How much can Pingmei workers claim for cancer in 2014 when they get serious illness insurance?

Generally, the sum insured of critical illness insurance is between 100,000 and 200,000, and the compensation is standard, and the compensation of critical illness insurance is a one-time payment. However, it is important to remind patients that their cancer is not covered.

Claims for critical illness insurance are relatively simple, and you can generally get a full claim once you are diagnosed, but there are also some products on the market that do not get a full claim once you are diagnosed. It is understood that a small number of critical illness insurance products will only pay a part of the insurance after diagnosis.

The remaining part should be paid after the death of the insured, which may affect the subsequent claim of the insured, so you should ask about the claim method of the critical illness insurance product before applying for insurance.

1) The minimum payment line is 8,000 yuan: excluding the personal expenses below the basic medical insurance threshold, it should include the civil affairs preferential care subsidy and the amount of medical assistance for poor patients, and the part of the personal burden below the basic medical insurance reimbursement threshold standard for each hospitalization of low-income households, special poverty preferential care recipients, and rural five-guarantee households is included in the threshold standard for reimbursement for serious illnesses. The starting line of 8,000 yuan is an annual deductible, which can only be deducted once a year.

2) The compensation standard implements the method of "segmented proportion, from low to high, progressive compensation": the segmented proportion is %, of which: 8,000 yuan to 30,000 yuan (inclusive) compensation is 50%, 30,000 yuan to 50,000 yuan (inclusive) compensation is 60%, and more than 50,000 yuan compensation is 70%.

3) Not included in the scope of reimbursement of critical illness insurance: The medical expenses incurred in non-designated medical institutions in the province and non-public hospitals outside the province are not included in the scope of reimbursement of critical illness insurance. The medical expenses incurred in the abnormal referral of designated medical institutions in the province and the medical treatment in public hospitals outside the province shall be included in the calculation of the self-borne compliant medical expenses of the serious illness insurance at a rate of 60% after being reimbursed by the basic medical insurance in accordance with the relevant policies.

4) The maximum amount of reimbursement for critical illness insurance: The maximum annual compensation amount of critical illness insurance is 500,000 yuan per person per year.

5) For accidental injuries and traffic accident self-injuries without third-party liability, the full amount of compliant out-of-pocket expenses of participating residents shall be included in the coverage of critical illness insurance after compensation by basic medical insurance**; The cost of large-scale materials implanted in the body is within the range of 30,000 yuan, and the cost after the basic medical insurance** compensation is fully included in the coverage of the serious illness insurance, and the part exceeding 30,000 yuan will not be compensated. The above-mentioned compliance expenses of insured urban residents shall be included in the scope of critical illness insurance in accordance with the existing relevant policies.

You can check your insurance contract for details, but the CIRC stipulates that the first 25 diseases in critical illness insurance are the same, including malignant tumors, acute myocardial infarction, sequelae of stroke, major organ transplantation or hematopoietic stem cell transplantation, coronary artery bypass grafting or coronary artery bypass grafting, end-stage renal disease, multiple limb loss, acute or subacute severe hepatitis, benign brain tumor, decompensated chronic liver failure, sequelae of encephalitis or meningitis, deep coma, Deafness in both ears, blindness in both eyes, paralysis, heart valve surgery, severe Alzheimer's disease, severe brain injury, severe Parkinson's disease, severe burns, severe primary pulmonary hypertension, severe motor neuron disease, loss of speech, severe aplastic anemia, aortic surgery.

Reimbursement of Critical Illness Medical Insurance: Critical illness insurance for urban residents is a system that provides further protection for the high medical expenses incurred by patients with serious illnesses on the basis of basic medical security, and the reimbursement of critical illness insurance is settled once a year. At the same time, six medical out-of-pocket expenses can be reimbursed.

Employee medical insurance and cooperative medical care can be reported, but the reimbursement ratio is low, but also to subtract the deductible, it is best to attach a critical illness insurance and commercial medical insurance, the former is diagnosed with immediate compensation, the latter is the employee medical insurance or cooperative medical reimbursement after the reimbursement, the remaining part of the 10,000 deductible, can be fully reimbursed, the economic loss to the minimum.

It's okay to answer kissing. Hospitalized cancer patients can apply for serious illness medical insurance, and the coverage of serious illness medical insurance: 1. The coverage of critical illness insurance is connected with urban residents' medical insurance and NCMS, and urban residents' medical insurance and NCMS provide basic medical security according to the policy provisions.

2. The high medical expenses shall be determined by the annual cumulative compliant medical expenses borne by the individual exceeding the annual per capita disposable income of urban residents and the annual per capita net income of rural residents announced by the local statistical department in the previous year, and the specific amount shall be determined by the local government.

3. Compliant medical expenses refer to the actual and reasonable medical expenses (items that may not be paid), which are determined by the local government.

I also hope that you will not lose confidence, you must be positive, there is always hope in life, I hope you will be as soon as possible.

