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Data:2009-12-12 2:34
Repeated at different companies similar to medical insurance coverage is not uncommon, these claims for the insured eager to be able to enjoy double protection that can often many policyholders are unaware of their cost of insurance is the type of insurance reimbursement or allowance-based insurance . Led to more than Paul, although more than pay the premium and did not play a more practical role,花了冤枉?
Zhuhai public Jiang Yong-Yun is a small business owner for many years, the business done over the years steadily Dangdang, there is no social security in 2004, she purchased a business for their own medical expenses insurance to protect their own high medical expenses under the disease . However, Jiang Yong-yun, or feeling of heart not at ease. In early 2005, another insurance agent's repeated recommendation, Jiang Yong Yun has bought a personal hospitalization expenses insurance. In fact, the scope of the two declarations or less protection, but there are some minor differences. However, Jiang Yong Yun feel that two-pronged approach, and my heart at ease a lot.
Days of unpredictable things can happen one day in August 2005 at midnight blowing a typhoon, Jiang Yong-Wan remembered not closed the window, standing on her stool accidentally closed the window, lost balance and fell down from a high stool. Worst of all, Jiang Yong Yun head first touch the ground, the first inner product a lot of congestion. Situation is very serious surgery Jiang Yong Yun is also a hospital, treatment, rehabilitation of more than a month before.
The face of high treatment costs, and nearly 5,000 imported drug costs, Jiang Yong Yun thought to myself forward to: According to the insurance company the insurance provisions, and only used to treat the insured person for medical expenses in line with publicly-funded health care, labor claims and the reimbursement conditions of social health insurance , the insurance company will compensate some imported medicines in the declaration form is expressly shall not be reimbursed. But he has two medical insurance, two insurance companies for compensation should be sufficient to cover medical expenses not reimbursed the cost of imported drugs.
In October 2005, Jiang Yong-yun after discharge from hospital and went to the first insurance claims, insurance companies, to quickly compensate the medical expenses compensation insurance premium more than 6000 yuan, hospitalization subsidies, costs 1,000 yuan. Later, Jiang Yong-Wan went to another insurance company to apply the same claims, however, replied that this insurance, medical insurance claims can only be within the first outside company has claims that part of the amount, must register only a few dozen yuan.
Jiang Yong-yun so that different companies, to repeat a similar health insurance coverage is not uncommon. This does not mean you can repeat the claims in different companies. Do not understand insurance, Jiang Yong-yun on the wonder, and his two declarations cast took different money, do not get double protection, would not it injustice?
It is understood that the medical insurance on the market today, there are two: one is the type of insurance reimbursement, a type of insurance is a subsidy. Reimbursement-type insurance according to the actual medical expenses claims, follow the principle of compensation insurance. That is, when the insured person's medical expenses have been in one place, such as other insurance companies, or social security, or the unit for reimbursement, after compensation, you can not exceed the actual expenditures from the insurance company to obtain compensation for the excess. Pro rata payment of medical benefits does not apply to those types of insurance, benefits-based insurance is not necessary to follow the principle of compensation, which are generally real real indemnity insurance. As long as surgery or hospitalization occurs, you can file a successful claim from the insurance companies; if the insurance companies, you can receive compensation payments from the companies, no matter how many copies have to pay the insured. In addition to grant-based insurance can buy multiple copies without restriction other than life insurance in the major diseases, there is no duplication of insurance, the insurance amount is not capped, as long as you are willing to pay premiums, you can buy a higher amount of insurance.
Jiang Yong-rhyme can be insured medical expenses insurance are two types of insurance reimbursement. In accordance with "Insurance Law" stipulates that the nature of insurance reimbursement payment amount shall not exceed actual costs. Repeated claims of medical costs, the insurers are generally paid in accordance with the ratio. Jiang Yong Yun carried out first in which an insurance company claims, the insurance company will be stamped receipts for all expenses, and in the hospital out of the total cost indicated on a single company name, payment amount and date specific. Finally, together with the policy, claims and documentation with the list returned to Yung-Yun Kang. When Jiang Yong Yun took over the documents have been claims to the second insurance claims, insurers will be based on specific terms of the contract, the actual medical expenses, after deducting the amount paid has been paid. Therefore, the total amount of payment will not exceed actual costs. In fact, Jiang Yong Yun in the second part of the company's medical insurance to repeat the insurance, that is, more than Paul, although more than pay the premium and did not play a more practical role.
Jiang Yong-yun at the same time if the two insurance companies in the subsidy-based insurance, the two companies will be the amount specified in accordance with the contract payment in full, without regard to whether other companies had also received similar claims in nature.
After the lesson, Jiang Yong Yun regretted insured, there is no detailed understanding of the nature of declarations, leading to spent a lot of money wasted. In December 2005, Jiang Yong-wan, professional advice, have been carefully examined his two insurance protection. Cost reimbursement type of health insurance insurance companies in a just one is enough to subsidize insurance scheme for more than type it anyway. Jiang Yong Yun So insurance companies in the second house of personal insurance, hospitalization costs to stop the part of the premium savings to turn into a subsidy-based health insurance in order to play a greater role.
The insured in the insured medical expenses compensation insurance, to measure their specific circumstances, not to duplicate insurance costs caused by waste. Although the medical insurance subsidy program may be multiple claims, but also according to their income and the actual situation to decide, generally the same level of income and their own principle.
Tips:
China's "Insurance Law" states: duplicate insurance means insurance policyholders on the same subject matter, the same insurance benefits, the same insurance, accident insurance, respectively, two or more entered into insurance contracts of insurance. Many medical expenses insurance, the insured did not know where the compensation principle, repeat the insurance has become "more money does not please the" matter.
Repeat purchase of medical insurance claims costs based method:
One at the same time have a social health insurance, according to the social security takes precedence over the principle of commercial insurance should be paid by the social health insurance, the insurance company for medical expenses for the remaining part of the claims.
2, for third party liability, such as traffic accidents, other injuries, etc., under the "Civil Law" requirement, it should be by a third party payment of medical expenses, the remaining part by the victim's medical expenses (such as traffic accidents to determine the book to determine 30% of the victims bear the responsibility), in accordance with the terms of the insurance claims.
3, for the employer to pay medical expenses, personal insurance, when deemed as social insurance. For the employer group insurance, and can provide reasonable compensation from the insurance company.
4, as in other insurance companies insuring the same time, medical expenses insurance, the insured person shall be issued by the insurance information of other companies, in principle, the amount to be apportioned in accordance with the insurance and assume liability insurance. As in other companies have claims, applicant is required to provide medical expenses, or a copy of the original invoice (required by the insurance company to save the original invoice issued certificates and payment of medical expenses related to the number). Of course, you can advance at another insurance company claims, according to the insured person a statement to other companies to provide relevant evidence, medical expenses, invoices or copies of, and indicate the amount of claims. Even if the insurance companies are not paid, it still indicated.
5, as in the other series the same time, insurance companies insured medical expenses insurance, in principle, the light of the implementation of Article IV. But can also be based on customer requirements, be thoroughly in any one series of claims.
