1. What is critical illness insurance?
Critical illness insurance refers to a commercial insurance behavior in which the insurance company pays the insurance money according to the insurance contract when some major diseases such as malignant tumor, myocardial infarction and cerebral hemorrhage occur as risks and the insured reaches the state of major diseases agreed in the insurance clauses.
From 2002 1 February1day, the insurance products defined by the old version of critical illness will be completely removed from the shelves. According to the new regulations, some diseases will be paid according to the severity, and the insurance can be renewed, and the number of diseases paid has also increased. The new regulations of critical illness insurance introduce the definition of mild illness for the first time, and divide the three core diseases of malignant tumor, acute myocardial infarction and stroke sequelae into two grades according to their severity, and determine the upper limit of the proportion of insurance coverage for these three minor diseases as 30% of the total insurance coverage.
Two. Function of critical illness insurance: 1. Resist risks:
Critical illness insurance, in short, is disease insurance with illness as the condition of paying insurance money. That is, as long as the insured suffers from a certain disease listed in the insurance clause, regardless of whether or not medical expenses occur or how much expenses occur, he can get the fixed compensation from the insurance company. The "serious illness" covered by critical illness insurance usually has the following three basic characteristics: First, the "serious illness" will seriously affect the normal work and life of patients and their families for a long time; Second, "the cost of treatment is huge", such diseases need to be treated with more complicated drugs or surgery, and expensive medical expenses need to be paid; Third, it is not easy to cure for a long time, or even permanently. The insurance money paid by critical illness insurance mainly has two purposes: one is to pay the high medical expenses incurred by the insured due to illness, disease state or surgical treatment; The second is to provide financial security for the insured after illness, and try to avoid the insured family from falling into financial difficulties.
You can only get compensation if you meet the terms of the insurance contract.
After buying critical illness insurance, if you go out after the waiting period and need to meet the disease type, degree of illness, treatment method and specified time in the insurance contract, you can get the compensation from the insurance company at one time. On the one hand, there is no need to advance medical expenses after illness, and more importantly, it can reduce the burden of personal medical expenses.
Step 3: ear tag
Insurance protection is a process, not a fragment. Under the same terms, everyone is equal. There is no doubt that the safeguard function of critical illness insurance in the early stage makes insurance companies bear huge risk opportunities. Because the risk of serious illness is unpredictable, no one can say when he will get sick. We can't wait until the fourth steamed bread is full to complain that the first three steamed bread should not be eaten, and we can't eat the fourth steamed bread at the beginning.
4. Everyone is suitable.
(1) Social security only reimburses medical expenses caused by diseases, but medical expenses caused by accidental injuries cannot be reimbursed; Social security does not pay for accidental injuries and accidental medical responsibilities during non-work; Regardless of accidental death or illness, social security has no compensation for death. After death, only the amount of personal account at that time is returned, which is very small.
(2) China's social security reimbursement or unit reimbursement is first of all a concept of expenditure before compensation, that is to say, even within the scope of compensation, how much you have to spend before you can reimburse on this basis, and the amount we reimburse will not be greater than the total expenditure. Imported drugs and nutritional drugs that are not on the list of publicly-funded medical drugs cannot be reimbursed.
(3) The social medical co-ordination fund is "guaranteed but not helpful" to medical insurance personnel. Social security has the limitation of deductible, and the expenses within the limit need to be paid by themselves. The proportion and amount of hospitalization expenses and serious illness medical care are relatively high.
(4) Social security focuses on security, and the payment standard is based on ensuring the basic life of the insured. It is not enough for people who pursue high quality.
Therefore, for people without medical insurance, critical illness insurance is particularly important. For people with medical insurance, critical illness insurance can be a necessary supplement. [3]