Does mutual insurance not cover claims
Lawyer's analysis:
Problems in claims settlement of mutual insurance
Mutual insurance is an institutional arrangement based on the mutual protection of members. Its idea is to gather a group of people with the same beliefs and pursuits to achieve the purpose of common protection by sharing risks and supporting each other. The emergence of this kind of mutual insurance business aims to overcome the limitations of the traditional insurance industry in many aspects, such as the scope of protection and payment of fees, and is committed to providing more extensive and diversified insurance protection for the general public.
Legal basis:
Article 28 of the Social Insurance Law: Medical expenses that meet the requirements of the basic medical insurance drug catalogue, diagnosis and treatment items, medical service facility standards, and emergency and rescue shall be paid from the basic medical insurance fund in accordance with national regulations.
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