Accident Insurance Reimbursement Questions? How accident insurance is compensated

Since it is an accident insurance, it is used for the aftermath of the elderly, and the brothers and sisters who are left after the aftermath discuss the inheritance, and the inheritance rights of the brothers and sisters are the same in law, but the customs are different due to the different obligations of the inheritance in various places.

Insurance is paid in accordance with the terms and conditions of the insurance. As for how your family will split the cost of the claim, it is your personal question and choice, and it is up to you to decide.

The beneficiary of accident insurance is generally the legal heir.

1. If the beneficiary is named at the time of application, the beneficiary shall own the indemnity.

2. There is no designated beneficiary, and the death benefit is owned by the heirs in the first order. First-in-line heirs include: spouse, children, parents.

3. According to the Civil Code, children are entitled to compensation as heirs. If you support the elderly, you can share more. It can also be divided equally. It is also possible to renounce the inheritance in writing. These need to be coordinated between the children, and if the coordination fails, justice can be pursued.

1. After accidental injury or hospitalization, you should call the customer service 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, and you need to report to the insurance company within 3 days.

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;

2) Certificate of accidental injury issued by the relevant department;

3) Original receipts and prescriptions for medical expenses;

4) A copy of your ID card or household registration certificate.

3. The insurance company will make a notice of closure within 7 days when all the documents are complete, and the insured or beneficiary can go to the insurance company to receive compensation with his ID card and household registration certificate after receiving the notice.

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Hello, your question depends on who the beneficiary of the accident insurance is, if the beneficiary is the son, then the compensation amount belongs to the son, and others are not eligible to share the compensation. If the beneficiaries are a son and two daughters, then there are three people who divide the compensation. Hope it helps.

The payout ratio of accident insurance is generally about 80%. The compensation standards are: (1) If the victim suffers personal injury, the compensation obligor shall compensate for the expenses incurred due to medical treatment and the income lost due to lost work, including medical expenses, lost work expenses, nursing expenses, transportation expenses, accommodation expenses, hospital meal subsidies, and necessary nutrition expenses.

2) If the victim is disabled due to injury, the compensation obligor shall also compensate for the necessary expenses incurred by the victim due to the increase in living needs and the loss of income caused by the loss of working ability, including disability compensation, disability assistive devices, and living expenses of dependents, as well as the necessary expenses, nursing expenses, and follow-up expenses actually incurred due to the care and continuation. (3) In the event of the death of the victim, the compensation obligor shall, in addition to compensating the relevant expenses provided for in the first paragraph of this article in accordance with the circumstances of the rescue, also compensate for the funeral expenses, the living expenses of the dependents, the death compensation expenses, and other reasonable expenses such as transportation expenses, accommodation expenses, and loss of work incurred by the victim's relatives in handling funeral matters.

Legal basis: Measures for the Administration of Insurance Clauses and Insurance Rates of Life Insurance Companies Article 12 Accident insurance refers to life insurance that takes the death or disability of the insured or the occurrence of other accidents agreed in the insurance contract as the condition for the payment of insurance benefits.

Article 43 of the Insurance Law Where the insured intentionally causes the death, disability or illness of the insured, the insurer shall not be liable to pay the insurance money. If the policyholder has paid the insurance premium for more than two years, the insurer shall refund the cash value of the insurance policy to the other right holders in accordance with the contract.

If the beneficiary intentionally causes the death, disability or illness of the insured, or intentionally attempts to kill the insured, the beneficiary loses the right to benefit.

The accident insurance claim process is as follows:

2. Prepare the required materials for claim settlement and submit the claim application after the end of the claim;

3. If the insurance company verifies the claim, the materials are complete, and the facts are clear and meet the requirements of the claim, the payment will be notified within 2-3 working days.

