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意外门急诊理赔文件

来源:本站 最后更新:2019-10-24 13:19:23 作者:佚名 浏览:5225次

意外门急诊理赔

Accidental Injury Outpatient & Emergency Department

医院Hospital

1. 就医时请选择公立医院、普通科室。

   私立、合资医院、特需、国际门急诊、外宾病房、VIP病房、医疗整形美容科、康复科、干部病房、包间、单间、包床、挂床等情况不能理赔报销,

 

  2. Please go to Public Hospital, Normal Department . 

     Private and joint-venture hospitals, special needs, international outpatient and emergency department, foreign guests' wards, VIP wards, medical plastic surgery and cosmetic department, rehabilitation department, cadre wards, private rooms, single rooms, packaged bed and hanging beds are not eligible for reimbursement. 

 

发票、病历Invoice & Medical Record

1. 每次就诊时,请收集有效发票原件并务必提醒医生书写详细的就诊记录/病历。

  收费发票日期与门急诊病历所记载的就诊日期一致,且发票和病历上姓名与护照姓名中某个字段一致,不一致时到医院收费处变更或找留办老师开具《姓名证明》,发票为中文名的,《保险理赔申请书》上须标注中文名。 

 

 2. Every time you go to hospital, please collect every valid original invoices and ask doctor to write medical records for you. 

The billing invoice date is consistent with the medical treatment date recorded in the outpatient and emergency medical records, and the name on the invoice and medical records is consistent with a field in the name of the passport. In case of any inconsistency, please change the name at the charge office of the hospital or ask the teacher who holds the office to issue the name certificate. If the invoice is in Chinese name, the Chinese name shall be marked on the application form for insurance claims.  

 

意外伤害医疗保险责任介绍:

  1. 意外伤害医疗保险责任

   被保险人因遭受意外事故,并自事故发生之日起 180 日内进行治疗,保险人就其实际支出的合理且必要的医疗费用按 100%给付意外伤害医疗保险金,累计给付金额以20,000元为限。被保险人不论一次或多次发生意外伤害保险事故,保险人均按上述规定分别给付“意外伤害医疗保险金”,但累计给付金额以不超过该被保险人的保险金额为限,累计给付金额达到其保险金额时,对该被保险人的该项保险责任终止。即:如因磕伤、烧烫伤、崴脚、切菜不小心切着手、猫狗抓咬伤等等造成意外伤害事故的。

  2. 报销公式

合理费用合计*100%=可报销金额(合理费用合计不含当地社会基本医疗保险规定的自费及部分自费费用)。

 

Medical Insurance for Accidental Injury claim:

  1. Medical Insurance for Accidental Injury

  If the Insured, who suffers from the accidental incident, receives medical treatment within 180 days since the occurrence of the accident, the Insurer shall be liable for the full amount of the reasonable and necessary expenses actually paid by the Insured for the medical treatment, but the accumulative amount of payment shall not exceed RMB 20,000. Whether an accidental injury happens to the Insured for once or several times, the Insurer shall pay the “medical insurance for accidental injury” respectively in accordance with the aforesaid provisions, but the accumulative amount of payment shall not exceed the insured sum of the Insured. When the accumulative amount of payment reaches the insured sum of the Insured, the said insurance liability for the said Insured shall be terminated. For example, the accidental injuries such as bruises of bumps, burns, sprained ankle, accidental cut- wound when cutting vegetables, scratches and bites by cats and dogs.  

  2. Reimbursement equation

 total amount of reasonable expenditure * 100%=reimbursable amount (the total amount of reasonable expenditures shall exclude the self-paid or partly self-paid items and expenses stipulated by the local regulations of the social basic medical insurance)

 

申请理赔所需提交资料清单:

  1. 理赔/垫付申请及委托书(需学生手写签字、院校盖章)
  2. 护照首页复印件
  3. 所有发票原件
  4. 所有病历(需提供每天就医病历)
  5. 银行账户信息(请携带护照和银行卡去银行打印客户信息表,该表内容需包括,准确的户名、
  6. 卡号、银行名称)
  7. 意外伤害证明(学生本人签字或留学生办公室盖章,意外证明中要写清受伤过程(包括什么
  8. 时间、在哪里、因为什么导致受伤、伤到哪里); 如因交通事故受伤,还需提供交通事故认定书
  9. 原件(盖红章)
  10. 联系方式(请写明您的联系电话和邮箱地址,并建议提供留学办公室或负责老师的联系电话。)

 

List of materials required for claim:

  1.  Reimbursement Application Form (Insured’s handwritten signature & school stamp are required.)
  2.  Copy of your passport
  3. All original invoices
  4. All the medical records (Provide daily medical records.)
  5. Bank account information (You are required to go to the bank with your passport and debit card, ask the staff there to print the account information for you. The information should include: account name, account number and sub-branch name.)
  6. Accident Report (Please write a report to show us clearly where, when and how you get  injured. Your clear handwritten signature is required. If you have a traffic accident, you also have to write if you call the police and get any compensation from the third party. If you call the police, we also need the certification from the police.)
  7. Contact Information (Please write your contact number and e-mail address on a piece     of paper. You are also suggested to provide contact in

 

理赔资料快递地址Postal address

收件人Recipient:来华项目组,

地址Address:北京市西城区金融街23号平安大厦9层,

电话Tel400-810-5119                  

 

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