the relevant identity certificate and relationship certificate to go through the payment procedures. In order for the insurance company to contact the relevant beneficiary accurately and quickly, the application form must be filled in with the accurate ** number and contact address. In short, insurance companies must be objective and fair in handling claims cases, and protect the due interests of customers to the greatest extent possible on the basis of facts, contracts and laws as the criterion.