Most consumers have a puzzle, and they already have a society medical insurance , if you buy again insurance company Of commercial insurance Can I get another compensation? Related to insurance department of a university expert I will explain this problem for you in detail.
social insurance The essential difference of commercial insurance. Social medical insurance, as a social welfare undertaking, has a non-profit nature. Secondly, the objects and functions of insurance are different. Commercial medical insurance takes natural persons as the insurance object, and its role is to ensure that the insured citizens have Accidental injury Or disease medical expense Certain economic compensation can be obtained to reduce the loss; Social medical insurance is mainly based on worker As the insurance object, the social insurance department or its entrusted unit will provide basic compensation when the laborer pays medical expenses for medical treatment due to illness.
In addition, their rights and obligations are equal relationship Different. The rights and obligations of commercial medical insurance are based on contract In terms of relationship, that is, the insurance company and policy-holder The right and obligation relationship between them is a reciprocal relationship of equivalent exchange, which is manifested as more investment and more insurance, less investment and less insurance, and no investment and no insurance. The right and obligation relationship of social medical insurance is based on labor relations. As long as workers fulfill their obligations to work for the society, they can enjoy social medical insurance benefits insurance premium The amount is not proportional, that is, the relationship between rights and obligations is not equal.
Compensation of commercial medical insurance, Brother Yunyang Taoge According to insiders, commercial insurance is mainly supplemented to social insurance in two situations:
First, major disease products. Serious disease products are generally paid upon diagnosis. I.e Insured The insured amount can be compensated once by virtue of the diagnosis certificate and pathological report issued by the hospital. This does not conflict with social insurance.
Second, medical insurance. At present, most life insurance companies sell medical insurance Additional insurance , and it is mainly aimed at the expense compensation demand of customer's inpatient medical treatment. That is, the remaining part of the social insurance after the insured goes to the insurance company with the necessary medical documents Contract terms Agreed compensation. Customers who need reimbursement for outpatient services are generally solved through group supplementary medical insurance. This insurance refers to group hospital insurance products purchased by enterprises or groups for their employees. The insurance company shall be responsible for the outpatient and inpatient medical expenses of the insured due to diseases and accidental injuries, and pay medical insurance benefits according to the principle of insurance loss compensation.
To sum up, there are two types of social insurance and commercial insurance. For the part of social medical insurance that has not been reimbursed, the customer can make corresponding compensation to the insurance company according to the type of insurance purchased and the contract.
Finally, Yunyang Taoge wanted to say that there are no real experts in the insurance industry, only those who are proficient in a certain field Old driver 。 Insurance is more sold by experience, and specialty is only an auxiliary tool, so finding an old insurance driver is more reliable than finding a so-called expert. A lot of experience is gained through practice or lessons, no one can teach and no place to learn! The older the insurance drivers are, the more timid and cautious they are. Because the more you experience, the easier it is to know the complexity of insurance. Insurance is not recommended when a product seems cheap. It's also common accident insurance It's also very complicated, let alone popular today Million medical insurance 。 Most people Medical insurance Accident insurance should be sold as cabbage. Brother Yunyang Taoge suggested being cautious in everything. Welcome to add Brother Yunyang WeChat 381249336 (QQ with the same number) learn and exchange together Insurance knowledge And share Insurance matching skills.
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