First, the scope of protection of employee accident insurance
Employee accident insurance is a kind of accident insurance, so the scope and conditions of payment are roughly the same as those of ordinary accident insurance. There are four types of employee accident insurance: death benefit, disability benefit, medical benefit and hospitalization allowance.
1. Payment for death. When the insured suffers an accidental injury resulting in death, the insurer pays the full amount of the insurance money, and the insurance contract is automatically terminated after the payment of the insurance money.
Disability benefits. When the insured suffers an unintentional injury resulting in disability, the insurer shall pay the disability insurance according to the degree of disability of the insured. It should be noted that disability payments are partial payments, and the maximum payment is limited to the amount of death payments.
3. Medical payment. Medical Payment refers to the medical expenses required by the insured for the operation of accidental injury, and the insurer shall pay the compensation according to the proportion. Medical claims are subject to a maximum limit and can only be paid as an addition to death and disability claims.
4. Payment of hospitalization allowance. When the insured suffers temporary loss of labor capacity due to accidental injury, the insurer shall pay the corresponding compensation.
II. Case presentation
Li works in a private enterprise, the salary is not high, but Li like the company’s working environment, and the company’s welfare security is very complete. In a business trip, Li in the field out of a car accident, medical expenses spent tens of thousands of, during hospitalization, Li can not work, less income. Li’s family to help him to the insurance company to apply for the insurance company to cover the accident insurance, the insurance company in the insurance contract without Li’s signature and refused compensation, let them and the company to consult, to obtain the company’s claims. Finally, Li’s family contacted the company and obtained the right to claim.
Three, pay attention to the insurance of employee accident insurance
The experience of small and small Li in the above case shows that the collective accident insurance should pay attention to the right to know of the insured, the designation of the beneficiary and the attribution of the right to claim. Employee accident insurance should also pay attention to the following issues:
1, pay attention to the degree of occupational hazards of employees. The degree of risk of employees in different companies is different, so the insurance company will determine the level of premium according to the degree of risk of occupation. You cannot deliberately hide or reduce the degree of risk at the time of notification.
2, to ensure that the insured person’s right to know. Although the insured employee accident insurance is the company’s collective purchase, but the beneficiary is each employee, so to protect each employee’s right to know the insurance situation, otherwise there will be disputes in the risk.
3, the employee turnover and other information should inform the insurance company. When the employee leaves the company, the company shall inform the insurance company, and then the insurance company shall stop the insurance of the employee’s insurance or the employee’s personal renewal.