Medical insurance bureau how to investigate their own accidental fall

Surveys are carried out by the county's NPS Supervisory Section by asking the relevant people who were there, or relatives who took the patient to the hospital, or the exact location of the injury, which is verified to be eligible for reimbursement. A field survey is conducted in order to find out if it is covered by the reimbursement, and then the rate of reimbursement for trauma patients is determined based on the demographic facts of the area. Accidental injuries involving a liable party are not reimbursed, and the NICC has to exclude these factors through the survey, and there is no payout and liable party to be reimbursed.

Medicare Bureau to investigate their own accidental fall way, as follows:

1, accidental injuries if the accident involved in a more complex, serious nature, the amount of claims is large, the insurance company will investigate, usually commissioned by an authoritative third-party professional investigation company, which is also designed to reduce the risk of claims, so as not to be fraudulent insurance;

2, the investigation is the county NPS Supervisory Section Implemented by asking the relevant people who were at the scene at the time, or relatives who took the patient to the hospital, or the specific location of the injury, after verification, meet the reimbursement conditions can be reimbursed. A field survey is conducted in order to find out if it is covered by reimbursement, and then the percentage of reimbursement for trauma patients is determined based on local demographic facts. Accidental injuries involving a liable party are not reimbursed, and the NICC is reimbursed only when these factors must be excluded through the survey and there is no payout and liable party.

3, door-to-door verification. Trauma patients hospitalized in medical institutions, must pay the full amount of medical expenses, to be audited to confirm the scope of payment of medical insurance fund before entering the medical insurance system settlement. Medical insurance agencies, medical institutions audit, require the insured units, villages, public security departments and other traumatic injury certificate, explaining the cause of their injuries, and to prove that there is no third party responsible for the settlement of the medical insurance system before they are allowed to enter the medical insurance system.

4, for accidental fracture, the medical insurance bureau investigation is carried out by the county new rural cooperative supervisory section, ask the relevant personnel at the scene or send the patient to the hospital relatives, ask the specific location of the injury, the matter, after verification, meet the reimbursement conditions can be reimbursed.

How to compensate for work-related injuries

Work-related injuries can be compensated for: medical treatment of work-related injuries; the cost of installing auxiliary aids; the original salary during the period of leave of absence without pay, where the unit will be paid on a monthly basis for up to twelve months; the employee assessed the level of disability, the enjoyment of the disability treatment; the enjoyment of payment of the cost of living care on a monthly basis, the standard of the employee's average monthly salary of fifty percent, forty, thirty.

I hope the above can help you, if you have other questions please consult a professional lawyer.

Legal basis: "Chinese People's *** and State Social Insurance Law"

Article 12 of the employer shall, in accordance with the state regulations of the proportion of the total wages of the employees of the unit shall pay the basic pension insurance premiums, credited to the basic pension insurance co-ordination fund. Employees shall pay the basic pension insurance premiums in accordance with the proportion of their own wages prescribed by the State and credited to their individual accounts. Individual industrial and commercial households without employees, part-time workers who do not participate in basic pension insurance with their employers, and other flexibly employed persons who participate in basic pension insurance shall pay basic pension insurance premiums in accordance with the state regulations, which shall be credited to the basic pension insurance general fund and the individual account respectively.

Article 60 Employers shall declare themselves and pay social insurance premiums in full and on time, and shall not defer or reduce them except for force majeure and other legal reasons. Employees shall pay social insurance premiums by the employer withholding, the employer shall pay social insurance premiums on a monthly basis to inform the details of the person. Individual entrepreneurs without employees, part-time workers who do not participate in social insurance with the employer, and other flexibly employed persons can pay social insurance premiums directly to the social insurance premium collection organization.