1. If the other party is determined to be fully responsible for the accident, the medical expenses of the party concerned shall be borne by the other party and cannot be reimbursed through medical insurance;
2. If the parties are fully responsible, they shall bear all medical expenses by themselves, and can be reimbursed through medical insurance in accordance with relevant regulations;
3. If both parties and the other party are responsible, the medical insurance will be reimbursed according to the proportion of both parties' responsibilities.
4. In real life, this may happen. After the accident, in order to reduce the liability for compensation, the perpetrator negotiated with the injured party to conceal the real situation of the accident and the division of responsibilities, resulting in medical insurance reimbursement of the compensation that should be borne by the perpetrator.
What are the events in traffic accident compensation?
1. Items and standards of personal injury compensation: The compensation obligor shall compensate the medical expenses and income reduced due to missed work, including all expenses such as medical expenses, missed work expenses, nursing expenses, transportation expenses, accommodation expenses, hospital food subsidies and necessary nutrition expenses.
2. Disability compensation items and standards: The compensation obligor shall also compensate the necessary expenses incurred due to the increase of daily life needs and the income loss caused by the loss of working ability, including disability compensation, disability AIDS, living expenses of dependents, and necessary rehabilitation expenses, nursing expenses and follow-up treatment expenses actually incurred due to rehabilitation nursing and continuing treatment.
3. Items and standards of death compensation: In addition to paying the relevant expenses specified in 1 according to the rescue and treatment, the compensation obligor shall also compensate the funeral expenses, living expenses of the dependents, death compensation and other reasonable expenses such as transportation expenses, accommodation expenses and lost time expenses incurred by the relatives of the victims in handling the funeral.
As can be seen from the above, under normal circumstances, if there is a third party responsible for traffic accidents, the medical expenses should be borne by the third party responsible person, and medical insurance cannot be reimbursed. If you have certain responsibilities, the medical expenses and medical insurance for which you are fully responsible can be reimbursed.
Legal basis:
Social insurance law
Article 30
The following medical expenses are not included in the payment scope of the basic medical insurance fund:
(a) shall be paid by the industrial injury insurance fund;
(2) It shall be borne by a third party;
(three) shall be borne by public health;
(4) Go abroad for medical treatment.
Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.