What's the difference between social insurance and commercial insurance?

First, the difference between social security and commercial insurance lies in:

1, management department: social insurance is managed by government functional departments; Commercial insurance is managed by enterprise insurance companies.

2. Payment standard: The payment standard of social security is not fixed and will increase or decrease with the development of social and economic level. Commercial insurance is a fixed payment, usually for up to 20 years.

3. Beneficiary: Social security pension has no beneficiary. If there is an accident in the middle, you may pay more than you pay. In any case, commercial insurance guarantees more money than it pays. Even if you don't get the required number of years, future generations can inherit a large amount of health insurance.

4. Exemption function: Social medical insurance cannot exempt premiums. When a major illness occurs, social medical insurance needs to continue to pay, while commercial insurance has an exemption function, and insurance companies pay the remaining premiums.

5. Responsibility: Social medical insurance has limited liability, and there are many uninsurable responsibilities, such as certain drugs (new drugs, imported drugs, expensive drugs, etc. ) and part of the diagnosis and treatment items are not within the reimbursement scope, traffic accidents, food poisoning, injuries caused by medical accidents or other responsibilities, and important organ transplants are not within the reimbursement scope, while commercial insurance can reimburse 65,438+000% of the insured amount, and

6. Reimbursement method: Social medical insurance is reimbursed afterwards (that is, it can only be reimbursed after discharge settlement), with a threshold fee (that is, the part below the deductible line will not be reimbursed) and a capping line (the excess part will be reimbursed according to a certain proportion). As long as commercial insurance is diagnosed as a major disease agreed in the contract, it can be paid according to the diagnosis certificate of the hospital, and no matter how many times it is paid, it will pay the insured amount and choose better medical equipment for the insured.

7. Social endowment insurance can only meet the needs of the minimum living standard, and it is uncertain to receive it every year. If you die unexpectedly before receiving it, you can only get back the money, funeral expenses and pensions in your personal account, and there is no other compensation; The amount of commercial insurance is up to you. It must be so much. There are also bonuses to fight inflation and make you richer in your later years. Even if the insured dies, not only the remaining premium will be paid by the insurance company, but also the family can continue to receive the pension!

8. Different coverage. Social security is complicated, and the degree of security varies greatly according to the specific situation, but it is insufficient in living security.

Second, the concepts of social insurance and commercial insurance:

1, social insurance:

Social insurance is a social and economic system that provides income or compensation for those who lose their ability to work, are temporarily unemployed or suffer losses due to health reasons. The social insurance plan is organized by the government, forcing a certain group to use part of its income as social insurance tax (fee) to form a social insurance fund. Under certain conditions, the insured can get fixed income or loss compensation from the fund. It is a redistribution system, and its goal is to ensure the reproduction of material and labor and social stability. The main items of social insurance include endowment insurance, medical insurance, unemployment insurance, industrial injury insurance and maternity insurance.

2. Commercial insurance:

Commercial insurance refers to the form of for-profit insurance operated by concluding insurance contracts, which is operated by specialized insurance enterprises. Commercial insurance relationship is a contractual relationship concluded by the parties voluntarily. The insured pays the insurance premium to the insurance company according to the contract, and the insurance company shall be liable for the property losses caused by the possible accidents agreed in the contract, or the death, disability, illness or reaching the agreed age and time limit of the insured. The so-called social insurance refers to a social security system that forms a social insurance fund by collecting insurance premiums to provide basic living security for members who lose their working ability or job opportunities due to old age, illness, maternity, disability, death and unemployment.

Third, citing legal basis:

Article 2 of People's Republic of China (PRC) Social Insurance Law

The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, so as to guarantee citizens' right to receive material assistance from the state and society in accordance with the law when they are old, sick, injured, unemployed and have children. Article 3 The social insurance system adheres to the principles of wide coverage, basic protection, multi-level and sustainability, and the level of social insurance should be compatible with the level of economic and social development.

Article 4 of People's Republic of China (PRC) Social Insurance Law

Employers and individuals in People's Republic of China (PRC) pay social insurance premiums according to law, and have the right to inquire about payment records and personal rights records, and require social insurance agencies to provide social insurance consultation and other related services. Individuals enjoy social insurance benefits according to law and have the right to supervise the payment of their own units.