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Claims Procedure


  • pg 1
									Claims Procedure
(A) easy for health claims (b) Claim Service Highlights
Simplicity claims process
Faster claims processing application data table
Comprehensive services report notes
?Recipients Notes

(A) the health insurance claims easily
Insurance claims as an important part of the direct embodiment of
service related to the vital interests of each customer. PICC Health
Insurance Co., Ltd. As the first specialized health insurance company,
using a new claims model, the majority of health insurance is
committed to helping clients achieve easy claim. Has the following
1 simplicity
Application is simple: Just follow the insurance contract, the
relevant documents submitted by mail or directly to the company claims
department to complete the application.
Receive simple: many recipients to choose from. You can choose
according to their bank transfer, counter recipients way. For the
convenience of customers, the company commissioned to allow recipients
to others (need to fill out claim the power of attorney.)
If the claims made by mail the application to receive insurance money
by bank transfer, under normal circumstances can get your claim in the
2, dealing with rapid
Is committed, the case of simple closed 3 days, 10 days of
conventional closed the case, the special case of the facts are clear
and specific responsibilities as soon as closed.
3, good service
For claims decision, the company will notify you in writing, including
"claims notice of decision" and "a breakdown of
claims," and so on. On group insurance customers, the company
will report regularly to the insured to provide Peifu.
If your interpretation and decision on any questions or dissent, may
consult by phone or in writing for re-trial.

(B) Claim Service Highlights
1, the claims process

2, the claim application data table
Files should be prepared to apply the code project description
Insured out-patient medical 1,2,4,9 identification, beneficiary
identification and proof of the relationship
Certificate issued by the hospital diagnosis, prescription and medical
Certificate issued by the hospital diagnosis and medical history, such
as hospital treatment the insured must provide the certificate issued
by the hospital admissions and discharges
The original medical expense receipts and detailed list
Issued by the hospital accompanied by pathological microscopic
examination, blood tests and other scientific methods of disease
diagnosis certificate inspection reports
The provision of hospital stay issued by the medical records during
the intensive care unit
Operation proved
Insured issued by the hospital burn degree of physical disability or
Certificate of Authenticity
Accident proof (who advocate accident caused by an accident must
provide proof)
Issued by public security departments or hospital certificate of death
of the Insured
Cancellation of the insured household registration certificate
The insured person declared dead by a people's court should provide
proof of accident and the court declared dead missing the original
The company's request for confirmation insured with the nature, causes
and other information related to the other certificates and

Hospital charges 1,3,4,9
The amount of insurance at the general hospital 1,3,4,9,13
Intensive care at the amount of insurance 1,3,4,6,13
Surgery medical insurance 1,3,4,7,13
Critical illness insurance 1,5,9,13
Accident disability insurance 1,8,9,13
Disease death insurance 1,10,11,13
Accidental Death 1,9,10,11,12,13

3, the report notes
Please visit or other insurance after the accident promptly notify the
Company reported receiving department. Medical treatment occurred,
please notify within 72 hours, accidents and other major insurance
accident, please notify within 24 hours.
Notification to the person's name to escape from danger and ID number,
location and status of escape from danger, and contacts.
Notification methods can be telephone, fax, counter, letter, e-mail
National Service Phone: 4006695518
4, Application Notes
You can apply for claims made in the following ways:
Application letter: a letter in the envelope marked "Claim"
character, and carefully specify your customer number and name,
enclose the appropriate original evidence of accidents.
Counter to apply: In accordance with the relevant provisions of the
insurance provisions, to carry the appropriate proof of the accident
to the company for the original application materials
5 recipients Notes
Once your claims application review and approval by the Company, the
company claims will be made according to your application in the
selected manner of payment recipients, specifically in the following
If you choose bank transfer recipients way, the company through the
financial system directly to your designated bank account transfer
payments. Need your bank, account name, account number and other
information for the company in a timely manner for processing.
If you choose to approach the counter of recipients, the company will
be by letter, telephone, SMS or email to inform you that the place
designated to collect the insurance money. When you come to
recipients, the need to provide my ID card, claims the notice (if
notified of the letter) and other documents.
If you need to entrust others to collect the insurance money, provided
by the client needs to be a power of attorney set out above, delegated
authority, time limit and with your own signature. In addition, the
client and the need to provide proof of identity by the client.

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