How to solve social insurance claims

Legal analysis: 1. Report the accident to the insurance company in time, and the adjuster will assist in arranging rescue and inform the follow-up claims process. 2. Confirm that the claim adjuster of the accident loss insurance company or the entrusted assessment institution or technical appraisal institution goes to the scene of the accident to investigate the accident and the loss, consult and preliminarily collect relevant evidence and materials, and confirm whether the accident belongs to insurance liability. 3. Submit the claim materials According to the contents of the insurance company's claim notice, submit all the materials required for the claim, and the insurance company will review and confirm the submitted claim materials in time. 4. Calculation and review of claims In the case that the submitted claims application materials are true and complete, the insurance company will accurately calculate and conduct internal review of insurance claims according to the insurance contract. 5. Indemnity Payment The insurance company shall notify the applicant in accordance with the provisions of the insurance contract and pay the indemnity in accordance with the agreed payment method.

Legal basis: People's Republic of China (PRC) Social Insurance Law.

Article 12 The employing unit shall pay the basic old-age insurance premium according to the proportion of the total wages of employees stipulated by the state and record it in the basic old-age insurance pooling fund.

Employees shall pay the basic old-age insurance premium in accordance with the proportion of wages stipulated by the state and record it in their personal accounts.

Individual industrial and commercial households without employees, part-time employees who have not participated in the basic old-age insurance in the employing unit and other flexible employees who have participated in the basic old-age insurance shall pay the basic old-age insurance premiums in accordance with state regulations and record them in the basic old-age insurance pooling fund and individual accounts respectively.

Twenty-third employees should participate in the basic medical insurance for employees, and employers and employees should pay the basic medical insurance premiums in accordance with state regulations.

Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.

Article 35 The employing unit shall pay the work-related injury insurance premium according to the total wages of employees and the rate determined by the social insurance agency.

Forty-fourth employees should participate in unemployment insurance, and employers and employees should pay unemployment insurance premiums in accordance with state regulations.

Fifty-third employees should participate in maternity insurance, the employer should pay maternity insurance premiums in accordance with state regulations, and employees do not pay maternity insurance premiums.