1. Accidental death: the insured dies unexpectedly during the insurance period, and pays 100% of the basic insured amount.
2. Accidental disability: If the insured is accidentally disabled during the insurance period, 10- 100% of the basic insurance premium shall be paid according to the disability level.
3. Accidental medical treatment (optional): After deducting other expenses compensation and deductible agreed in the contract, the medical expenses will be reimbursed according to the agreed proportion.
4. Accidental hospitalization allowance (optional): If you are hospitalized in an agreed hospital due to an accident, you will be paid according to the agreed fixed compensation amount multiplied by the number of days of compensation.
Broadly speaking, simply speaking, the scope of medical insurance mainly refers to the people covered by medical insurance and the degree of medical security enjoyed by this group. For example, China's basic medical insurance system for urban workers stipulates that "all employers in cities and towns, including enterprises (state-owned enterprises, collective enterprises, foreign-invested enterprises and private enterprises), organs, institutions, social organizations, private non-enterprise units and their employees, must participate in the basic medical insurance". The American medical insurance system for the elderly provides medical insurance for the elderly over 65 years old and those who receive social welfare benefits due to disability and chronic nephritis. The old-age medical insurance law promulgated according to 1965. For another example, social medical insurance in France pays special attention to the protection of some special diseases. For some patients who need long-term treatment and have high expenses, such as tuberculosis, leprosy, tumor, diabetes, etc., except for the examination fee and the service fee of private sanatorium, the rest expenses are reimbursed at 100%.
In a narrow sense, the scope of medical insurance coverage is usually defined by the scope of medical insurance liability and the exclusion of medical insurance liability. For example, in Germany's social medical insurance, the medical services covered include outpatient treatment, dental treatment (including maxillofacial plastic surgery and provision of dentures), provision of drugs, bandages and auxiliary treatment, family medical care and housework help, hospitalization, artificial replacement materials, psychological and functional rehabilitation and work ability rehabilitation. For another example, Singapore's dual health insurance plan stipulates that the total compensation for medical expenses received by patients from the plan should not exceed S $70,000; According to the health savings plan, the daily hospitalization fee for health savings is S $300, and the doctor's rounds fee is S $50. If there is an overrun, the patient should be paid in cash.
Different medical insurance has different purposes. As a national compulsory insurance, social medical insurance usually needs to reflect the political intention of the country. Most countries that implement social medical insurance determine that the purpose of social medical insurance is to ensure that all citizens get proper medical care services when diseases occur, and to ensure that their lives are not greatly affected by the occurrence of diseases; The purpose of commercial medical insurance is to obtain commercial profits and ensure the maximization of profits. Insurers achieve the purpose of developing medical insurance by providing a certain range of medical insurance, so when determining the coverage of medical insurance, the coverage of insurance should fully realize its purpose.