The claim application materials generally include:

1. The identity certificate of the insured (or the insurer), when the insured is a minor or has no capacity for civil conduct, the guardian shall apply for the claim on behalf of the guardian, and the guardian's identity certificate and relationship certificate shall be provided;

2. Beneficiary's identity certificate, household registration certificate, and relationship certificate with the insured;

3. Outpatient (emergency) medical records;

4. Discharge summary (discharge record);

5. Original vouchers of medical expenses, list of expenses (prescription), and medical insurance settlement list (provided with medical insurance compensation);

6. Copy of receipt of medical expenses;

7. Certificate of diagnosis (certificate of disease diagnosis issued by the hospital with the results of pathological examination, blood test or other scientific tests);

8. Surgical certificate;

9. Accident certificate;

10. Forensic science appraisal or hospital appraisal certificate;

11. Death certificate: death certificate, funeral certificate, household registration cancellation certificate;

12. Certificate of death issued by the court;

13. The insured's guardian's bank account information for the beneficiary to receive the claim payment.

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Accident insurance is a type of insurance that pays financial compensation for personal or economic injury or loss caused by an accident.

Accidental injury refers to the injury to the body caused by an external, sudden, unintentional and non-disease objective event as a direct and isolated cause.

When an accident occurs, you can refer to the following steps:

2. After being hospitalized in an accident or incurring other expenses, keep the hospital hospitalization voucher, diagnostic information, expenditure procedures, etc.;

3. The policyholder submits the above evidence to the insurance company, and the insurance company will review and determine the relevant information, and there will be specific results.

1. How to compensate for accident insurance.

1. If the insured dies due to an accident, the insurance company shall pay a lump sum compensation for the death insurance in accordance with the contract. Usually, the insured's physical condition 180 days after the accident is used as the compensation standard, that is, if there is no death within 180 days, the compensation will be made according to the disability level;

2. If the insured is disabled due to an accident, the insurance company shall pay the disability insurance benefit according to the degree of disability;

3. If the insured needs to pay medical expenses due to an accident, the insurance company shall pay the medical insurance benefits according to the provisions of the insurance contract and the actual medical expenses;

4. If the insured is unable to work or loses his job due to an accident, the insurance company will pay a stoppage allowance.

2. The concept of personal accident insurance.

Personal accident insurance, also known as accident insurance, is also known as personal accident insurance. It refers to an insurance in which the policyholder pays a certain amount of premium to the insurance company, and when the insured suffers an accidental injury during the insurance period and dies or becomes disabled as a direct cause, the insurance company pays a certain amount of insurance money to the insured or beneficiary in accordance with the provisions of the insurance contract. It is short-term, flexible and has low premiums.

3. Elements of personal accident insurance.

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 refer to accidents that the insured did not expect and did not intended, such as aircraft crashes, etc., and some accidents that can be foreseen or avoided but cannot be avoided due to irresistibility or performance of duties, should also be included in the scope of "accidents", such as the ship caught fire and was forced to jump into the sea to escape, and was injured in the fight with gangsters.

4. Non-disease, the injury caused by the disease, although it is not expected by the person in advance, but it is the result of the human body itself, and it 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 hurt the body, the fact of injury is not established).

The above is an introduction to "how to compensate for accident insurance", which mainly introduces the compensation of personal accident insurance, as well as the concept of personal accident insurance and the elements of personal accident insurance, I hope it can help you.

Accident insurance is divided into accidental medical treatment and accidental dismemberment.

Accidental medical treatment is based on medical expenses, keep invoices and reimburse them to the insurance company.

Accidental disability claims are made to the insurance company based on the level of disability.

Claims are made accordingly according to product liability, and accident insurance generally does not have an observation period.

Accident insurance compensation generally consists of four steps: reporting, investigation, review and negotiation, and claim settlement.

1. Report the case: After the insured has an insured accident, contact the insurance company and report the case in a timely manner.

3. Review and negotiation: The insurance company will review the materials to ensure that there is no insurance fraud. If the insured or his or her family disagrees with the insurance company's compensation amount, the two parties may negotiate or go to court to file a lawsuit.

4. Claim: When the insurance company passes the review and the two parties reach an agreement on the insurance money, the insurance company will issue the insurance money.

Materials required for personal accident insurance claims:

1. Insurance policy, list of insureds or other insurance certificates;

2. Proof of identity of the insured;

3. Other certificates and materials related to the confirmation of the nature, cause, and degree of injury of the insured accident;

4. Medical expense invoices, hospitalization settlement schedules, and medication lists;

5. Outpatient medical records, diagnosis certificates, discharge certificates, transfer certificates and related examination reports issued by the hospital;

6. Other materials according to the policy or the insurer according to the situation.