Social health insurance reimbursement is reimbursed after discharge or transfer.

Settlement procedures for inpatient and special disease outpatient**:

Before the 10th of each month, the designated medical institutions shall report the cost statement, hospitalization statement and relevant information of the discharged patients in the previous month to the medical insurance agency, and the medical insurance agency shall review and use it as the basis for monthly pre-allocation and year-end accounts;

The medical insurance agency pre-allocates the overall expenses of the previous month's inpatient and special disease outpatient clinics** every month;

Insured persons who have been identified as suffering from special diseases shall go to a designated medical institution designated by the labor and social security department to seek medical treatment and purchase medicines, and the medical expenses incurred shall be directly billed and settled immediately.

Under normal circumstances, China Coal Insurance's auto insurance claims are quite fast.

Only the insurance company needs to further confirm the actual claim status of the car before the claim process can be carried out. The premise of the fast claim process for car insurance is that the compensation amount is within 5,000 yuan, and both parties have no traffic violations such as drug driving and drunk driving, and the documents are complete. The owner's vehicle was not significantly damaged.

It generally takes about a week for China Coal Insurance to settle a claim.

China Coal Insurance Claim Process:

Claims reporting and forensics.

All units or project departments that have suffered losses due to accidents at the scene should report directly to the on-site insurance working group of the project management department, and at the same time take necessary measures to prevent further expansion of losses, personnel should be arranged to protect the accident site, and before the insurance company conducts an investigation, the status of the accident scene and relevant physical evidence should be retained, and evidence collection should be carried out within their capabilities. For example, taking pictures of the scene, recording the testimony of the parties and eyewitnesses, etc.

Work of the Working Group on Insurance.

After receiving the accident report, the on-site insurance working group shall immediately carry out the following work items:

Notify the insurance company and the insurance management personnel of the project management department in the form of ** and "Notice of Accident" (P01-30-B1), briefly explain the subject of loss, time, place, cause, location, loss status and the implementation of the emergency plan, etc., and form a "loss table" (P01-30-B2) to record the accident loss. After the "Notice of Insurance" is issued to the insurance company by email or fax, it should be contacted for confirmation.

Complete the "Accident Report" (using the standard format text of the insurance company) within 24 hours of the accident and submit it to the person in charge of the insurance company's on-site accident. Cooperate with and assist the insurance company to deal with the aftermath of the on-site accident.

After receiving the accident report from the on-site insurance working group, it should immediately contact the service organization agreed by the insurance company (if it is jointly insured by multiple insurance companies, it should contact the agreed service organization of the chief insurance company) to confirm that the insurance company has received the notice of accident and has arranged personnel to go out of insurance, and rush to the scene of the accident as soon as possible to carry out the following work:

Review and confirm the "Notice of Insurance", "Loss Table", "Accident Report" and "Notice of Claim" (using the standard format text of the insurance company); Assist and coordinate the insurer or adjuster to conduct on-site investigation and evidence collection; Separate records of the costs incurred in each claim case; Organize the relevant parties to collect the documents required for the insurance claim.

In the process of adjustment between the insurance company and the adjuster, fully communicate with the insurance company and the adjuster on the principle of claim settlement; Convene and participate in coordination meetings chaired by other parties as needed.

People were sent to the hospital, China Coal Insurance Company did not see a fly flying over, four months, September 28 I went to Handan China Coal Insurance Company, only to know that my friend gave me a large company a total of 100 square meters of China Coal Insurance Company, China Coal Don't lie to people, close the door, close the door, don't harm people.

Very fast, the truck and my bus collision accident, the truck is fully responsible, the truck insurance company is China Coal. Don't lose money, don't set the price, come to shoot ** and let you ship the repair shop to price, the repair shop will send the goods, set the price, Yutong bus electric reversing mirror + sheet metal painting + working hours a total of 1200 yuan He said that it is not the original factory, only give 1000, let the insurance company send an original factory to me to see, he said that there is no service, and then send a message to **ignore it, just a sentence, you can't sue the insurance company. It's a powerful insurance company, the key is to hear the name of this insurance company for the first time, it is estimated that it is also a large company, and many people know it for fear that the name is too loud.

China Coal Insurance Company, everyone should not buy, the reputation is low, there is no service. I am the victim, and the owner of the car is fully responsible for the accident. During the hospitalization, the insurance company did not take the money, and other large insurance companies respected the law for the same accident in the ward, paid the hospital, and reported how much money was spent, but I didn't have a penny, and China Coal Insurance ignored it.

Afterwards, the insurance company thought about it and avoided the claim or underpaid it. Now that the court has decided the case, ignoring the law to evade the claim, my victim has not taken a penny for two years. China Coal Insurance is too shameless.

I'm helpless, wait! Don't try to save money to buy China Coal Insurance.

In other words, China Coal Insurance did not deal with the rear-end claim accident for me for a month, and the accident occurred in early October, and the claim was issued at the end of October.

Hello, it is advisable to ask the insurance company.