What is the reimbursement ratio of accident insurance, and what is the reimbursement ratio of medica

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Hello, it is necessary to analyze according to the specific product you purchased, which is reimbursed according to the proportion specified in the contract.

How much can be reimbursed by the purchased accident insurance, and the scope of reimbursement depends on the terms and conditions of the product, and the proportion is thereTherefore, different products are not quite the same, and the reimbursement scope is also limited within the social security and also includes the social insurance.

We buy the best choice of accident insurance 100% reimbursement, but also choose unlimited social security, in order to facilitate everyone's purchase, I specially sorted out the excellent accident insurance on the market, you can take a look at what you need:In 2020, the most worthwhile accident insurance is here

Accident insurance generally ranges from tens to hundreds of yuan per year, with an insurance amount of tens to millions, and the insurance period is one year.

The full name is personal accident insurance, in layman's terms, that is, after we have purchased accident insurance, if during the insurance period, due to accidental injury resulting in death or disability, you can find the insurance company to obtain corresponding compensation in accordance with the contract.

There are two basic points:

Time Definition:If it occurs during the validity period of the contract, it shall be within the insurance liability period.

Definition of Responsibilities:Foreign, sudden, unintended, non-diseased.

Accidental death: the probability is small, the loss is large. If it happens to the breadwinner of the family, it will be a loss of the family's financial resources.

Accidental medical treatment: The probability of occurrence is high, and different medical expenses are incurred according to different severity, and medical insurance cannot cover all of them.

It depends on the reimbursement requirements of the insurance you purchase, most consumer accident insurance is 100 deductible, more than 100 reimbursement 80%, up to the sum insured.

Chinese Life Accident Insurance reimbursement of hospitalization expenses can generally be reported at a rate of 70%, if the customer first purchases medical insurance, and then reimburses Chinese Life Company for reimbursement, 90% of the balance can be reimbursed.

There is medical insurance and no medical insurance, and the reimbursement ratio is different.

Depending on the specific terms, there are 80%, 90%, 100%.

Subject to the policy as stated.

Which insurance company did you buy?

It depends on which company, the terms are different, and the Pacific is 100% reimbursed.

Pacific Personal Accident Coverage 100%.

Which company's accident and insurance do you buy?

Accident insurance according to the different protection responsibilities, the proportion of reimbursement is also different, under normal circumstances, accident insurance for accidental death is 100% of the insured amount of compensation, for accidental disability will be paid according to the level of disability, if it is accidental medical and accidental hospitalization allowance will be in accordance with the terms of the insurance contract to claim, accidental disability will be based on the level of disability to pay from 10% to 100% in proportion, Accidental medical and accidental hospitalization benefits are based on different accident insurance products.

In the claim clause of accident insurance, if the insured dies due to the accident within 180 days after the accident, the insurance company will compensate the insured or its beneficiary for 100% of the insured amount in accordance with the terms and conditions of the insurance contract.

2. Accidental Disability If the insured is disabled due to the accident within 180 days after the accident, the insurance company will compensate according to the insured's disability level and the insurance amount agreed in the insurance contract. Normally, the insured is required to provide an appraisal of the disability level, and the specific disability claim ratio will be determined according to the insured's disability level. 100% for Level 1 disability and 10% for Level 10 disability.

The higher the disability level, the higher the percentage of claims.

3. Accidental medical treatment If the insured needs to be hospitalized due to accidental injury**, then the insurance amount must be paid in combination with the provisions of the insurance clause when the insurance product is settled. For example, if we take an accident insurance product on the market as an example, in terms of accidental medical protection, this product stipulates that the maximum claim amount of the insurance is 10,000 yuan, and the deductible is zero yuan, and the compensation ratio is 90%, so that if the insured has an accidental medical accident. The insurance company will pay for the expenses he spends at a rate of 90%.

4. Medical expenses and reimbursement ratio.

Taking student insurance as an example, there are many types of student insurance on the market, so the reimbursement ratio will be different, but compared with medical insurance, the reimbursement ratio of student insurance is higher. The following reimbursement rates are for reference only.

If the medical expenses are 1,000 yuan or less, the reimbursement ratio is 50%;

If the medical expenses are between 1000-4000, the reimbursement rate is 60%;

If the medical expenses are between 4000-7000, the reimbursement rate is 70%'

If the medical expenses are between 7,000 and 10,000, the reimbursement ratio is 80%;

If the medical expenses are between 1,000 and 30,000, the reimbursement rate is 90%;

If the medical expenses are more than 30,000, the reimbursement rate is 95%.

The provisions of the reimbursement ratio of medical insurance accident insurance are as follows: outpatient reimbursement ratio: 1. If it is an in-service employee, after going to the outpatient and emergency department of the hospital, the medical expenses of more than 2,000 yuan can be reimbursed, and the reimbursement ratio is 50%; 2. If it is a retiree under the age of 70, the expenses of more than 1,300 yuan can be reimbursed, and the reimbursement ratio is 70%; 3. If it is a retiree over 70 years old, the expenses of more than 1,300 yuan can be reimbursed, and the reimbursement ratio is 80%.

