1. The insurance company needs to determine the compensation amount according to the traffic accident certificate, the injured person's situation, the medical expense invoice and the disability grade appraisal opinion.
2. The insurance company only pays claims within the scope of compensation that the insured needs to bear;
3. Medical expenses, hospitalization expenses, transportation expenses, nursing expenses, hospital food subsidies, nutrition expenses, lost time, death compensation or disability compensation, funeral expenses, spiritual comfort, living expenses of dependents, follow-up treatment expenses, assistive devices and appliances are all within the scope of insurance claims.
Second, the compensation standard of the traffic accident certificate
1. How to calculate the compensation for mental damage: If the victim or a close relative of the deceased suffers mental damage and the obligee requests compensation for mental damage from the people's court, it shall be determined according to the Interpretation of the Supreme People's Court on Several Issues Concerning Determining the Liability for Compensation for Mental Damage in Civil Torts.
2. How to calculate the compensation fee: The compensation obligor shall compensate the victim for personal injury caused by missing work, expenses incurred by seeking medical treatment and reduced income, including medical expenses, lost time, nursing expenses, transportation expenses, accommodation expenses, hospital food subsidies and necessary nutrition expenses.
3. How to calculate the medical expenses: The medical expenses are determined according to the receipt vouchers such as medical expenses and hospitalization expenses issued by medical institutions, combined with relevant evidence such as medical records and diagnosis certificates. If the obligor for compensation disagrees with the necessity and rationality of the treatment, he shall bear the corresponding burden of proof.
4. How to calculate the lost time fee: The lost time fee is determined according to the lost time fee and income of the victim.
5. How to calculate the nursing fee: The nursing fee is determined according to the income of nursing staff, the number of nurses and the nursing period.
6. How to calculate the transportation fee: The transportation fee is calculated according to the actual expenses incurred by the victim and his necessary accompanying personnel for medical treatment or transfer to hospital for treatment. Transportation expenses should be based on official bills; Relevant credentials shall be consistent with the place, time, times and frequency of medical treatment.
7. How to calculate the hospital food subsidy: The hospital food subsidy can be determined by referring to the standard of food subsidy for ordinary staff of local state organs.
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