There was a fight, and the other party was injured and hospitalized for treatment. I paid for the medical expenses, but I didn’t ask him for a medical bill, so I couldn’t go to the medical insurance center for reimbursement.
Fights and fights cannot be covered by medical insurance. Lost work time and lost work pay are determined based on the certificate issued by the medical institution where the victim received treatment.
The following items are not covered by medical insurance:
(1) Service items. (1) Registration fees, out-of-hospital consultation fees, medical record costs, etc.; (2) Consultation fees, expedited examination and treatment fees, roll-call surgery surcharges, high-quality and low-price fees, self-recruitment of special nurses and other special medical services.
(2) Non-disease treatment items. (1) Various beauty and bodybuilding items, as well as non-functional plastic surgery, orthopedic surgeries, etc.;
(2) Various weight loss, fattening, and height-increasing items; (3) Various health examinations; (4) ) Various preventive and health-care diagnosis and treatment items; (5) Various medical consultations and medical appraisals.
(3) Diagnostic equipment and medical materials. (1) Examination and treatment projects using large medical equipment such as positron emission tomography (PET), electron beam CT, ophthalmic excimer laser therapy equipment; (2) Rehabilitation using glasses, dentures, eyes, prostheses, hearing aids, etc. Sexual appliances; (3) Various health care, massage, examination and treatment equipment for self-use; (4) One-time medical use that cannot be charged separately according to the price departments of various provinces.
(4) Treatment items. (1) Organ sources or tissue sources for various types of organ or tissue transplantation;
(2) Other organ or tissue transplants except kidney, heart valve, corneal skin, blood vessel, bone, and bone marrow transplantation, ( 3) Orthopedic surgery for myopia; (4) Qigong therapy, music therapy, health nutritional therapy, magnetic therapy and other auxiliary treatment projects.
(5) Others. (1) Various diagnosis and treatment items for infertility (pregnancy) and sexual dysfunction; (2) Various scientific research and clinically verified diagnosis and treatment items.
According to Article 20 of the "Interpretations of the Supreme People's Court on Several Issues Concerning the Application of Laws in the Trial of Personal Injury Compensation Cases", "the lost work pay is determined based on the victim's lost work time and income status." The lost work time is based on the victim's acceptance Confirmed by a certificate issued by the medical institution where the treatment was given. If the victim continues to miss work due to injury and disability, the time missed from work can be calculated to the day before the disability date. "If the victim has a fixed income, the lost wages will be calculated based on the actual reduced income. If the victim does not have a fixed income, it will be calculated based on his average income in the last three years; if the victim cannot provide evidence to prove his average income in the last three years, he can Calculated with reference to the average salary of employees in the same or similar industries in the location of the court being sued in the previous year. ”