Regardless of the type of person, the maximum amount of outpatient and emergency medical expenses paid is 20,000 yuan. Hospitalization reimbursement ratio: At present, when the basic medical insurance is used for the first time in a year, whether it is an incumbent or a retiree, the minimum payment amount is 1,300 yuan, and the medical expenses of the second and subsequent hospitalization, the minimum payment standard is determined by 50, that is, 650 yuan.

Dear, I hope the above answer can help you, thank you [Bixin].

Legal analysis: Under normal circumstances, the reimbursement ratio of medical insurance fluctuates around 70%. The amount of reimbursement is related to factors such as medical grade, examination, and medication.

Class A drugs can enjoy full coverage, Class B can be reported 80%, and the proportion of self-responsibility is 20%, while Class C needs to be fully co-payed.

Legal basis: Social Insurance Law of the People's Republic of China Article 2 The State shall establish social insurance systems such as basic endowment insurance, basic medical insurance, work-related injury insurance, unemployment insurance, and maternity insurance, to protect citizens' right to receive material assistance from the State and society in accordance with the law in the event of old age, illness, work-related injury, unemployment, childbirth, etc.

1. If it is a unified purchase of "student insurance" at the school, it depends on the specific terms and regulations.

Directly find out the policy receipt issued to you by the school after paying the premium, and you can see the specific deductible amount and reimbursement ratio, which is usually between 80-100; If you don't have one, you can ask for or ask the teacher at the school to check it on your behalf.

Second, if you buy accident insurance separately, it also depends on the specific product terms, generally speaking, the exemption quota is between 0-200 yuan, and the reimbursement ratio is between 60-100%. For specific reimbursement procedures, you can refer to this:

1. After an accident or hospitalization, you should call the customer service staff of the insurance company in time to understand the documents that need to be prepared, so that the insurance company can quickly settle the claim.

2. The procedures required for the insured to handle the claim due to accidental injury (hospitalization medical insurance shall be hospitalized in a hospital of the second level (including the second level) or above recognized by the insurance company):

1) Medical diagnosis certificate; (If you have been hospitalized**, you also need to provide a copy of the medical record and discharge summary during the hospitalization, and if there is a radiological or imaging examination, you need to provide an examination report, etc.).

2) Certificate of accidental injury issued by the relevant department; (If there is a traffic accident or an accident that has been committed by a public security organ, it is necessary to issue an accident statement of the organ or department; If not, a certificate issued by the insured's work unit or neighborhood committee is required, see the attachment for details).

3) Original receipts (invoices) and prescriptions (drug lists) for medical expenses;

4) A copy of the applicant's ID card or household registration certificate;

5) A copy of the ICBC passbook.

3. The insurance company will make a notice of closure within 7 working days when all the documents are complete, and the insured or beneficiary can go to the insurance company to receive the compensation with his ID card and household registration certificate or check whether the compensation has been received in the passbook account account provided by the insured or beneficiary after receiving the notice.

Attached: Accident certificate.

It is hereby proved that xx is an employee of our company (a student of our school), ID number: ** on *year*month*day, * incident, and went to * hospital for medical treatment, the situation is true, hereby proved.

Company (with official seal).

Year*month*day.

The reimbursement ratio of medical insurance accident insurance is: the reimbursement ratio of in-service employees is 50%, and medical expenses of more than 2,000 yuan can be reimbursed; The reimbursement ratio for retirees under the age of 70 is 70%, and medical expenses of more than 1,300 yuan can be reimbursed; The reimbursement rate for retirees over the age of 70 is 80%, and medical expenses above 1,300 yuan can be reimbursed.

Legal basis. Article 28 of the Social Insurance Law in line with the basic medical insurance drug list, diagnosis and treatment items, medical service facility standards and medical expenses, emergency and rescue medical expenses, in accordance with the provisions of the state from the basic medical insurance **.

Article 29 of the Social Insurance Law.

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.

How much does accident insurance pay?

Under normal circumstances, the insurance company will settle claims in three situations: 1. Accidental death: that is, death caused by an accident, in which case the insurance company will directly pay the insurance money according to the contract; Accidental Dismemberment:

The higher the disability level, the higher the compensation amount, of which the first level is more severe and the tenth level is less (the disability level is subject to the insurance contract).

Accidental Disability Insurance Benefit = Accidental Disability Sum Insured Proportion of Benefits Corresponding to Disability Level.

2. Accidental medical treatment: When the reasonable medical expenses incurred by the insured due to accidental injury in the hospital**, as long as it is within the scope of insurance liability, it can be reimbursed according to the agreed proportion.

3. There are also some accident insurance that will provide accidental hospitalization allowance, that is, if you are hospitalized in the hospital due to an accident**, you can pay a certain amount of hospitalization allowance every day to reduce the financial burden and income loss of the insured.