請問機車強制險看中醫的理賠項目? - 保險
By Isla
at 2011-06-24T12:46
at 2011-06-24T12:46
Table of Contents
之前把在市立中醫院看傷科的收據副本拿到保險公司申請強制險理賠
前兩天收到付款明細表 發現保險公司並沒有理賠所有的看診費用
自己把收據正本拿出來看了一下 所有的自負費用項目大概有下列幾項:
1.掛號費
2.部份負擔
3.證明書費(最後一次看診時開立)
4.丸散膏丹(因撞到膝蓋 看診的前十次左右醫師除了針灸或推拿外也會開藥膏給我
回去貼)
5.藥品費(醫師處方所開的藥 也是科學中藥的藥粉 不過在藥袋上有註明自費)
6.藥費加收(可能是超過健保給付範圍所收的藥費吧? 不太清楚 偶爾會有)
查了一下相關條文 發現強制險對於診療費用的理賠規定是:
(一)受害人以全民健康保險之被保險人診療者,包括下列:
1.全民健康保險法所規定給付範圍之項目及受害人依法應自行負擔之費用。
2.非全民健康保險法所規定給付範圍之項目,以病房費差額、掛號費、診斷證
明書費、膳食費、自行負擔之義肢器材及裝置費、義齒或義眼器材及裝置費
用,及其他經醫師認為治療上必要之醫療材料(含輔助器材費用)及非具積
極治療性之裝具所需費用為限。
稍作估算 1.2.3的總和剛好是保險公司的理賠金額
我比較有疑問的是 4.5.6也都是本次治療所需 為什麼不列入理賠項目呢?
請瞭解的人幫忙解答一下好嗎? 謝謝 :)
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